Evaluation of an Oral Health Intervention among Mothers of Young Children: A Clustered Randomized Trial

Background: Oral health education for the mothers of very young children is important in reducing the risk of early childhood caries. This study aimed to evaluate the impact of an oral health intervention among mothers of 1-2 years old children. Methods: This cluster randomized controlled trial (2012) was conducted among ninety mothers of 1-2 year old children. The setting of study was 10 child day-care centers out of 18 in Hamadan, western Iran. Day-care centers were randomly allocated into two groups: an intervention group (5 day-care centers, 45 mothers) and a control group (5 day-care centers, 45 mothers). Intervention consisted of three sessions, a booklet, and mobile phone text-message reminders. The primary outcome was change in cleaning the childrenʹ teeth, while the secondary outcomes were changes in Theory of Planned Behavior (TPB) cognitions. Questionnaires at baseline, 10 days, and 3 months assessed intervention effects. Data were analyzed using SPSS v.16. T tests, chi- square, and logistic and linear generalized estimating equations (GEE) regression were used to test intervention impact. Results: At 10-day assessment, mothers in intervention group reported a significant difference in knowledge (P=0.001), attitude (P=0.004), perceived behavioral control (P=0.008), and cleaning of childrenʹs teeth (P=0.011). Also, at 3-month assessment compared to control group, the mothers in intervention group significantly improved in scores of knowledge (P=0.001), attitude (P=0.001), perceived behavioral control (P=0.001), and cleaning of childrenʹs teeth (P=0.001). However, the effect sizes were small to medium and ranged from 0.1 to 0.4 for all cognitions except knowledge (effect size > 0.70). Generalized estimating equations (GEE) showed that score of attitude and perceived behavioral control of intervention group improved between the two post-test assessments. Conclusions: A brief multicomponent theory-based intervention among mothers of 1-2 years old children was effective moderately in improving cognitions and self-reported cleaning childrenʹs teeth.