Feasibility and preliminary outcomes of a culturally adapted motivational interviewing intervention to reduce early childhood caries among children of two American Indian communities

Objective: Early childhood caries (ECC) are prevalent among ethnic minoritized children in the US. Specifically, American Indian/Alaska Native (AI/AN) children face the highest burden of ECC compared to other children. Oral health (OH) interventions using adapted Motivational Interviewing (MI) to educate AI/AN parents/caregivers have demonstrated some promise. This study assessed the feasibility and short-term impact of a culturally adapted MI intervention designed for AI/AN pregnant women and mothers with young children. Methods: We partnered with two tribal Community Advisory Boards who helped culturally tailor program materials including adapted MI sessions. Community Health Representatives (CHRs) from both tribes were trained in adapted MI and conducted the OH education sessions with eligible mothers. OH knowledge and attitude assessments were conducted before and after the adapted MI sessions. Results: CHRs were able to recruit participants and implement the intervention as intended. Following the adapted MI sessions, we observed increases in general OH knowledge and modest increases in ratings of the importance of oral hygiene, oral self-efficacy, and perceived benefits of engaging in recommended OH behavior. No post-MI changes were observed in perceived severity of, or susceptibility to, OH problems. Conclusions: This study demonstrated the feasibility of developing and implementing a culturally tailored, MI-based OH intervention for AI/AN caregivers, resulting in improved OH knowledge and self-efficacy. Given no significant change in other outcome variables, suggests a need for longer-term follow-up and integration with additional preventive strategies (e.g., fluoride varnish). Future research should explore the effectiveness of MI-based approaches in reducing ECC incidence over time.