Childcare center directors\u27 oral health literacy and attitudes towards pediatric oral health

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Goal and Objectives. The main goal of this study is to assess childcare center directors (CCCDs) oral health literacy, knowledge, and attitudes towards pediatric oral health. We also determined the associations between CCCDs oral health literacy, knowledge, attitudes towards pediatric oral health, and 1) number of oral health preventive strategies (OHPS) implemented in their child care center (CCC), and 2) intent to adopt OHPS in the future. Background. Childcare utilization has substantially increased over the past decade with children enrolled in these centers spending substantial amount of time. CCCs, a non-traditional setting, can be used to actively promote pediatric oral health. However, before this setting can be used to promote oral health, a better understanding of Florida CCCDs\u27 oral health literacy, knowledge, and attitudes on pediatric oral health is needed. Methods. In this cross-sectional study we used a 45-item pre-tested questionnaire to survey Florida CCCDs working primarily in licensed CCCs through survey monkey online portal. Descriptive, bivariate statistics and multivariate regression analyses were conducted using SAS analysis software. Results. Of the 877 CCCD participants, 90% did not train staff about traumatic dental injuries, 87% did not have an oral health consultant, and 82% did not promote enrollees to brush their teeth after meals or snacks. Mean oral health literacy (12.3±2.3) and attitude levels (16.8±2.7) were high, however mean oral health knowledge (1.6±2.0) was low. CCCDs with more years of experience (p=0.01), who work at Head Start CCCs ( p\u3c0.0001), and have more positive attitudes (p\u3c0.0001), were more likely to have implemented OHPS in their centers compared to their counterparts. Non-White CCCDs (p=0.03), those with more positive attitudes(p=0.001), and who reported to have already implemented one or more OHPS (p=0.002) were more willing to implement OHPS in the future compared to their counterparts. Conclusions. No significant associations between oral health literacy, knowledge and number of OHPS implemented were observed. Similarly, oral health literacy, oral health knowledge was not associated with intent to implement OHPS in the future. CCCDs with more positive attitudes towards pediatric oral health had implemented more OHPS within their CCCs, and also were willing to implement more OHPS in the future compared to their counterparts