Long‐term effects of a lay health advisor intervention on immigrant children’s dental caries and maternal preventive behaviour: A randomized controlled trial

Abstract

Objectives An oral health disparity exists between native and immigrant children in Taiwan. This study evaluated the long‐term effectiveness of a lay health advisor (LHA) intervention on immigrant children's dental caries and maternal preventive behaviours. Methods Fifty‐one immigrant mother‐child pairs were randomly assigned to LHA intervention (n = 23) and control (n = 28) groups. Mothers in the LHA group received a four‐chapter one‐on‐one lesson plan, which included dental caries–related knowledge, brushing techniques, caries prevention and free preventive services, from the LHA over 4 weeks. Mothers in the control group received only a health brochure. Baseline and 1‐week, 2‐month, and 8‐month follow‐up information was collected using dental examinations and questionnaires. Results The mean ages of the children in the LHA and control groups were 4.0 ± 1.4 and 4.2 ± 1.5, respectively. The decayed, missing due to caries, filled teeth (dmft) index in the LHA and control groups was 4.8 ± 6.0 and 5.4 ± 5.4, respectively, at baseline. At the 8‐month postintervention follow‐up, the number of filled teeth (ft) in the LHA group was higher than that in the control group (β = 8.3, P = .033). The effect size (ES) demonstrated an upward trend at 1‐week, 2‐month and 8‐month follow‐ups in ft (ES = 0.21, 0.50 and 0.59, respectively) and a decrease in the number of decayed teeth (dt) (ES = 0.30, 0.43 and 0.57, respectively). The mothers in the LHA group were observed to be 10.9 times more likely than control mothers to assist their children in toothbrushing for 3 min at the 1‐week follow‐up (95% CI = 1.98‐59.40, P = .006). Conclusions The LHA intervention strategy had positive effects on the immigrant children's new dt and ft and on maternal preventive behaviour, such as assisting their children in toothbrushing.

Effectiveness of the lay health advisor program on oral function and quality of life in aboriginal older adults: A randomized controlled trial

“…The results revealed that the participants' mouth self‐examination after the intervention enhanced their self‐efficacy and reduced barriers to oral cancer screening. Another LHA intervention study 17 conducted in Taiwan reported that at the 8‐month postintervention follow‐up, the use of the LHA strategy among immigrant women improved maternal preventive behaviour, such as assisting their children in toothbrushing. Interventions, such as those that incorporate sending reminders, can improve or maintain participants' adherence to medication, influenza vaccination and mammography screening 38–40 .…”

“…13 Another Taiwanese study confirmed a community-level LHA intervention can enhance the level of dental caries-related knowledge and dental caries preventive behaviours of immigrant mothers, leading to lower dental caries among immigrant children over 8 months. 17 Oral health promotion programs for community-dwelling older adults can improve oral health-related quality of life. 18 Early oral health intervention may be a valuable and actionable target for older adults as a means of maintaining their quality of life.…”

“…One of a recent study reported that employing an LHA strategy in aboriginal communities in Taiwan was more effective than providing leaflets alone in reducing barriers toward oral cancer screening and increasing self‐efficacy for oral cancer self‐examination 13 . Another Taiwanese study confirmed a community‐level LHA intervention can enhance the level of dental caries‐related knowledge and dental caries preventive behaviours of immigrant mothers, leading to lower dental caries among immigrant children over 8 months 17 …”