{"doi":"10.1136/bmjopen-2021-059665","title":"HABIT: Health visitors delivering Advice in Britain on Infant Toothbrushing – an early-phase feasibility study of a complex oral health intervention","abstract":"<jats:sec>\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>To conduct an early-phase feasibility study of an oral health intervention, Health visitors delivering Advice on Britain on Infant Toothbrushing (HABIT), delivered by Health Visitors to parents of children aged 9–12 months old.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Design</jats:title>\n                  <jats:p>A mixed-methods, early-phase, non-controlled, feasibility study.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Participants</jats:title>\n                  <jats:p>Recruitment consisted of Group A—HABIT-trained Health Visitors (n=11) and Group B—parents of children aged 9–12 months old about to receive their universal health check (n=35).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Setting</jats:title>\n                  <jats:p>Bradford, West Yorkshire, UK.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention</jats:title>\n                  <jats:p>A multidisciplinary team co-developed digital and paper-based training resources with health visitors and parents of young children. The intervention comprised of two components: (A) training for health visitors to deliver the HABIT intervention and (B) HABIT resources for parents, including a website, videos, toothbrushing demonstration and a paper-based leaflet with an oral health action plan.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures</jats:title>\n                  <jats:p>Recruitment, retention and intervention delivery were analysed as key process outcomes for Groups A and B. Group B demographics, self-reported toothbrushing behaviours, dietary habits and three objective measures of toothbrushing including plaque scores were collected at baseline, 2 weeks and 3 months post intervention.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>HABIT intervention delivery was feasible. Although the intended sample size was recruited (Group A=11 and Group B=35) it was more challenging than anticipated. Retention of Group B participants to final data collection was satisfactory (n=26). Total compliance with toothbrushing guidelines at baseline was low (30%), but significantly improved and was maintained 3 months after the intervention (68%). Plaque scores improved post intervention and participants found video recording of toothbrushing acceptable. Dietary habits remained largely unchanged.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion</jats:title>\n                  <jats:p>This feasibility study has demonstrated that HABIT is an appropriate oral health intervention. Adaptions to the study design are recommended to maximise recruitment and data collection in a definitive study. These quantitative findings have demonstrated an early signal of impact for improved oral health behaviours for young children at high risk of decay.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number</jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN55332414\">ISRCTN55332414</jats:ext-link>.</jats:p>\n               </jats:sec>","journal":"BMJ Open","year":2022,"id":619791,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1599687,"name":"Faye Wray","orcid":null,"position":1,"is_corresponding":false},{"id":1599688,"name":"Ieva Eskyte","orcid":"0000-0001-9486-0033","position":2,"is_corresponding":false},{"id":1599689,"name":"Kara A Gray-Burrows","orcid":"0000-0002-1550-5066","position":3,"is_corresponding":false},{"id":1599690,"name":"Jenny Owen","orcid":null,"position":4,"is_corresponding":false},{"id":1599691,"name":"Amrit Bhatti","orcid":null,"position":5,"is_corresponding":false},{"id":1599692,"name":"Tim Zoltie","orcid":"0000-0003-3411-341X","position":6,"is_corresponding":false},{"id":237199,"name":"Rosemary McEachan","orcid":"0000-0003-1302-6675","position":7,"is_corresponding":false},{"id":1599693,"name":"Z Marshman","orcid":"0000-0003-0943-9637","position":8,"is_corresponding":false},{"id":497082,"name":"Sue Pavitt","orcid":"0000-0001-7447-440X","position":9,"is_corresponding":false},{"id":408990,"name":"Robert West","orcid":"0000-0001-7305-3654","position":10,"is_corresponding":false},{"id":1599694,"name":"Peter F Day","orcid":"0000-0001-9711-9638","position":11,"is_corresponding":false},{"id":1599686,"name":"Erin Giles","orcid":"0000-0001-8631-4809","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"HABIT: Health visitors delivering Advice in Britain on Infant Toothbrushing – an early-phase feasibility study of a complex oral health intervention","abstract":"<jats:sec>\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>To conduct an early-phase feasibility study of an oral health intervention, Health visitors delivering Advice on Britain on Infant Toothbrushing (HABIT), delivered by Health Visitors to parents of children aged 9–12 months old.