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Abstract：
Individual child-level risk factors for Early Childhood Caries (ECC) have been studied, but broader family- and community-level influences on child oral hygiene behaviors are less well understood. This study explored multiple levels of influence on oral hygiene behaviors for young children in Early Head Start (EHS) to inform a future behavioral intervention targeting children from low-income families.
Twenty-four semi-structured interviews were conducted with mothers of children under 4 years old, enrolled in the home visitor (HV) component of one EHS program in Los Angeles, CA, who participated in the BEhavioral EConomics for Oral health iNnovation pilot study (BEECON) in 2016-7. Audio-recordings of interviews were translated if needed, and transcribed in English, and coding and analysis was facilitated by Dedoose qualitative software. This investigation used general thematic analysis guided by the Fisher-Owens child oral health conceptual framework to identify influences on oral hygiene behaviors for the young children.
Many mothers reported brushing their children\'s teeth twice/day, and concern that most children frequently resisted brushing. They identified children being sick or tired/asleep after outings as times when brushing was skipped. Several child-, family-, and community-level themes were identified as influences on child oral hygiene behaviors. At the child-level, the child\'s developmental stage and desire for independence was perceived as a negative influence. Family-level influences included the mother\'s own oral hygiene behaviors, other family role models, the mother\'s knowledge and attitudes about child oral health, and mothers\' coping skills and strategies for overcoming challenges with brushing her child\'s teeth. Overall, mothers in the EHS-HV program were highly knowledgeable about ECC risk factors, including the roles of bacteria and sugar consumption, which motivated regular hygiene behavior. At the community-level, mothers discussed opportunities to connect with other EHS-HV families during parent meetings and playgroups that HV coordinated. A few mothers noted that EHS-HV playgroups included brushing children\'s teeth after snacking, which can be a potential positive influence on children\'s hygiene practices.
Child-, family- and community-level factors are important to consider to inform the development of tailored oral health preventive care programs for families in EHS-HV programs.
Twenty-four semi-structured interviews were conducted with mothers of children under 4 years old, enrolled in the home visitor (HV) component of one EHS program in Los Angeles, CA, who participated in the BEhavioral EConomics for Oral health iNnovation pilot study (BEECON) in 2016-7. Audio-recordings of interviews were translated if needed, and transcribed in English, and coding and analysis was facilitated by Dedoose qualitative software. This investigation used general thematic analysis guided by the Fisher-Owens child oral health conceptual framework to identify influences on oral hygiene behaviors for the young children.
Many mothers reported brushing their children\'s teeth twice/day, and concern that most children frequently resisted brushing. They identified children being sick or tired/asleep after outings as times when brushing was skipped. Several child-, family-, and community-level themes were identified as influences on child oral hygiene behaviors. At the child-level, the child\'s developmental stage and desire for independence was perceived as a negative influence. Family-level influences included the mother\'s own oral hygiene behaviors, other family role models, the mother\'s knowledge and attitudes about child oral health, and mothers\' coping skills and strategies for overcoming challenges with brushing her child\'s teeth. Overall, mothers in the EHS-HV program were highly knowledgeable about ECC risk factors, including the roles of bacteria and sugar consumption, which motivated regular hygiene behavior. At the community-level, mothers discussed opportunities to connect with other EHS-HV families during parent meetings and playgroups that HV coordinated. A few mothers noted that EHS-HV playgroups included brushing children\'s teeth after snacking, which can be a potential positive influence on children\'s hygiene practices.
Child-, family- and community-level factors are important to consider to inform the development of tailored oral health preventive care programs for families in EHS-HV programs.
摘要：
已经研究了儿童早期龋齿（ECC）的个体儿童水平危险因素，但更广泛的家庭和社区层面对儿童口腔卫生行为的影响却鲜为人知。这项研究探讨了在早期开始（EHS）中对幼儿口腔卫生行为的多层次影响，以告知针对低收入家庭儿童的未来行为干预措施。
对4岁以下儿童的母亲进行了24次半结构化访谈，参加了洛杉矶一个EHS计划的家庭访客(HV)部分，CA,他在2016-7年参加了口腔健康创新行为EConomics试点研究(BEECON)。如果需要，采访的录音被翻译，用英语转录，Dedoose定性软件促进了编码和分析。这项调查使用了以Fisher-Owens儿童口腔健康概念框架为指导的一般主题分析，以确定对幼儿口腔卫生行为的影响。
许多母亲报告说，每天给孩子刷牙两次，并担心大多数孩子经常抵制刷牙。他们将外出后生病或疲倦/入睡的孩子确定为跳过刷牙的时间。几个孩子-，家庭-,社区层面的主题被确定为对儿童口腔卫生行为的影响。在儿童层面，孩子的发育阶段和对独立的渴望被认为是负面影响。家庭层面的影响包括母亲自己的口腔卫生行为，其他家庭榜样，母亲对儿童口腔健康的知识和态度，和母亲的应对技巧和策略，以克服挑战，刷她的孩子的牙齿。总的来说,EHS-HV计划中的母亲对ECC风险因素非常了解，包括细菌和糖的消耗，这激发了正常的卫生行为。在社区一级，母亲们在家长会议和HV协调的游戏小组中讨论了与其他EHS-HV家庭联系的机会。一些母亲指出，EHS-HV游戏小组包括在吃零食后刷牙，这可能对儿童的卫生习惯产生潜在的积极影响。
儿童，在EHS-HV计划中，家庭和社区层面的因素对于为家庭制定量身定制的口腔健康预防保健计划很重要。
对4岁以下儿童的母亲进行了24次半结构化访谈，参加了洛杉矶一个EHS计划的家庭访客(HV)部分，CA,他在2016-7年参加了口腔健康创新行为EConomics试点研究(BEECON)。如果需要，采访的录音被翻译，用英语转录，Dedoose定性软件促进了编码和分析。这项调查使用了以Fisher-Owens儿童口腔健康概念框架为指导的一般主题分析，以确定对幼儿口腔卫生行为的影响。
许多母亲报告说，每天给孩子刷牙两次，并担心大多数孩子经常抵制刷牙。他们将外出后生病或疲倦/入睡的孩子确定为跳过刷牙的时间。几个孩子-，家庭-,社区层面的主题被确定为对儿童口腔卫生行为的影响。在儿童层面，孩子的发育阶段和对独立的渴望被认为是负面影响。家庭层面的影响包括母亲自己的口腔卫生行为，其他家庭榜样，母亲对儿童口腔健康的知识和态度，和母亲的应对技巧和策略，以克服挑战，刷她的孩子的牙齿。总的来说,EHS-HV计划中的母亲对ECC风险因素非常了解，包括细菌和糖的消耗，这激发了正常的卫生行为。在社区一级，母亲们在家长会议和HV协调的游戏小组中讨论了与其他EHS-HV家庭联系的机会。一些母亲指出，EHS-HV游戏小组包括在吃零食后刷牙，这可能对儿童的卫生习惯产生潜在的积极影响。
儿童，在EHS-HV计划中，家庭和社区层面的因素对于为家庭制定量身定制的口腔健康预防保健计划很重要。
