IADR Abstract Archives
Peer-Delivered Motivational Interviewing to Prevent ECC in Public Housing Residents
Objectives: In a cluster-randomized controlled trial, a motivational interviewing intervention (INT) was hypothesized to reduce caries over 2-years compared to Standard Care (SC) in children aged 0-5 living in public housing (PH).
Methods: PH residents were trained in motivational interviewing (MI) with a focus on early childhood caries (ECC) prevention. All 26 eligible PH developments were randomized to either SC (residents received quarterly dental screening, fluoride varnish, toothbrush/paste and educational brochures) or INT (SC plus quarterly MI counseling). 1065 children (49% female, 55% non-white, 61% Hispanic, 89% below poverty level, n=379 INT, n=686 SC) and their caregivers completed baseline activities and were enrolled. MI sessions were audio recorded and assessed for treatment fidelity. Primary outcome was the increment in decayed, missing, and filled tooth surfaces (dmfs). Secondary outcomes included caregiver oral health knowledge and oral health behaviors assessed via caregiver questionnaire. Data were nested: housing-sites, participants, and repeated assessments. Baseline characteristics were compared between groups and adjusted for housing-site clusters. A mixed-effects marginalized zero-inflated overdispersed Poisson (MZIP) model was fit to the baseline, 12-, and 24-month dmfs outcomes and tested intention-to-treat group, time, and group-by-time effects. Linear mixed models of secondary outcomes were fit.
Results: dmfs increased over 24 months in both INT (M=1.28 to M=3.12; Factor Change (FC)= 2.02(1.63-2.51) p<.0001) and SC (M=1.64 to M=3.12; FC= 1.76(1.53-2.04) p<.0001). At 24-months, there was no difference in dmfs increment between groups. There was a significant group-by-time interaction effect on caregiver knowledge (F(2,1593)=3.48, p=.0310) but not for child sugar-sweetened beverage intake. At baseline, 57.8% of SC and 56.8% of INT brushed their child’s teeth twice/day; at 24 months, there were no significant group differences.
Conclusions: While MI counseling plus an intensive set of ECC prevention activities resulted in increases in knowledge, it did not improve oral health related behaviors or dmfs increment.
Methods: PH residents were trained in motivational interviewing (MI) with a focus on early childhood caries (ECC) prevention. All 26 eligible PH developments were randomized to either SC (residents received quarterly dental screening, fluoride varnish, toothbrush/paste and educational brochures) or INT (SC plus quarterly MI counseling). 1065 children (49% female, 55% non-white, 61% Hispanic, 89% below poverty level, n=379 INT, n=686 SC) and their caregivers completed baseline activities and were enrolled. MI sessions were audio recorded and assessed for treatment fidelity. Primary outcome was the increment in decayed, missing, and filled tooth surfaces (dmfs). Secondary outcomes included caregiver oral health knowledge and oral health behaviors assessed via caregiver questionnaire. Data were nested: housing-sites, participants, and repeated assessments. Baseline characteristics were compared between groups and adjusted for housing-site clusters. A mixed-effects marginalized zero-inflated overdispersed Poisson (MZIP) model was fit to the baseline, 12-, and 24-month dmfs outcomes and tested intention-to-treat group, time, and group-by-time effects. Linear mixed models of secondary outcomes were fit.
Results: dmfs increased over 24 months in both INT (M=1.28 to M=3.12; Factor Change (FC)= 2.02(1.63-2.51) p<.0001) and SC (M=1.64 to M=3.12; FC= 1.76(1.53-2.04) p<.0001). At 24-months, there was no difference in dmfs increment between groups. There was a significant group-by-time interaction effect on caregiver knowledge (F(2,1593)=3.48, p=.0310) but not for child sugar-sweetened beverage intake. At baseline, 57.8% of SC and 56.8% of INT brushed their child’s teeth twice/day; at 24 months, there were no significant group differences.
Conclusions: While MI counseling plus an intensive set of ECC prevention activities resulted in increases in knowledge, it did not improve oral health related behaviors or dmfs increment.