Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 17, 2025
Date Accepted: Apr 20, 2026
Theory- based digital intervention to improve maternal oral health behaviors for young children: A quasi-experimental study
ABSTRACT
Background:
Parental oral health education is critical for preventing early childhood caries (ECC). However, few interventions are theoretically grounded or employ mHealth solutions.
Objective:
This study evaluated a health belief model (HBM)-based digital intervention targeting maternal oral health behaviors.
Methods:
This quasi-experimental study enrolled 648 mothers of young children (aged 11–14 months) recruited from 19 community healthcare centers (CHCs) in Beijing, China. Ten CHCs (n=332) were assigned to the intervention group, where mothers received an online oral health education program based on HBM and gained prioritized access to a dental referral system upon request. The remaining nine CHCs (n=316) served as the control group, in which mothers continued to receive standard child health care services. The primary outcome was parent-assisted toothbrushing, and the secondary outcome included other oral health behaviors, including night feeding practice, sugar intake and dental visits. To evaluate the intervention effects on behavioral outcomes, generalized linear mixed models were employed, accounting for repeated measures and potential confounding factors.
Results:
Compared with the control group, the intervention group demonstrated a significant increase in parent-assisted toothbrushing, with an absolute difference of 10.5 percentage points (95% CI: 3.1–17.8) at 6 months and 1.5 percentage points (95% CI: -7.2–10.1) at 12 months. Additionally, dental visit rates were significantly higher in the intervention group at 12 months, with an increase of 2.0 percentage points (95% CI: 0.5–4.4; P < 0.05). However, no statistically significant differences were observed between groups in nighttime feeding cessation or sugar intake control at either the 6- or 12-month follow-ups (P > 0.05).
Conclusions:
This study demonstrated that the HBM-based digital intervention achieved short-term improvements in parent-assisted toothbrushing among young children, but this effect was not sustained over longer follow-up periods. To enhance the long-term sustainability of oral health behaviors, future interventions should incorporate strategies targeting maternal psychosocial determinants. Clinical Trial: ChiCTR2000039866
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