Bias in Caregiver Reporting of Children’s Oral Health Behaviors

A cross sectional study examining social desirability bias in caregiver reporting of children’s oral health behaviors

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Research article overview in layman's terms.

Caregivers play a critical role in their children's oral health and hygiene. Good oral health is associated with higher health literacy. The REALD-30 test is a validated word recognition test used to measure the oral health literacy of caregivers. Our research found that social desirability bias (SDB) has a weak association with oral health behaviors (OHBs). By comparing caregivers' responses to traditional OHB items and newer SDB-modulating items, we were able to better estimate OHBs. Higher literacy scores were associated with better parental report of OHBs.

<a href="https://www.treebread.com/tag/caregivers-children/">Caregivers children</a> | <a href="https://www.treebread.com/tag/health-literacy/">Health Literacy</a> | <a href="https://www.treebread.com/tag/oral-health/">Oral health</a> | <a href="https://www.treebread.com/tag/oral-health-behaviors/">Oral health behaviors</a> | <a href="https://www.treebread.com/tag/oral-health-literacy/">Oral health literacy</a> | <a href="https://www.treebread.com/tag/oral-hygiene/">Oral hygiene</a> | <a href="https://www.treebread.com/tag/reald-30/">REALD-30</a> | <a href="https://www.treebread.com/tag/social-desirability-bias/">Social desirability bias</a>



A cross sectional study examining social desirability bias in caregiver reporting of children’s oral health behaviors

Abstract

Oral Health and Hygiene

Our previous research (Pediatrics 2010:126) found a strong association between caregiver oral health literacy (OHL) and children’s oral health status; however, we found a weak association with oral health behaviors (OHBs). We hypothesize that this may be due to social desirability bias (SDB). Our objectives were to compare caregivers’ responses to traditional OHB items and newer SDB-modulating items, and to examine the association of caregiver literacy with OHBs.

Methods

We performed a cross-sectional study of 102 caregiver-child dyads, collecting data for OHBs using both traditional and new SDB-modulating items. We measured OHL using REALD-30, a validated word recognition test. We relied upon percent agreement and Cohen's kappa (k) to quantify the concordance in caregivers’ responses and multivariate log-binomial regression to estimate the impact of OHL on OHBs.

Results

Caregivers’ mean REALD-30 score was 20.7 (SD=6.0), range 1-30. We found an association between OHL and 4 of 8 OHBs examined. A subset of behavior questions compared traditional versus SDB-modulating items: history of bottle-feeding: agreement=95%, k=0.83 (95% CL:0.68,0.99); daily tooth brushing: agreement=78%, k=0.25 (95% CL:0.04,0.46); fluoridated toothpaste use: agreement=88%, k=0.67 (95% CL:0.49,0.85). After controlling for caregivers' race, marital status and study site, higher literacy scores remained associated with a decreased prevalence of parental report of "decided not brush the child’s teeth because it would be frustrating".

Conclusions

Agreement between responses was high for 2 of 3 behavior items. Item 3 (tooth brushing frequency) revealed discordance, likely due to SDB. Use of the SDB-modulating items appears to yield a better estimate of OHB.

Authors

Lauren A Sanzone, Jessica Y Lee, Kimon Divaris, Darren A DeWalt, A Diane Baker, William F Vann Jr

Journal

Published Date

2013-06-01

DOI:

https://doi.org/10.1186/1472-6831-13-24

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Bias in Caregiver Reporting of Children’s Oral Health Behaviors
Bias in Caregiver Reporting of Children’s Oral Health Behaviors

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