Fluoride Varnish Acceptability and Dental Therapy Visit Completion Among Ghanaian Caregivers: A Discrete-Choice Experiment on Hygiene Service Attributes

Caregiver acceptance of fluoride varnish and completion of dental therapy visits are jointly determined by how preventive services are configured, yet the two outcomes are typically studied in isolation. The design varied five attributes: provider cadre, travel time, out-of-pocket cost, varnish application setting, and recall interval. A conditional logit model was estimated on 162 caregiver responses. The sample was predominantly female (78.4%), urban (61.7%), and had at least secondary education (54.3%). Mean caregiver age was 34.2 years (SD 7.8). The model fit was adequate (McFadden's pseudo-R² = 0.31; log-likelihood = −487.2). All five attributes were statistically significant at p < 0.05. Caregivers strongly preferred dental therapists over community health workers (β = 0.84, SE = 0.11, p < 0.001) and preferred varnish application in a school setting over a clinic (β = 0.52, SE = 0.09, p < 0.001). Cost sensitivity was substantial (β = −0.006 per Ghana cedi, SE = 0.001, p < 0.001). Predicted completion probability ranged from 0.41 to 0.89 across attribute configurations. The findings suggest that task-shifting varnish to community health workers without addressing caregiver preferences for provider cadre may depress visit completion, and that school-based delivery is a promising configuration for improving both acceptability and completion.