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Understanding topical fluoride hesitancy and refusal behaviors through the extended parallel process model and health belief model
Journal article   Peer reviewed

Understanding topical fluoride hesitancy and refusal behaviors through the extended parallel process model and health belief model

Esther Leung, Darragh Kerr, Natoshia Askelson and Donald L. Chi
Journal of public health dentistry, Vol.83(1), pp.3-8
Winter 2023
DOI: 10.1111/jphd.12512
PMCID: PMC9470784
PMID: 35288941
url
https://www.ncbi.nlm.nih.gov/pmc/articles/9470784View
Open Access

Abstract

Objectives: Topical fluoride helps prevent dental caries. However, many caregivers are hesitant about topical fluoride for their children and may refuse it during clinic visits. In this qualitative study, we assessed the relevance of the extended parallel process model (EPPM) and health belief model (HBM) in caregivers' decision-making about topical fluoride. Methods: We interviewed 56 fluoride-hesitant or fluoride-refusing caregivers using a semi-structured interview script that included questions based on select constructs from the EPPM (perceived severity, susceptibility, response efficacy) and HBM (perceived benefits and consequences). Two team members conducted a thematic analysis of the interview data. Results: Most caregivers acknowledged the severity of cavities but did not believe their child was susceptible. Caregivers also understood the general benefits of fluoride in preventing tooth decay, but reported low response efficacy of fluoride for their children especially compared to the other ways of reducing caries risk like reducing sugar intake and toothbrushing. Many caregivers had concerns about topical fluoride, especially regarding safety, with the potential consequences of fluoride outweighing its benefits. Conclusion: Our findings were generally consistent with the EPPM and HBM, which appear to be relevant in understanding fluoride hesitancy behaviors. Additional research is needed on ways to improve provider communications about topical fluoride with caregivers.
Oral Health Policy

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