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.

Trial registration: ClinicalTrials.gov Identifier NCT01120041.

Keywords: Community; Motivational interviewing; Oral health; PRAMS; Pregnancy; RCT.

Copyright © 2015 Elsevier Ltd. All rights reserved.

Figures

Figure 1

Overview of the Baby Smiles study design and measures.

Figure 2

Flow diagram of the Baby Smiles participant recruitment, randomization, study design and final disposition (e.g., completion of study questionnaires and/or debrief at specific study events) of participating mothers.