title: Evaluation of an oral health intervention among mothers of young children: a clustered randomized trial.
abstract: 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 children' 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 children's 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 children's 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 children's teeth.
authors.affiliation: Department of Public Health, School of Public Health, Hamadan University of Medical Sciences Hamadan, Iran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Makvandi
authors.affiliation: Social Determinants of Health Research Center & Department of Public Health,Research center for health sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. karimi71813@yahoo.com.
authors.forename: Akram
authors.initials: A
authors.lastname: Karimi-Shahanjarini
authors.affiliation: Modeling of Noncommunicable Diseases Research Center & Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Faradmal
authors.affiliation: Social Determinants of Health Research Center & Department of Public Health,Research center for health sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Bashirian
mesh_terms: D002675:Child, Preschool; D016000:Cluster Analysis; D003731:Dental Caries / Q000517:prevention & control; D005260:Female; D006267:Health Education, Dental / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D009035:Mothers / Q000193:education*; D009909:Oral Health / Q000193:education* / Q000592:standards; D010174:Pamphlets; D015397:Program Evaluation; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D060145:Text Messaging
keywords: Early Childhood Caries; Infants; Randomized Controlled Trial (RCT); Theory of Planned Behavior