title: Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial.
abstract: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of four conditions to receive prenatal or postpartum motivational interviewing/counseling (MI) or prenatal or postpartum health education (HE). Counselors also functioned as patient navigators. Primary outcomes were dental attendance during pregnancy for the mother and for the child by age 18 months. Attendance was obtained from the Oregon Division of Medical Assistance Programs and participant self-report. Statewide self-reported utilization data were obtained from the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Maternal attendance was 92% in the prenatal MI group and 94% in the prenatal HE group (RR = 0.98; 95% CI = 0.93-1.04). Children's attendance was 54% in postpartum MI group and 52% in the postpartum HE group (RR = 1.03; 95% CI = 0.82-1.28). Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40-50%) and for their children by 24 months (36% statewide; 95% CI = 27-44%). MI did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier NCT01120041.
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: Christine_Riedy@hsdm.harvard.edu.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Riedy
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: philw@uw.edu.
authors.forename: Philip
authors.initials: P
authors.lastname: Weinstein
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: llman@uw.edu.
authors.forename: Lloyd
authors.initials: L
authors.lastname: Mancl
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: garson@uw.edu.
authors.forename: Gayle
authors.initials: G
authors.lastname: Garson
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: colleenh@uw.edu.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Huebner
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: dfrc@uw.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Milgrom
authors.affiliation: University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA. Electronic address: grem@uw.edu.
authors.forename: David
authors.initials: D
authors.lastname: Grembowski
authors.affiliation: University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA. Electronic address: msb23@uw.edu.
authors.forename: Megan
authors.initials: M
authors.lastname: Shepherd-Banigan
authors.affiliation: Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA. Electronic address: darlenesmolen@gmail.com.
authors.forename: Darlene
authors.initials: D
authors.lastname: Smolen
authors.affiliation: Klamath County Department of Public Health, 305 Main Street, Klamath Falls, OR 97601, USA. Electronic address: msutherland@co.klamath.or.us.
authors.forename: Marilynn
authors.initials: M
authors.lastname: Sutherland
mesh_terms: D000293:Adolescent; D000328:Adult; D003729:Dental Care / Q000706:statistics & numerical data*; D003731:Dental Caries; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007223:Infant; D009034:Mother-Child Relations; D062405:Motivational Interviewing / Q000379:methods*; D009922:Oregon; D049590:Postpartum Period; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care; D012111:Residence Characteristics; D016037:Single-Blind Method; D055815:Young Adult
keywords: Community; Motivational interviewing; Oral health; PRAMS; Pregnancy; RCT