Theory-Based Digital Intervention for Low-Income Caregivers of Young Children Encourages Short-Term Improvements in Diet Quality and Dental Health Behaviors

Objectives: To assess pre-post change in diet quality and dental health behaviors across a 5-week, tailored, theory-based digital program for low-income caregivers of young children. Methods: Caregivers of 2 to 6-year-old children were recruited from community agencies for a pre-post study. First, caregivers completed an online survey aligned with the information, motivation, and behavioral skills (IMB) model that delivered tailored nutrition and dental health messages. Then, they set ∼3 diet and dental goals during a nutritionist-led motivational interview (MI), received 4 additional weeks of goal-promoting messages (email/text, 3-5/week), and completed a post-intervention survey (week 5). Primary outcomes were pre-post changes in diet quality and brushing/flossing behaviors. Secondary outcomes were changes in knowledge (7-item test) and self-monitoring constructs of motivation (±100 facial hedonic scale), behavioral skills (±100 confidence scale), and stage of change. Results: Of caregivers who completed a MI (n=107), 85 (79%) completed the week 5 survey. In repeated measures ANOVA, controlling child age category (< 4 vs ≥4 years) and food security (yes/no), there were improvements in liking- and frequency-based diet quality, significant in children aged ≥4. From baseline to week 5, more children met brushing (2/day, 68 to 80%) and flossing recommendations (1/day, 44 to 79%). Knowledge scores significantly increased (78±.02% to 81±.02% correct). Most caregivers completed self-monitoring: 66% reported motivation, 74% confidence, and 55% stage of change for the set goals. In weeks 1 to 4, average motivation stayed in the "love to" range, significantly dropping from week 1 to 2 and gaining from week 2 to 4. Average confidence ranged as "very confident" without significant change from week 2 to 4. Caregivers in the action stage for all set goals peaked at week 1 (69%), dropped at week 2 (44%), and climbed from week 3 (53%) to 4 (59%). Conclusions: Caregivers showed reasonable intervention and self-monitoring engagement to promote short-term improvements in diet quality and dental health behaviors. Preliminary findings need testing in a randomized controlled trial with attention to less engaged caregivers. Funding Sources: Colgate Palmolive Fellowship in Nutrition, Oral Health/Dental Education from the Academy of Nutrition and Dietetics Foundation.