Developing a Prototype Home-Based Toothbrushing Support Tool for Families in Scotland: A Mixed-Methods Study With...

Area of Science:

• Public Health
• Pediatric Dentistry
• Behavioral Science

Background:

• Childsmile, Scotland's National Oral Health Programme for Children, offers home toothbrushing support for young children (0-3 years).
• An existing Dutch intervention, Uitblinkers, was adapted for the Scottish context.
• The study aimed to identify barriers, consensus on behavior change techniques, and design considerations for a home-support tool.

Purpose of the Study:

• Identify parental barriers to supervised home toothbrushing for children aged 0-3 years.
• Explore consensus on effective behavior change techniques (BCTs) for addressing these barriers.
• Recommend design and implementation facilitators for a co-produced home-support tool within the Childsmile program.

Main Methods:

• A modified Delphi study with 21 experts established consensus on barriers, BCTs, and implementation.
• Literature reviews, expert discussions, and the Uitblinkers intervention informed Delphi propositions.
• 12 semi-structured interviews with Dental Health Support Workers validated findings and explored practicalities.

Main Results:

• Consensus was reached on 11 key barriers (child, parent, environmental/social) to home toothbrushing.
• Motivational Interviewing, Operant Conditioning, Stimulus Control, and Goal-Setting were identified as appropriate BCTs.
• A physical, card-based tool was preferred for home delivery, deemed feasible and applicable for children with additional support needs.

Conclusions:

• A card-based conversational intervention, adapted from a Dutch model, is suitable for targeted home toothbrushing support in Scotland.
• Expert consensus and staff feedback support the tool's design and feasibility for the Childsmile program.
• The intervention warrants further testing for improving oral health in young children and their families.