title: Maternal self-efficacy and 1-5-year-old children's brushing habits.
abstract: OBJECTIVE
  This study investigates the relationships between maternal cognitive, behavioral, and psychosocial factors and brushing practices in low-income African-American preschool children.
  
  
  METHODS
  Data are from a population-based sample of 1021 African-American families with at least one child <6 years of age and living in the 39 low-income Census tracts in Detroit, Michigan. Analyses were limited to 1-5-year-old children and their mothers (n = 719). Mothers were surveyed about oral health-related self-efficacy (OHSE), knowledge about appropriate bottle use (KBU), knowledge about children's oral hygiene (KCOH), oral health fatalism (OHF), their own toothbrushing behavior, depressive symptoms (CES-D), parenting stress, practical social support, and their child's dental history. Children's 1-week reported brushing frequency was the main outcome measure. Analyses were conducted in SUDAAN to account for the complex sampling design.
  
  
  RESULTS
  Children's 1-week brushing frequency (range 0-40) averaged 8.50 times per week among 1-3-year olds and 9.75 among the 4-5-year olds. Maternal OHSE was a strong and significant predictor of children's brushing frequency; for each unit increase in OHSE, 1-3-year olds were expected to brush 18% more frequently on average during 1 week [incidence density ratios (IDR) = 1.18, 95% confidence interval (CI) 1.08-1.28; P < 0.001], and 4-5-year olds were expected to brush 9% more often (IDR = 1.09, 95% CI 1.00-1.19; P < 0.10). Mothers' KCOH score was also significantly positively associated with brushing frequency; for each unit increase on the KCOH scale, 1-3-year olds were expected to brush 22% more frequently (IDR = 1.22, 95% CI 1.10-1.35; P < 0.001) and 4-5-year olds were expected to brush 13% more frequently (IDR = 1.13, 95% CI 1.02-1.26; P < 0.05). If a mother brushed her own teeth at bedtime during the week, her 1-3-year old child's brushing frequency was expected to increase by one-third (IDR = 1.34, 95% CI 1.12-1.60; P < 0.01) and among the 4-5-year olds, the child's frequency was expected to increase by one-quarter (IDR = 1.26, 95% CI 1.12-1.42; P < 0.001). Availability of help with transportation and financial support were also relevant variables for 1-3-year olds. Higher family income and dental insurance coverage were both positively associated with brushing among 4-5-year olds.
  
  
  CONCLUSIONS
  Several maternal cognitive, behavioral, and psychosocial factors were associated with young children's brushing practices. Oral health-specific self-efficacy and knowledge measures are potentially modifiable cognitions; findings suggest that intervening on these factors could help foster healthy dental habits and increase children's brushing frequency early in life.
authors.affiliation: Agency for Healthcare Research and Quality (AHRQ), University of California, Berkeley, CA, USA. tracyf@berkeley.edu
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Finlayson
authors.forename: Kristine
authors.initials: K
authors.lastname: Siefert
authors.forename: Amid I
authors.initials: AI
authors.lastname: Ismail
authors.forename: Woosung
authors.initials: W
authors.lastname: Sohn
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002652:Child Behavior; D002675:Child, Preschool; D003863:Depression; D004522:Educational Status; D005260:Female; D006267:Health Education, Dental; D006801:Humans; D007223:Infant; D008824:Michigan; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D020377:Self Efficacy; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D014099:Toothbrushing / Q000706:statistics & numerical data*