Motivational Techniques for Preventing Tooth Decay in Children

(BTCF Trial)

Recruiting at 15 trial locations

Overseen By Jennifer Bowman-Reif, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Iowa

Disqualifiers: Premature delivery

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 7

634 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial seeks better methods to prevent tooth decay in young children, focusing on those from minority and low-income families, by using motivational techniques. Researchers are testing whether messages based on self-determination theory (a motivation strategy) can enhance children's oral health habits more effectively than traditional messages. Pregnant mothers enrolled in Iowa's WIC program who can communicate in English or Spanish may qualify for this trial. Participants will receive oral health messages during pregnancy and when their child reaches 12 and 24 months. The goal is to determine if these messages help reduce tooth decay and improve oral hygiene in children. As an unphased trial, this study offers a unique opportunity to contribute to innovative strategies for enhancing children's oral health.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that these motivational techniques are safe for preventing tooth decay in children?

Research shows that treatments based on self-determination theory (SDT) are generally safe. In past studies, SDT has encouraged good habits in oral health. For example, one study found that using SDT to guide dental care improved dental hygiene. Participants in that study had less dental plaque after receiving guidance based on SDT.

These studies reported no harmful effects, suggesting that SDT is well-tolerated when promoting better oral health habits. The approach focuses on motivation and behavior change, not medication or physical treatment, which reduces the risk of physical side effects. Overall, SDT appears to be a safe and effective way to improve oral health behaviors. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using self-determination theory (SDT) to prevent tooth decay in children because it emphasizes autonomy and motivation in a way that differs from traditional methods. Unlike standard oral health education, which often relies on straightforward information delivery, SDT involves giving mothers autonomy-supportive messages. This approach aims to empower and motivate them to make healthier choices for their children's dental care. By fostering a sense of control and personal relevance, SDT has the potential to create lasting behavioral changes that standard educational methods might not achieve.

What evidence suggests that this trial's motivational techniques could be effective for preventing tooth decay in children?

Research shows that self-determination theory (SDT) can help people improve their oral health habits. In previous studies, SDT successfully changed behaviors in various health areas, including dental care. This trial will compare two groups: one where mothers receive autonomy-supportive messages informed by SDT, and a control group where mothers receive the same oral health care messages delivered in a neutral style. The SDT approach motivates people by supporting their ability to make their own choices. It has shown promising results in improving oral hygiene, such as increasing regular brushing and flossing. These improvements can lead to better overall oral health and may reduce early childhood tooth decay. Research has not identified any safety concerns with using SDT in dental health programs. ^{1 6 7 8 9}

Who Is on the Research Team?

Karin Weber-Gasparoni, PhD

Principal Investigator

University of Iowa

Are You a Good Fit for This Trial?

This trial is for pregnant women aged 18-45, enrolled in the WIC program, who are between 12 and 32 weeks into their pregnancy. They must understand English or Spanish and plan to stay in the area for at least 4 years. Women who give birth before the first study visit cannot participate.

Inclusion Criteria

Between 12 and 32 weeks of the gestational period

No intention to move away in the next 4 years

I can speak, understand, and read English or Spanish.

Exclusion Criteria

Mothers who deliver their child prior to their first study intervention visit

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Pregnant mothers receive autonomy-supportive or neutral oral health messages during pregnancy, and at 12 and 24 months of child's age

36 months

3 visits (in-person) at pregnancy, 12 months, and 24 months

Follow-up

Mothers receive follow-up booster messages 3 months after each oral health message, and children's oral health outcomes are monitored

36 months

4 visits (in-person) at 12, 24, and 36 months, with additional activities at 1 and 9 months between site visits

What Are the Treatments Tested in This Trial?

Interventions

• Self-determination theory

Trial Overview The trial tests if motivational videos based on self-determination theory can improve oral health behaviors to prevent early childhood cavities. It compares these videos against traditional neutral messages from pregnancy until the child turns three.

How Is the Trial Designed?

Group I: SDT Experimental Treatment 1 Intervention

Pregnant mothers will be randomly assigned to either an experimental group (Group 1) where mothers will receive autonomy-supportive messages informed by the SDT or a control group (Group 2) where mothers will receive the same oral health care messages delivered using a neutral style. All mothers will be exposed to oral health messages - one during pregnancy, one later when their child is 12 months of age, and one when their child is 24 months of age. Three months after receiving the oral health messages at each time point, mothers will be sent a follow-up booster message.

Group II: Control Experimental Treatment 1 Intervention

Pregnant mothers will be randomly assigned to either an experimental group (Group 1) where mothers will receive autonomy-supportive messages informed by the SDT or a control group (Group 2) where mothers will receive the same oral health care messages delivered using a neutral style. All mothers will be exposed to oral health messages - one during pregnancy, one later when their child is 12 months of age, and one when their child is 24 months of age. Three months after receiving the oral health messages at each time point, mothers will be sent a follow-up booster message.

Who Is Running the Clinical Trial?

University of Iowa

Lead Sponsor

Trials

486

Recruited

934,000+

Published Research Related to This Trial

The Motivation to Limit Screen-time Questionnaire (MLSQ) was developed and evaluated for its effectiveness in measuring adolescents' motivation to reduce screen time, involving 342 boys in the validation process.

