Using intervention mapping to develop a home-based parental-supervised toothbrushing intervention for young children

Area of Science:

• Public Health
• Pediatric Dentistry
• Behavioral Science

Background:

• Dental caries is a significant public health issue for young children and families.
• UK national guidance recommends parental supervision of brushing with fluoride toothpaste until age 7.
• Evidence-based interventions to support this parental practice are lacking.

Purpose of the Study:

• To develop a home-based intervention to promote parental-supervised toothbrushing (PSB) in young children.
• To reduce the incidence of dental caries through improved oral hygiene practices.
• To address barriers preventing consistent PSB.

Main Methods:

• Intervention Mapping (IM) protocol used, involving needs assessment, barrier identification, and strategy selection.
• Systematic review, qualitative interviews, and multi-disciplinary group meetings informed development.
• Theoretical Domains Framework (TDF) mapped psychological determinants of PSB.

Main Results:

• Key barriers to PSB include parental knowledge, skills, self-efficacy, routine setting, and behavior regulation.
• Parenting skills, particularly routine establishment and managing reluctant children, are critical.
• Two intervention pathways developed: a universal, low-cost option and an intensive targeted program.

Conclusions:

• PSB is a complex behavior influenced by individual, social, and structural factors.
• Intervention Mapping facilitated the development of community-based universal and targeted intervention pathways.
• Further research is required to assess the acceptability and sustainability of the developed interventions.