Date of Award

Summer 8-2023

Document Type


Degree Name

Doctor of Philosophy (PhD)


Heath Services Research

Committee Director

Denise M. Claiborne

Committee Director

Deanne Shuman

Committee Member

Harry Zhang

Committee Member

Hadiza Galadima


Early childhood caries (ECC) remains one of the most common preventable diseases among children under the age of 6 years. Several national stakeholders recommend establishing a continuous collaboration of individuals involved with receiving oral health services (dental home) and routine dental care for the child by 12 months. Despite this recommendation, disparities exist among young, low-income children in preventive dental service utilization. The Early Head Start (EHS) program serves low-income children aged 0-3 years and their families and promotes oral health practices and service utilization within the program. This study aims to examine predictors of dental care utilization among children participating in U.S.EHS programs utilizing Andersen’s Behavioral Model of Health Services Use.

Early Head Start Family and Child Experiences Survey (Baby FACES) data from Spring 2009 was used for the analysis. Data were collected on a sample of 782 one-year-old cohort group of children enrolled in 89 U.S. EHS programs. The primary independent variables were constructs from Anderson’s Behavioral Model of Health Services Use: predisposing characteristics (mother’s age, race, education, and employment), enabling resources (family income, public assistance, WIC, public health insurance, and EHS program’s services), and need (household member couldn’t see a dentist). The dependent variable was the parent’s report of the child’s dental visit. Descriptive statistics, chi-square, and logistic regression models were used to examine the key variables.

The predisposing, enabling, and need variables were insignificant in predicting the use of dental services by EHS-enrolled children. However, this study found that only about a quarter of EHS-enrolled children followed the recommendations of age-one dental visits, as reported by parents in 2009. The EHS programs are important stakeholders in promoting age-one dental visit for children in order to establish a dental home and prevent ECC. Further research is needed utilizing a more recent dataset and larger sample size to better understand the predictors of dental service use among EHS-enrolled children.


In Copyright. URI: This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).