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Larson E, Jeglum N, Shmays C. Mixed-method evaluation of fidelity of motivational interviewing-based coaching in 5Minutes4Myself Wellness Program for caregivers of children with autism. PEC Innov 2023; 2:100149. [PMID: 37214523 PMCID: PMC10194175 DOI: 10.1016/j.pecinn.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/28/2023] [Accepted: 03/20/2023] [Indexed: 05/24/2023]
Abstract
Objective This mixed method analysis examined fidelity of the motivational interviewing (MI) delivered during the 5Minutes4Myself wellness program for caregivers of children with Autism Spectrum Disorders. Methods Coaches used a manualized MI-approach to collaboratively design participants' individualized wellness programs, and then used it in monthly coaching sessions to support goal pursuit. Audio-recorded consultations and post-participation focus groups were transcribed verbatim. Consultation transcripts were rated for MI adherence using Motivational Interviewing Treatment Integrity Code. Focus group data was coded by the team to identify conceptual categories. Results Eighty-seven percent of consultations achieved a beginning (competent) level expert-derived MI standard. Caregivers noted that coaches' MI approach evoked deep emotions and understandings about their lives related to wellness goals, allowed for a permissive flexibility in goal pursuit, and fostered supportive accountability. Conclusion MI was used with high levels of fidelity. Participants described the MI approach as more productive, precise, and useful in addressing their needs compared to other available interventions.
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Affiliation(s)
- Elizabeth Larson
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
| | | | - Chloe Shmays
- Providence Child Development Institute, Portland, OR, USA
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Lassemo E, Rodd HD, Skeie MS, Johnsen JAK, Nermo H, Sand K, Eftedal RK, Fagerhaug TN, Jasbi A, Marshman Z, Dahllöf G, Høiseth M. Dental professionals' views on motivational interviewing for the prevention of dental caries with adolescents in central Norway. BMC Oral Health 2023; 23:889. [PMID: 37986160 PMCID: PMC10662639 DOI: 10.1186/s12903-023-03649-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Establishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients. METHODS As part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level. RESULTS A total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists. CONCLUSIONS A high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.
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Affiliation(s)
- Eva Lassemo
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway.
| | - Helen D Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Hege Nermo
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kari Sand
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway
| | - Randi Krog Eftedal
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Tone Natland Fagerhaug
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Arefe Jasbi
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Göran Dahllöf
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Dental Medicine, Division of Orthodontics and Paediatric Dentistry, Karolinska Institutet, Stockholm, Sweden
| | - Marikken Høiseth
- Department of Health Research, SINTEF Digital, SINTEF, Trondheim, Norway
- Department of Design, Faculty of Architecture and Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Arrow P, Raheb J, McInnes R. Motivational Interviewing and Childhood Caries: A Randomised Controlled Trial. Int J Environ Res Public Health 2023; 20:4239. [PMID: 36901250 PMCID: PMC10001603 DOI: 10.3390/ijerph20054239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study tested the occurrence of early childhood caries (ECC) and changes in potential mediators of ECC after an early childhood oral health promotion intervention. METHODS Consenting parent/child dyads in Western Australia were randomised into test [motivational interviewing (MI) + anticipatory guidance (AG)] or control (lift the lip assessments by child health nurses). A questionnaire at baseline and follow-ups (at 18, 36 and 60 months) evaluated the parental factors and the children clinically examined. Data were analysed using parametric and non-parametric tests for two groups and paired comparisons. Multivariable analysis used negative binomial regression with robust standard errors for over-dispersed count data and effect estimates presented as incidence rate ratios. RESULTS Nine hundred and seventeen parent/child dyads were randomised (test n = 456; control n = 461). The parental attitude toward a child's oral hygiene needs improved among the test group at the first follow-up (n = 377; baseline 1.8, SD 2.2, follow-up 1.5, SD 1.9, p = 0.005). Living in a non-fluoridated area and parents holding a fatalistic belief increased the risk of caries (IRR = 4.2, 95% CI 1.8-10.2 and IRR = 3.5, 95% CI 1.7-7.3), respectively, but MI/AG did not reduce the incidence of dental caries. CONCLUSION The brief MI/AG oral health promotion intervention improved parental attitude but did not reduce ECC.
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Affiliation(s)
- Peter Arrow
- Dental Health Services, Department of Health, Perth, WA 6152, Australia
- Dental School, University of Western Australia, Crawley, WA 6009, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA 5005, Australia
| | - Joseph Raheb
- Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Rowena McInnes
- Dental Health Services, Department of Health, Perth, WA 6152, Australia
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Aiuto R, Dioguardi M, Caruso S, Lipani E, Re D, Gatto R, Garcovich D. What Do Mothers (or Caregivers) Know about Their Children’s Oral Hygiene? An Update of the Current Evidence. Children 2022; 9:1215. [PMID: 36010105 PMCID: PMC9406871 DOI: 10.3390/children9081215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022]
Abstract
Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents’ incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children’s oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman’s care should increase parents’ knowledge, solve their doubts, collect and compare data in order to design effective intervention programs.
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Leske AM, Mustchin C, Clarke-Errey S, Satur J, Bhujel N, Rajan S. Motivational interviewing versus conventional caries prevention strategies in high-caries-risk children and families: a non-randomised trial. Br Dent J 2022:10.1038/s41415-022-4341-4. [PMID: 35676460 DOI: 10.1038/s41415-022-4341-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/30/2021] [Indexed: 11/09/2022]
Abstract
Background This study compared the effectiveness of motivational interviewing (MI) and conventional caries prevention (CCP) for primary (caries increment) and secondary outcomes (caries intensity, gingival health, caregiver-reported oral health-related knowledge, behaviours and attitudes) over 12 months.Methods High-caries-risk children and caregivers received CCP or MI with comprehensive dental care. Fidelity was monitored using MI treatment integrity code 4.2.1. Caries increment, intensity and gingival health were measured at baseline, six and twelve months. Readiness Assessment of Parents Concerning Infant Dental Decay questionnaires recorded oral health-related knowledge, behaviours and attitudes.Results In total, 86 caregiver-child dyads (CCP = 51; MI = 35) were recruited. The mean difference (95% confidence interval [CI]) in caries increment (ΔdICDAS1-6mfs + DICDAS1-6MFS) was significantly higher with MI compared to CCP at six (MI 2.3 [1.2, 3.5] vs CCP 0.6 [0.1, 1.0]; p <0.001) and twelve (MI 4.3 [2.5, 6.0] vs CCP 1.2 [0.6, 1.8]; p <0.001) months. Multivariate analysis with CCP as reference group, odds ratio (95% CI) for new/progressed caries (Δdecayed, missing and filled surface score [permanent] + decayed, missing and filled surface score [primary] >0) at six and twelve months were 18.2 (4.0, 81.7); p <0.001 and 12.6 (3.3, 47.8); p <0.001, respectively. The MI group reported positive behaviours and attitudes.Conclusions CCP was more effective in reducing caries increment when behaviour change technique was incorporated into the preventative strategies as per current paediatric dentistry guidelines.
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Affiliation(s)
- Amanda M Leske
- Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia
| | - Claire Mustchin
- Oral Health Therapy, Melbourne Dental School, The University of Melbourne, Australia
| | - Sandy Clarke-Errey
- Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Australia
| | - Julie Satur
- Oral Health Therapy, Melbourne Dental School, The University of Melbourne, Australia
| | - Nabina Bhujel
- Paediatric Dentistry, Guy´s and St Thomas´ NHS Foundation Trust, UK
| | - Sadna Rajan
- Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia; King´s College London, London, UK.
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