Analysis Of Influencing Factors Of Early Childhood Caries Based On Health Belief Model

[Objective]Based on the health beliefs model,the parents’ oral health beliefs questionnaire was designed and developed.A survey was conducted among children aged 3-5 years old and their parent to analyze the current situation and influencing factors of early childhood caries.To explore the impact of early childhood caries on children’s oral health related quality of life,and provide a basis for carrying out targeted oral health education activities for children and making effective prevention and intervention programs.[Methods]1.The questionnaire of parents’ oral health beliefs was initially formed through literature search and group discussion.After two rounds of expert letter consultation,the questionnaire of parents’ oral health beliefs was finally formed according to the opinions,positive coefficient,authority coefficient and coordination degree of experts.A total of 200 parents of children were who visited Department of Pediatric Stomatology Medical School of Nanjing University were selected for a pre-survey.Content validity and construct validity were used for validity test.Cronbach’s acoefficient was used for reliability test.2.A total of 328 children aged 3-5 years old and their parents who met the inclusion and exclusion criteria were selected.The main research tools included: general information questionnaire,parents’ oral health beliefs questionnaire,Early Childhood Oral Health Impact Scale(ECOHIS)and children’s oral health questionnaire.SPSS23.0 was used for statistical analysis.The measurement data was represented as median quad.MannWhitney rank sum test was used between two groups and Kruskal Wallis rank sum test was used between multiple groups.Counting data were represented by frequency,and differences between groups were compared by chi-square test.Spearman correlation analysis was used to analyze the correlation between the dmft index.parents’ oral health beliefs and children’s oral health related quality of life.Binary Logistic regression analysis was used for multivariate analysis,and P<0.05 was considered statistically significant.[Results]1.Expert consultation: the effective recovery rates of the first round and the second round of letter consultation were 100% and 93.75% respectively,and the authority coefficients of the experts were 0.872 and 0.86 respectively.After the two rounds of letter consultation,the coefficient of variation of the importance of each indicator was less than 0.25.Reliability and validity test of parents’ oral health beliefs questionnaire: The overall consistency of the content validity of the questionnaire(S-CVI)was 0.81,the average S-CVI was 0.96,and the content validity(I-CVI)of each item was between 0.8 and1.The cumulative contribution rate of 5 factors was 56.142%,and each item had a large factor load value on the corresponding common factor(>0.4).The Cronbach’sa coefficient of the questionnaire was 0.885,each dimension Cronbach’sa coefficient was between 0.705 and 0.813.The final questionnaire included 26 items in 5 dimensions.2.Analysis of Influencing Factors :(1)The results of single-factor analysis showed that: the habit of brushing your teeth,duration of bottles use,the frequency of eating sweets and chocolate,age when toothbrushing started,brushing frequency every day,the use of fluoride toothpaste,brushing duration,mouthwash after meals,using dental floss,the age of first visited dentist,toothache or discomforted experience,oral health and general health assessment of the child’s parents,method of brushing teeth,parents supervise or help kids brush their teeth,oral maintenance before teething,the leading cause of dental caries,treatment of oral discomfort,the main way to acquire oral health knowledge,the highest educational level of parents,family per capita income differences between the two groups have statistical significance P<0.05).Spearman correlation analysis showed that parents’ oral health beliefs(r=-0.498,P<0.05),cognitive impairment(r=0.342,P<0.05),behavioral benefit perception(r=-0.485,P<0.05),severity perception(r=-0.383,P<0.05),susceptibility perception(r=-0.442,P<0.05),self-efficacy(r=-0.460,P<0.05)had the statistically significant correlation with dmft index.(2)Binary logistic regression analysis showed that flossing(OR=0.061,[95%CI:0.020~0.184]),perceived behavioral benefits(OR=0.729,[95%CI:0.678~0.784]),perceived susceptibility(OR=0.657,[95%CI:0.497~0.869])and perceived self-efficacy(OR=0.801,[95%CI:0.692 ~0.926])were associated with early childhood caries.3.The influence of early childhood caries on children’s oral health related quality of life.The ECOHIS score of children without caries was significantly lower than that of children with caries,and the difference was statistically significant(P<0.05).Spearman correlation coefficient test showed that the total score of ECOHIS(r=0.460,P<0.05),its child impact section(r=0.420,P<0.05),and its family impact section(r=0.381,P<0.05)were correlated with the dmft index of children,showing statistical significance.[Conclusions]1.Parental oral health beliefs questionnaire has good reliability and validity and can be used to understand the status of parents’ oral health beliefs.2.Multivariate analysis showed that flossing,behavioral benefit perception,susceptibility perception and self-efficacy were protective factors for early childhood caries.3.Dental caries will affect the quality of life of children and their families to some extent.The more dental caries and fillings children have,the worse their oral health related quality of life will be.4.From the perspective of health belief,we can improve children’s oral hygiene by improving parents’ oral health belief and reduce the prevalence of dental caries...