A Theory-Based Digital Intervention to Improve Maternal Oral Health Behaviors for Young Children: Quasi-Experimental Study

Abstract Background Parental oral health education is critical for preventing early childhood caries. However, few interventions are theoretically grounded or use digital approaches. Objective The objective of this study was to evaluate the effects of a health belief model–based digital intervention on maternal oral health behaviors. Methods This quasi-experimental study enrolled 648 mother-child dyads from 19 community health care centers (CHCs) in Beijing, China. CHCs were allocated to intervention or control groups depending on their voluntary adoption of the dental referral system. Ten CHCs (n=332, 52.6%) were assigned to the intervention group, where mothers received oral health education materials and had access to a dental referral system. The remaining 9 CHCs (n=316, 47.4%) 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 practices, sugar intake, and dental visits. To evaluate the intervention effects on behavioral outcomes, generalized linear mixed models were used, 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 10.3 (95% CI 3.0 to 17.6; P =.006) percentage points at 6 months and 1.5 (95% CI −7.2 to 10.1; P =.74) percentage points at 12 months. Additionally, dental visit rates were significantly higher in the intervention group at 12 months (odds ratio 4.65, 95% CI 1.30 to 16.70; P =.02). 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. Conclusions The health belief model–based digital intervention was effective in the short term for enhancing parent-assisted toothbrushing in young children, but its long-term effectiveness remains unproven. Future research should therefore prioritize exploring sustainability strategies.