Influence of Parental Health Literacy on Change over Time in the Oral Health of American Indian Children

• Main Authors: Angela G. Brega, Rachel L. Johnson, Luohua Jiang, Anne R. Wilson, Sarah J. Schmiege, Judith Albino
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: health literacy; pediatric oral health; American Indian; longitudinal studies
• Online Access: https://www.mdpi.com/1660-4601/18/11/5633

In cross-sectional studies, parental health literacy (HL) is associated with children’s oral health. It is unclear, however, whether HL <i>influences</i> pediatric outcomes. We examined the relationship of HL with change over time in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes. We used longitudinal data from a study designed to reduce dental decay in American Indian children (<i>N</i> = 579). At baseline and annually for three years, parents answered questions assessing HL; oral health knowledge, beliefs, and behaviors; and pediatric oral health status. The number of decayed, missing, and filled tooth surfaces (dmfs) was computed based on annual dental evaluations. Linear mixed models showed that HL was significantly associated with all constructs, except dmfs, at their reference time points and persistently across the three-year study period. HL predicted <i>change over time</i> in only one variable, parents’ belief that children’s oral health is determined by chance or luck. HL is strongly associated with oral health knowledge, beliefs, behaviors, and status prospectively but is not a key driver of change over time in these oral health constructs.