Latino Children's Oral Health: Translating Qualitative Data to Behavioral Theory

Objective: Latino children have disproportionately high rates of caries, including early childhood caries (ECC). Parental beliefs and behaviors are key determinants of children's oral health status, especially for children at high risk for ECC. Aiming at intervention development, this study tested how well findings about Latino parents' cognitions of children's oral health mapped onto particular constructs in the Social Cognitive Theory (Bandura 1986). Methods: In an urban setting in California, a convenience sample of 48 Mexican-American mothers of preschool children provided in-depth qualitative interviews, primarily in Spanish, about their beliefs and experiences surrounding brushing their children's teeth. Transcripts were thematically analyzed using NVivo® software. Findings from interviews were mapped onto the Social Cognitive Theory constructs to create an explanatory model for this important oral hygiene behavior. Operationalized explanatory concepts were presented back to three focus groups (n=14) in a separate but similar Latino population to test for community consensus with the theoretical constructs and their application. Results: Findings from the qualitative study matched well the constructs from Social Cognitive Theory. Behavioral capability (in particular, knowledge of when to initiate toothbrushing, how to do it safely for young children, and how to manage or motivate uncooperative children), self-efficacy (the confidence to carry out toothbrushing properly under a variety of conditions), and behavioral expectations (perceived positive outcomes resulting from toothbrushing, and perceived negative outcomes from not brushing) were among the more important issues mentioned as affecting parental brushing behaviors. Parents in the subsequent focus groups confirmed the operationalization of the constructs. Conclusion: Social Cognitive Theory works well as an explanatory model for parents' behaviors for brushing their young children's teeth, and can serve as the basis for intervention development. We recommend further quantitative testing of the model to measure the strength of the various constructs. Funding: NIDCR R21DE019210; U54DE014251