Theory-Based Oral Health Education and Self-Efficacy of Pediatric Providers

Objectives: Objective: This study assessed theory-based education versus standard oral health education to improve the self-efficacy of pediatric providers (physicians, nurse practitioners: NPs) in addressing oral health with parent/caregivers.
Methods: Methods: Sixty-three pediatric providers participated in a cluster-randomized clinical trial (cRCT) from 18 practices (n = 9 intervention arm, n = 9 control arm). Intervention arm providers received theory-based oral health (OH) education using the Common-Sense Model of Self-Regulation (CSM) and Social Cognitive Theory (SCT), and control arm providers received standard American Association of Pediatrics based OH education. The self-efficacy questionnaire included ten items in the categories of caries identification, risk assessment, fluoride varnish application, communicating and educating caregivers about their child’s oral health, and providing dental referrals and prescriptions on a 3-point Likert scale (not confident, somewhat confident, and very confident) before and after education at baseline.
Results: Results: Pediatric providers were 76% female, 78% white, and 86% had a MD/DO degree. All providers completed the self-efficacy questionnaires at baseline. No significant differences were found between arms in the pre-education self-efficacy questionnaire. In the post-education questionnaire, intervention providers had significantly higher mean self-efficacy scores for identifying plaque (2.63±0.49 and 2.35±0.49, p=0.03), conducting an OH screening (2.74±0.45 and 2.44±0.61, p=0.03), and providing a prescription for dental care (2.89±0.32 and 2.59±0.61, p=0.02). Within the intervention arm, providers had significantly higher self-efficacy scores after educational intervention for most categories except telling parents to take their child to the dentist and providing a referral.
Conclusions: Conclusion: Primary care providers can gain confidence and knowledge with theory-based OH education based on the CSM framework to address early childhood caries with parent/caregivers of children in their practice.