Objectives: To develop and pilot theory-based OHB-change narrative videos.
Methods: Using Theories of Planned Behavior and Normative Social Behavior, we assessed determinants related to OHB (mouth-to-mouth sharing, bed bottle, and tooth brushing) of Hispanic parents/caregivers receiving care at a large safety-net health care system. We first conducted qualitative, semi-structured focus groups (FG) (English/Spanish) to identify determinants of adherent/non-adherent OHB. FGs were audiotaped, transcribed, and thematically categorized. We then surveyed (English/Spanish) Hispanic caregivers recruited from waiting rooms to quantify the determinants’ effects. Descriptive, chi-square, and multiple-logistic regression analyses were conducted. Determinants associated with OHB adherence were scripted into three 2-minute, professionally-produced, theory-based narrative videos and piloted at medical visits.
Results: We conducted 7 FGs with 41 primarily Hispanic, disadvantaged mothers (39% attendance rate) and surveyed 351 caregivers of primarily Hispanic (85%), Medicaid/SCHIP-insured (87%) children 0-6 years of age (91% response rate). Barriers/facilitators to adherent/non-adherent OHB are summarized (Table 1). Three narrative videos were piloted at 40 visits.
Table 1. |
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OHB |
Focus Groups |
Survey |
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Chi-square (p<0.05) |
Logistic Regression |
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Mouth-to-mouth sharing |
Non-adherent |
-Don’t think about it -Saves time -Shows love -Convenient -Too stressful -Confidence won’t share |
Confidence won’t share OR:1.21, 95% CI:1.05-1.39 |
-Don’t think about it -Convenient -Sharing within family okay -Shows love -Helps child try foods |
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Adherent |
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-Spreads germs |
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Bed bottle |
Non-adherent |
-Child sleeps -Child gets hungry -I sleep -Not important -I feel better |
Child gets hungry OR:2.6, 95% CI:1.79- 3.87 |
-Helps not cry -Helps not be hungry -Just a baby -Influential people say okay |
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Adherent |
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-Leads to cavities |
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Tooth-brushing |
Non-adherent |
-Child refusal -Child not ready -Forget
|
Child refusal OR:1.37, 95% CI:1.06-1.78 Forget OR:0.66, 95% CI: 1.29- 3.25 |
-Child refusal -Forget |
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Adherent |
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-Daily routine -Keeps teeth strong -Influential people say brush |
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Conclusion: Theory-based OHB-change narrative-videos have potential to improve OHB.