Sustainability of Supervised Toothbrushing in Israeli Nurseries - Teachers' Perspective

Purpose: The national supervised toothbrushing programme was implemented in 2015-2016 among 3- to 4-year-old children attending 600 nurseries in Israel. The objectives of this study were to assess factors associated with sustainability of programme implementation, based on nursery teachers' attitudes towards the programme, beliefs in its success and willingness to continue it in in the future. Materials and Methods: A phone survey was conducted among nursery teachers participating in the programme. Study objectives were assessed using a 19-item structured questionnaire. A linear regression model was built to identify factors which contributed to the positive attitude of the teachers towards programme sustainability. Results: Some 300 teachers were interviewed over the telephone. The programme was implemented daily or several times a week in 66% of the nurseries. Around 70% of teachers reported willingness to continue the programme in the future. Teachers' confidence in programme success (r = 0.73), acknowledgment of their role in teaching children to brush their teeth (r = 0.53), tendency to like teaching toothbrushing (r = 0.59) were positively associated with their willingness to continue the programme. Teachers who anticipated more problems were less willing to implement the programme in the future (r = -0.34). Statistically significant differences in frequency of programme implementation were found according to teachers' attitudes towards the programme. A strong relationship (adjusted r2 = 0.71) was found between the teacher's positive perception of programme sustainability and the attribute variables. The degree of interest in continuing a programme and the belief in their ability to operate it attributed most to teachers' positive perception of programme sustainability. Conclusion: A high percentage of teachers expressed a positive attitude towards the programme. Factors contributing to the positive attitude of teachers towards programme sustainability were identified. The survey's results may help in the implementation of similar programmes and contribute to their future success. Keywords: community programme, caries, prevention, children, primary healthcare