The effect of motivational interviewing on oral healthcare knowledge, attitudes and behaviour of parents and caregivers of preschool children: an exploratory cluster randomised controlled study.

BACKGROUND: Motivational Interviewing (MI) has been used across primary healthcare and been shown to be effective in reducing the prevalence of early childhood caries (ECC) in preschool children. This study aimed to compare the effect of MI, in contrast to traditional dental health education (DHE), on oral health knowledge, attitudes, beliefs and behaviours among parents and caregivers of preschool children in Trinidad. METHOD: The design of this exploratory study included a cluster randomised controlled trial and semi-structured focus groups. Six preschools (79 parents and caregivers) in Eastern Trinidad were randomly assigned to a test or control group (3 preschools in each group). Parents and caregivers in the test-group (n = 25) received a talk on dental health using an MI approach and the control-group (n = 54) received a talk using traditional DHE. Both groups received additional, written dental health information. The MI group also received two telephone call follow-ups as part of the MI protocol. Both groups were given questionnaires before the talks and four months later. Question items included oral health knowledge, beliefs, attitudes, brushing behaviour, oral health self-efficacy, oral health fatalism and a specific instrument to asses 'readiness for change', the Readiness Assessment of Parents Concerning Infant Dental Decay (RAPIDD). Participants in the test-group were also invited to take part in a focus group to share their views on the dental health talk. RESULTS: At four month follow-up, knowledge items on fluoride use, tooth brushing, dietary practice and dental attendance increased in both the test (DHE + MI) and control (DHE) groups ((p < 0.05, Chi Square test). In the test-group there were increases in mean child tooth brushing frequency and reduction in oral health fatalism (p < 0.05 t-test). Findings from a thematic analysis of the focus group suggested that the MI talk and telephone follow-up were well accepted and helpful in supporting parent and caregiver efforts to improve oral health practices for their preschool children. CONCLUSION: In this exploratory controlled study there was some evidence that using an MI approach when delivering oral health information had a positive effect on parent/ caregiver oral health knowledge, attitudes and behaviours compared to traditional DHE. There is need for further research involving the use of brief-counselling techniques in this Caribbean population.

Activity and obesity of Colombian immigrants in Canada who use a food bank.

The purpose of this study was to provide some preliminary description of the Latin-Canadian community by reporting the socioeconomic status, physical activity, and weight status (i.e., healthy weight, overweight, or obese status) of Colombians newly immigrated to London, Ontario Canada. Face-to-face interviews were conducted on a convenience sample of 77 adult Colombian immigrant food bank users (46.8% men; mean age 39.9 yr., SD=11.8). Physical activity was gauged using the International Physical Activity Questionnaire and self-report Body Mass Index, and sociodemographic data were collected. Of respondents, 47% had a university education, and 97% received social support. 61% met recommended levels of physical activity. Men were more active, being involved in about 130 min. more of exercise per week, and more men were overweight than women (63.9% versus 39.0%, respectively). Of respondents, 73% reported being less active than before coming to Canada. This pilot study indicates that Latin-Canadian immigrants are a vulnerable group in need of acculturational support. Further study is warranted.

Food insecurity and dietary intake of immigrant food bank users.

PURPOSE: The degree of food insecurity and dietary intake was examined in adult Colombians who are new immigrants to Canada and use a food bank. METHODS: In-person surveys were conducted on a convenience sample of 77 adult Colombian immigrant food bank users in London, Ontario. Degree of food insecurity was measured by the Radimer/Cornell questionnaire, food intakes by 24-hour recall, sociodemographics, and questionnaires about changes in dietary patterns before and after immigration. RESULTS: Thirty-six men and 41 women participated in the study. Despite being highly educated, all respondents had experienced some form of food insecurity within the previous 30 days. The degree of food insecurity seems to be inversely associated with income and length of residency in Canada. Total daily energy intake was low, with a mean value of 1,568.3 +/- 606.0 kcal (6,217.5 +/- 2,336.4 kJ). In particular, a large proportion of participants consumed a diet low in fruits and vegetables (73%) and milk and dairy products (58%). CONCLUSIONS: Colombian immigrant food bank users new to Canada experience various degrees of food insecurity, which is associated with inadequate food intake. Interventions are needed to assist this population with adapting to society while concurrently sustaining healthy eating patterns.