Women, Infants, and Children (WIC) Certifiers' Knowledge and Attitudes regarding the Prevention of Early Childhood Caries

Abstract

Purpose: WIC health curricula provide minimal information on oral health yet early childhood caries (ECC) and tooth decay constitute the most common chronic childhood disease. WIC clinic certifiers deliver health information to their clients. This study explored if an educational intervention could influence the knowledge and attitudes of WIC clinic certifiers regarding the prevention of ECC. Factors limiting their ability and willingness to educate clients about ECC and instructional options that could improve their delivery of oral health education also were elicited. Methods: A purposive sample of nine WIC clinic certifiers from the Anne Arundel County, WIC Program, Maryland, participated in this exploratory study. The design included a pre intervention observation, the educational intervention, and a post intervention observation and a follow-up interview. Close-ended checklists captured pre and post intervention data regarding certifiers' knowledge level and attitudes regarding ECC. A PowerPoint educational intervention included content addressing ECC and ways to apply it to client counseling. A semi-structured interview sought WIC educators' insights regarding the educational intervention's benefits and suggestions for improved learning experiences. All measuring instruments were pilot tested and assessed for content validity. Data analysis included summarizations of qualitative narrative data and frequency counts. The study was approved by the Institutional Review Board, University of Maryland, Baltimore. Results: All WIC certifiers increased the scope and depth of the oral health counseling that they provided, as assessed through a comparison of pre and post intervention observation responses. Key barriers to delivering comprehensive oral health education identified were client resistance, a mismatch of client/provider value systems and inadequate appointment time. Conclusion: Following an oral health educational intervention, WIC clinic certifiers augmented and enhanced their delivery of oral health education. A dental hygienist's educational intervention has the potential to improve WIC educators' knowledge and attitudes toward the prevention of ECC. Longitudinal studies using larger and more diverse samples need to be conducted to assess the long term benefits of oral health educational interventions. Broad scale educational interventions may help reduce future childhood oral disease.