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J Public Health Dent. 2014 Winter;74(1):64-70. doi: 10.1111/j.1752-7325.2012.00369.x. Epub 2012 Sep 21.

Encouraging early preventive dental visits for preschool-aged children enrolled in Medicaid: using the extended parallel process model to conduct formative research.

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  • 1Public Policy Center, University of Iowa, Iowa City, IA, USA Oral Health Sciences, University of Washington, Seattle, WA, USA Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, IA, USA Anthropology, University of Iowa, Iowa City, IA, USA Center for Health Outcomes and Prevention Research, Sanford Research, University of South Dakota, Sioux Falls, SD, USA.



Preventive dental visits for preschool-aged children can result in better oral health outcomes, especially for children from lower income families. Many children, however, still do not see a dentist for preventive visits. This qualitative study examined the potential for the Extended Parallel Process Model (EPPM) to be used to uncover potential antecedents to parents' decisions about seeking preventive dental care.


Seventeen focus groups including 41 parents were conducted. The focus group protocol centered on constructs (perceived severity, perceived susceptibility, perceived self-efficacy, and perceived response efficacy) of the EPPM. Transcripts were analyzed by three coders who employed closed coding strategies.


Parents' perceptions of severity of dental issues were high, particularly regarding negative health and appearance outcomes. Parents perceived susceptibility of their children to dental problems as low, primarily because most children in this study received preventive care, which parents viewed as highly efficacious. Parents' self-efficacy to obtain preventive care for their children was high. However, they were concerned about barriers including lack of dentists, especially dentists who are good with young children.


Findings were consistent with EPPM, which suggests this model is a potential tool for understanding parents' decisions about seeking preventive dental care for their young children. Future research should utilize quantitative methods to test this model.

© 2012 American Association of Public Health Dentistry.


behavioral research; oral health; prevention; qualitative research

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