An evaluation of a storybook targeting parental attitudes, intention and self-efficacy to change their child’s oral health behaviour

Lucy O'Malley, Pauline Adair, Girvan Burnside, Louise Robinson, Margaret Coffey, Cynthia Pine

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Objective: Methods for reducing dental disease have traditionally focused on health education rather than targeting psychosocial determinants of the core behaviours through behaviour change strategies. This study tested a novel intervention in the form of a children’s story (Kitten’s First Tooth) embedded with behaviour change techniques (Abraham and Michie, 2008) with the aim of investigating how effective the intervention was at improving parents’ efficacy and intention to enact oral health behaviours for their child Methods: A controlled before and after study conducted in a deprived area of England (n=149; child mean age 4 years) with an intervention and control group. Changes in task specific parental self-efficacy (PSE) and intention were measured using the Oral Health Behaviours Questionnaire (OHBQ; Adair et al., 2004) at baseline and 3 months following intervention. Results: Of the 149 participants, 129 returned both baseline and evaluation questionnaires (retention 86.6%), 125 of these pairs of questionnaires were used in the analysis (83.4%). The OHBQ was analysed using a general linear model (ANCOVA). A significant difference was found in favour of the intervention group for PSE related to child tooth brushing behaviours (F(1,1)=12.04, p=0.001), however no change was observed for PSE related to control of dietary sugars. Conclusions: A theorized children’s story can be effective as an oral health promotion intervention by supporting parents to improve their child’s oral health-related behaviour. Change was observed for child tooth brushing but not sugar control. This may reflect story contents or may be indicative of difficulties of changing dietary behaviour.
Original languageEnglish
Pages (from-to)152-159
Number of pages8
JournalHealth Psychology
Issue number2
Early online date10 Nov 2016
Publication statusPublished - Feb 2017


  • oral health behaviours
  • child oral health
  • behaviour change techniques
  • storybook
  • parental self-efficacy


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