Background and aim
The roles of self-efficacy and self-monitoring as proximal predictors of dental flossing frequency are studied in the context of an oral health intervention.

Materials and methods
A study among 287 university students, aged 19 to 26 years, compared an intervention group that received a brief self-regulatory treatment, with a passive and an active control group. Dental flossing, self-efficacy, and self-monitoring were assessed at baseline and 3 weeks later.

Results
The intervention led to an increase in dental flossing regardless of experimental condition. However, treatment-specific gains were documented for self-efficacy and self-monitoring. Moreover, changes in the latter two served as mediators in a path model, linking the intervention with subsequent dental flossing and yielding significant indirect effects.

Conclusions
Self-efficacy and self-monitoring play a mediating role in facilitating dental flossing. Interventions that aim at an improvement in oral self-care should consider using these constructs.


Statement of contribution
What is already known on this subject? 

The adoption and maintenance of oral self-care can be facilitated by a number of social-cognitive variables.
Interventions that include planning, action control, or self-efficacy components have been shown to improve dental flossing.
In one recent study on flossing in adolescent girls, planning intervention effects were mediated by self-efficacy.


What does this study add? 

Self-monitoring is associated with better oral self-care.
A 10-min intervention improves self-efficacy and self-monitoring.
Self-efficacy and self-monitoring operate as mediators between treatment and flossing.

A brief intervention changing oral self-care, self-efficacy, and self-monitoring

To evaluate a theory-guided intervention on oral self-care and examine the possible mechanisms among self-regulatory factors, two brief intervention arms were compared, an information-based education treatment and a self-regulation treatment focusing on planning and action control. Young adults (N = 284; aged 18-29 years) were assessed at baseline and 1 month later. The self-regulation intervention improved levels of oral self-care, dental planning and action control. Moreover, a moderated mediation model with planning as the mediator between experimental conditions and dental outcome, and self-efficacy as well as action control as moderators elucidated the mechanism of change. More self-efficacious participants in the self-regulation condition benefitted in terms of more planning, and those who monitored their actions yielded higher levels of oral hygiene. Dental self-efficacy, dental planning and action control are involved in the improvement of oral self-care. Their joint consideration may contribute to a better understanding of health behavior change.

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Self-efficacy, planning and action control in an oral self-care intervention

Objectives With 60-90% of children worldwide reportedly experiencing dental caries, poor oral health in the younger years is a major public health issue. As parents are important to children's oral hygiene practices, we examined the key self-regulatory behaviours of parents for supervising their children's toothbrushing using the health action process approach. Design and method Participants (N = 281, 197 mothers) comprised Australian parents of 2- to 5-year-olds. A longitudinal design was used to investigate the sequential mediation chain for the effect of intention (Time 1) on parental supervision for their youngest child's toothbrushing (Time 3), via self-efficacy and planning (Time 2), and action control (Time 3). Results A latent-variable structural equation model, controlling for baseline behaviour and habit, revealed significant indirect effects from intention via self-efficacy and action control and intention via planning and action control, on parental supervision behaviour. The model was a good fit to the data, explaining 74% of the variance in parents' supervising behaviour for their children's toothbrushing. Conclusion While national recommendations are provided to guide parents in promoting good oral hygiene practices with their children, current results show the importance of going beyond simple knowledge transmission to support parents' intentions to supervise their children's toothbrushing actually materialize. Current findings make a significant contribution to the cumulative empirical evidence regarding self-regulatory components in health behaviour change and can inform intervention development to increase parents' participation in childhood oral hygiene practices, thus helping to curb rising oral health conditions and diseases. Statement of contribution What is already known on this subject? Self-regulatory skills are important to translate intentions into behaviour. Self-efficacy, planning, and action control are key self-regulatory skills for behaviour change. What does this study add? Self-regulatory skills are needed for parents to supervise their children's toothbrushings. Self-efficacy, planning, and action control are important self-regulatory skills in this context. Future interventions should map these self-regulatory predictors onto behaviour change techniques.

Parental supervision for their children's toothbrushing: Mediating effects of planning, self‐efficacy, and action control

Background
Frailty has been demonstrated to negatively influence dental service-use and oral self-care behavior of older people. The aim of this study was to explore how the type and level of frailty affect the dental service-use and oral self-care behavior of frail older people.

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The impact of frailty on oral care behavior of older people: a qualitative study

Although poor oral hygiene practices can have serious health consequences, a large number of adults brush or floss their teeth less than the recommended time or not at all. This study examined the mediating effect of two key self-regulatory processes, self-efficacy and planning, as the mechanisms that translate dental flossing intentions into behavior. Participants (N = 629) comprised young adults attending a major university in Queensland, Australia. A longitudinal design guided by sound theory was adopted to investigate the sequential mediation chain for the effect of dental flossing intentions (time 1) on behavior (time 3) via self-efficacy and planning (time 2). A latent variable structural equation model with standardized parameter estimates revealed the model was a good fit to the data. Controlling for baseline flossing, the effect of intentions on behavior was mediated via self-efficacy and planning, with 64 % of the flossing variance accounted for by this set of predictors. Controlling for age and sex did not change the results. The results extend previous research to further elucidate the mechanisms that help to translate oral hygiene intentions into behavior and make a significant contribution to the cumulative empirical evidence about self-regulatory components in health behavior change.

/pdf/translating-dental-flossing-intentions-into-behavior-a-3jugiklqox.pdf

Translating Dental Flossing Intentions into Behavior: a Longitudinal Investigation of the Mediating Effect of Planning and Self-Efficacy on Young Adults

Building on previous research on psychosocial variables associated with oral hygiene behavior, this study examined the ability of Health Belief Model variables (perceived benefits, barriers, susceptibility, severity) and self-efficacy beliefs about toothbrushing to inform prevalence of dental caries and toothbrushing frequency. To accomplish this goal, a sample of 125 dental patients completed self-report questionnaires and provided data on demographic and behavioral factors. A path analysis model with manifest variables was tested. Oral hygiene beliefs emerged as a multidimensional construct. Results suggested that stronger self-efficacy beliefs (β = .81) and greater perceived severity of oral diseases (β = .18) were related to increased toothbrushing frequency, which in turn was associated with better oral health status, as indicated by the total number of decayed, missing, and filled teeth due to dental caries (β = -.39). Possible strategies for improving oral health are discussed.

Sofia Frousiounioti

Papers

Self-efficacy and Oral Hygiene Beliefs about Toothbrushing in Dental Patients: A Model-guided Study