Mothers' self -efficacy and oral health in low -income African American children in Detroit.

Dental caries, the most common disease affecting humans, is disproportionately more prevalent in poor and minority populations in the U.S. This study seeks to advance knowledge of the social determinants of oral health, by examining how several specific maternal health beliefs, self-efficacy in particular, and psychosocial factors relate to young children's dental outcomes and practices. Survey and dental exam data were obtained from the Detroit Dental Health Project (DDHP), an NIH-funded 7-year research project (NIDCR grant U-54 DE 14261-01) that aims to study why some low-income children have dental caries and others do not even when they live in similar socioeconomic environments. Health belief scales reflecting efficacy, fatalism, and knowledge of appropriate bottle use and children's oral hygiene needs were constructed based on exploratory factor analysis. Mothers' brushing habits and psychosocial measures of depressive symptoms (CES-D), parenting stress, availability of social support and background characteristics were also predictors. The outcomes were children's brushing frequency, Early Childhood Caries (ECC) status, and mothers' subjective oral health rating. Descriptive and regression analyses were conducted in SUDAAN with a population-based sample of 719 African-American children aged 1--5 and their mothers who participated in DDHP in 2002--3. Efficacy, brushing behavior, and transportation support were significantly positively associated with children's brushing, while less hygiene knowledge, fatalism, and financial support were negatively associated. If mothers lacked bottle use knowledge, were depressed, more educated, and if the child had a restorative dental visit, it was more likely that 1--3 year olds' oral health was rated fair/poor. Among 4--5 year olds, having dental insurance, and mothers with more education and less bottle knowledge reduced their likelihood of a fair/poor rating, while less hygiene knowledge and help with errands increased the likelihood. Mothers' ratings were congruent with caries status based on dental exams. Higher parenting stress was inversely related to disease severity. Restorative dental treatment among 1--3 year olds increased the likelihood of ECC, and higher family income reduced the likelihood. Fatalism and less hygiene knowledge increased the likelihood of ECC for 4--5 year olds, while more education reduced the likelihood. Although some findings are counterintuitive and warrant further exploration, mothers' social cognitive and psychosocial characteristics affect her child's brushing frequency and dental health. Since cognitions are potentially modifiable, results can inform the design of a tailored intervention to improve children's oral health in earliest childhood.PhDBlack studiesDentistryHealth and Environmental SciencesPsychologyPublic healthSocial SciencesSocial psychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/124784/2/3163794.pd