The MLSQ demonstrated good validity and reliability, with a strong fit to the data and high intraclass correlation coefficients, indicating it can be a useful tool for understanding motivation in this age group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and evaluation of the Motivation to Limit Screen-time Questionnaire (MLSQ) for adolescents. Lubans, DR., Lonsdale, C., Plotnikoff, RC., et al.[2019]

The study involving 322 students found that providing autonomy support at dental clinics leads to greater patient satisfaction and motivation, which in turn increases dental attendance and improves oral health.

Conversely, conditional regard from dental staff can create frustration and anxiety, leading to avoidance of dental appointments and negatively impacting oral health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attending and avoiding dental appointments: Do "bright" and "dark" motivational paths have a role? Münster Halvari, AE., Halvari, H., Deci, EL.[2022]

A dental intervention that promotes patient autonomy significantly improved perceived clinician support and increased patients' motivation for dental care, leading to better dental behaviors over 5.5 months in a study of 141 patients.

The intervention resulted in very large reductions in dental plaque and gingivitis, highlighting its effectiveness compared to standard care and suggesting important implications for improving dental health practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-determined motivational predictors of increases in dental behaviors, decreases in dental plaque, and improvement in oral health: a randomized clinical trial. Münster Halvari, AE., Halvari, H., Bjørnebekk, G., et al.[2022]

A Self-Determination Theory (SDT) intervention significantly improved patients' caries competence and dental attendance compared to standard care, as shown in a study with 138 participants over 5.5 months.

The study found that patients' sense of autonomy (measured by relative autonomous locus of causality, RALOC) and the supportive approach of dental hygienists were key factors in reducing dental anxiety and increasing attendance for dental care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predicting dental attendance from dental hygienists' autonomy support and patients' autonomous motivation: A randomised clinical trial. Halvari, AE., Halvari, H., Williams, GC., et al.[2018]

A cluster randomized controlled trial with 196 adolescents showed that self-determination theory (SDT)-guided dental education significantly improved oral self-care in the short term compared to conventional instruction, as indicated by decreased dental plaque scores at the 6-month follow-up.

However, the improvement in oral self-care was not sustained at the 12-month follow-up, suggesting that while SDT-guided education is effective initially, ongoing support may be needed to maintain these benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-determination theory guided oral self-care training for adolescents-A cluster randomised controlled trial. Aleksejūniene, J., Dziaugyte-Eyeberdiyev, L., Rasteniene, R., et al.[2023]

Mothers who watched an autonomy-supportive psychoeducational video showed significantly greater improvements in oral health knowledge and behavioral intentions for preventing early childhood caries (ECC) compared to those who received a neutral brochure, with data collected from 415 children and their mothers over six months.

The positive effects of the video intervention on knowledge and intentions were sustained over time, indicating that this approach is effective for long-term ECC prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An effective psychoeducational intervention for early childhood caries prevention: part I. Weber-Gasparoni, K., Reeve, J., Ghosheh, N., et al.[2021]

Mothers who received an autonomy-supportive psychoeducational video message showed significantly greater improvements in their children's oral health behaviors compared to those who received a neutral brochure, as evidenced by follow-up data from 415 mothers.

The intervention group had notably fewer mothers sharing dining ware with their children and a higher rate of checking for white spot lesions at the six-month follow-up, indicating effective behavior change promoted by the video message.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An effective psychoeducational intervention for early childhood caries prevention: part II. Weber-Gasparoni, K., Warren, JJ., Reeve, J., et al.[2021]

Citations

1. selfdeterminationtheory.org selfdeterminationtheory.org/wp-content/uploads/2014/04/2006_HalvariHalvari_Oral-Health_ME.pdf

Motivational Predictors of Change in Oral Health Due to a lack of dental research based on self- determination theory we address studies of other health- related behaviors in deriving our hypotheses. Recent.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4870833/

An Effective Psychoeducational Intervention for Early ... In the dental domain, a psychological theory of motivation called self-determination theory (SDT) has been applied very successfully. In a study of 90 ...

3. withpower.com withpower.com/trial/phase-dental-caries-3-2023-e9a0d

Motivational Techniques for Preventing Tooth Decay in ... The studies using the Self-Determination Theory (SDT) approach for dental health interventions do not report any safety concerns, suggesting it is generally ...

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/j.1559-1816.2011.00867.x

Motivation for Dental Home Care: Testing a Self ... The present research developed the Self-Regulation for Dental Home Care Questionnaire (SRDHCQ), based on self-determination theory (SDT; Deci & ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4857723/

An Effective Psychoeducational Intervention for Early ... One psychological theory that may be particularly useful in promoting behavior change is the self-determination theory (SDT) of motivation. SDT is a theory of ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/22309881/

Self-determined motivational predictors of increases in ... Objective: The present study tested the hypotheses that: (a) a dental intervention designed to promote dental care competence in an autonomy-supportive way, ...

7. selfdeterminationtheory.org selfdeterminationtheory.org/SDT/documents/2012_MunsterHalvariEtAl_JOASP.pdf

Motivation for Dental Home Care The present research developed the Self-Regulation for Dental Home Care Ques- tionnaire (SRDHCQ), based on self-determination theory (SDT; Deci & Ryan,.

8. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/36000709/

Self-determination theory guided oral self-care training for ... Results indicated that from baseline to the 6-month follow-up, dental plaque scores decreased (oral self-care improved) in the intervention ...

9. researchgate.net researchgate.net/publication/200684308_Motivation_for_Dental_Home_Care_Testing_a_Self-Determination_Theory_Model

Motivation for Dental Home Care: Testing a Self ... The purpose of the present study was to test a self‐determination theory model with the following hypotheses: (1) Patients' autonomous ...