Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study

Introduction and aims: Early childhood caries (ECC) is a widespread chronic condition that significantly affect children’s health and well-being. Although parental psychosocial factors are key to shaping children’s oral health behaviours, few studies have examined the distinct influences of fathers’...

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Main Authors: Yi-Chang Chou, Feng-Shiang Cheng, Shih-Han Weng, Chih-Hao Tseng, Hsiao-Yun Hu, Chieh-Hsing Liu
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:International Dental Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S0020653925001911
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author Yi-Chang Chou
Feng-Shiang Cheng
Shih-Han Weng
Chih-Hao Tseng
Hsiao-Yun Hu
Chieh-Hsing Liu
author_facet Yi-Chang Chou
Feng-Shiang Cheng
Shih-Han Weng
Chih-Hao Tseng
Hsiao-Yun Hu
Chieh-Hsing Liu
author_sort Yi-Chang Chou
collection DOAJ
description Introduction and aims: Early childhood caries (ECC) is a widespread chronic condition that significantly affect children’s health and well-being. Although parental psychosocial factors are key to shaping children’s oral health behaviours, few studies have examined the distinct influences of fathers’ vs mothers’ health beliefs. The Health Belief Model (HBM) – which examines health behaviours through perceived susceptibility, severity, benefits, barriers, and self-efficacy – provides a valuable framework for examining these dynamics. This study applied the HBM to investigate the associations between caregiver beliefs, behaviours, and ECC risk, with a focus on differences between fathers and mothers. Methods: We conducted a longitudinal analysis utilizing data from the Taipei Preschool Oral Health Screening Program (2017-2018), including children aged 3-5 years. Eligible participants had complete oral examination records and parental HBM-based questionnaires for 2 consecutive years. Children with incomplete questionnaires were excluded, yielding a final sample of 6902. Generalized estimating equations assessed associations between caregiver oral health beliefs, self-efficacy, perceived barriers, cues to action, behaviours, and ECC risk, stratified by caregiver type (father or mother). Results: Higher parental education, better child oral health behaviours, lower perceived barriers, and greater self-efficacy were significantly correlated with reduced ECC risk. Conversely, higher cues to action were linked to increased ECC risk, indicating a reactive rather than preventive approach. Stratified analyses revealed differing patterns: among fathers, only education and oral health knowledge were significantly protective, whereas among mothers, child oral health behaviours, perceived barriers, and self-efficacy were also significant predictors. Conclusion: Parental psychosocial factors substantially influence ECC risk, with distinct roles for fathers and mothers. These findings highlight the importance of considering caregiver gender in future research and oral health intervention design. Clinical relevance: Family-centred, gender-specific interventions that address caregiver-specific beliefs and behaviours may improve ECC prevention strategies and help reduce oral health disparities in preschool-aged children.
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series International Dental Journal
spelling doaj-art-e8a6032723884b4abc7cfd605e2a73c12025-08-20T03:51:29ZengElsevierInternational Dental Journal0020-65392025-10-0175510090210.1016/j.identj.2025.100902Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal StudyYi-Chang Chou0Feng-Shiang Cheng1Shih-Han Weng2Chih-Hao Tseng3Hsiao-Yun Hu4Chieh-Hsing Liu5Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Health and Welfare, University of Taipei, Taipei, Taiwan; Department of Health and Welfare, University of Taipei, Taipei, TaiwanDepartment of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Urban Development, University of Taipei, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Education and Research, Taipei City Hospital, Taipei, TaiwanDepartment of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Health and Welfare, University of Taipei, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan; Corresponding author. Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, Sec. 1, Heping E. Rd., Da'an Dist., Taipei City 106209, Taiwan.Introduction and aims: Early childhood caries (ECC) is a widespread chronic condition that significantly affect children’s health and well-being. Although parental psychosocial factors are key to shaping children’s oral health behaviours, few studies have examined the distinct influences of fathers’ vs mothers’ health beliefs. The Health Belief Model (HBM) – which examines health behaviours through perceived susceptibility, severity, benefits, barriers, and self-efficacy – provides a valuable framework for examining these dynamics. This study applied the HBM to investigate the associations between caregiver beliefs, behaviours, and ECC risk, with a focus on differences between fathers and mothers. Methods: We conducted a longitudinal analysis utilizing data from the Taipei Preschool Oral Health Screening Program (2017-2018), including children aged 3-5 years. Eligible participants had complete oral examination records and parental HBM-based questionnaires for 2 consecutive years. Children with incomplete questionnaires were excluded, yielding a final sample of 6902. Generalized estimating equations assessed associations between caregiver oral health beliefs, self-efficacy, perceived barriers, cues to action, behaviours, and ECC risk, stratified by caregiver type (father or mother). Results: Higher parental education, better child oral health behaviours, lower perceived barriers, and greater self-efficacy were significantly correlated with reduced ECC risk. Conversely, higher cues to action were linked to increased ECC risk, indicating a reactive rather than preventive approach. Stratified analyses revealed differing patterns: among fathers, only education and oral health knowledge were significantly protective, whereas among mothers, child oral health behaviours, perceived barriers, and self-efficacy were also significant predictors. Conclusion: Parental psychosocial factors substantially influence ECC risk, with distinct roles for fathers and mothers. These findings highlight the importance of considering caregiver gender in future research and oral health intervention design. Clinical relevance: Family-centred, gender-specific interventions that address caregiver-specific beliefs and behaviours may improve ECC prevention strategies and help reduce oral health disparities in preschool-aged children.http://www.sciencedirect.com/science/article/pii/S0020653925001911Early childhood cariesHealth Belief ModelOral health behavioursParental health beliefs
spellingShingle Yi-Chang Chou
Feng-Shiang Cheng
Shih-Han Weng
Chih-Hao Tseng
Hsiao-Yun Hu
Chieh-Hsing Liu
Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
International Dental Journal
Early childhood caries
Health Belief Model
Oral health behaviours
Parental health beliefs
title Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
title_full Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
title_fullStr Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
title_full_unstemmed Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
title_short Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
title_sort impact of parental health beliefs on early childhood caries a two year longitudinal study
topic Early childhood caries
Health Belief Model
Oral health behaviours
Parental health beliefs
url http://www.sciencedirect.com/science/article/pii/S0020653925001911
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