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Design</jats:title>\n                  <jats:p>A mixed-methods, early-phase, non-controlled, feasibility study.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Participants</jats:title>\n                  <jats:p>Recruitment consisted of Group A—HABIT-trained Health Visitors (n=11) and Group B—parents of children aged 9–12 months old about to receive their universal health check (n=35).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Setting</jats:title>\n                  <jats:p>Bradford, West Yorkshire, UK.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention</jats:title>\n                  <jats:p>A multidisciplinary team co-developed digital and paper-based training resources with health visitors and parents of young children. The intervention comprised of two components: (A) training for health visitors to deliver the HABIT intervention and (B) HABIT resources for parents, including a website, videos, toothbrushing demonstration and a paper-based leaflet with an oral health action plan.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures</jats:title>\n                  <jats:p>Recruitment, retention and intervention delivery were analysed as key process outcomes for Groups A and B. Group B demographics, self-reported toothbrushing behaviours, dietary habits and three objective measures of toothbrushing including plaque scores were collected at baseline, 2 weeks and 3 months post intervention.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>HABIT intervention delivery was feasible. Although the intended sample size was recruited (Group A=11 and Group B=35) it was more challenging than anticipated. Retention of Group B participants to final data collection was satisfactory (n=26). Total compliance with toothbrushing guidelines at baseline was low (30%), but significantly improved and was maintained 3 months after the intervention (68%). Plaque scores improved post intervention and participants found video recording of toothbrushing acceptable. Dietary habits remained largely unchanged.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion</jats:title>\n                  <jats:p>This feasibility study has demonstrated that HABIT is an appropriate oral health intervention. Adaptions to the study design are recommended to maximise recruitment and data collection in a definitive study. These quantitative findings have demonstrated an early signal of impact for improved oral health behaviours for young children at high risk of decay.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number</jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN55332414\">ISRCTN55332414</jats:ext-link>.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36216423","pmcid":"PMC9557312","openalex_id":null,"authors":[],"funders":[{"funder_name":"Medical Research Council","grant_id":"MR/P017185/1","title":"Optimising an oral health intervention delivered by health visitors and establishing robust outcomes to measure its impact"},{"funder_name":"ARC","grant_id":"NIHR200166","title":null},{"funder_name":"National Institute for Health Research (NIHR)","grant_id":"ACF-2020-02-015","title":null}],"total_grants":3,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://bmjopen.bmj.com/content/bmjopen/12/10/e059665.full.pdf","host_type":"publisher"},{"url":"https://syndication.highwire.org/content/doi/10.1136/bmjopen-2021-059665","host_type":"publisher"},{"url":"https://doaj.org/article/cddb71abb87e46bbb6ba1abdd52af896","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9557312","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC9557312","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC9557312?pdf=render","host_type":"Europe_PMC"},{"url":"https://doi.org/10.1136/bmjopen-2021-059665","host_type":""},{"url":"https://pubmed.ncbi.nlm.nih.gov/36216423","host_type":""},{"url":"http://dx.doi.org/10.1136/bmjopen-2021-059665","host_type":""},{"url":"https://eprints.whiterose.ac.uk/id/eprint/192035/","host_type":""},{"url":"https://eprints.whiterose.ac.uk/id/eprint/192538/","host_type":""}],"fields_of_study":["03 medical and health sciences","0302 clinical medicine","Child","Child, Preschool","Feasibility Studies","Habits","Humans","Infant","Nurses, Community Health","Oral Health","Toothbrushing","United Kingdom"],"mesh_terms":["Humans","Feasibility Studies","Toothbrushing","Habits","Child","Child, Preschool","Infant","Oral Health","Nurses, Community Health","United Kingdom"],"keywords":["Public Health","Preventive Medicine","Community Child Health","Toothbrushing","R","Dentistry and Oral Medicine","Infant","Oral Health","Nurses, Community Health","United Kingdom","Habits","Child, Preschool","Medicine","Feasibility Studies","Humans","Child"],"sdg_mappings":[{"sdg_number":3,"sdg_label":"3. 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