Self-efficacy and self-rated oral health among pregnant aboriginal Australian women

BACKGROUND Self-efficacy plays an important role in oral health-related behaviours. There is little known about associations between self-efficacy and subjective oral health among populations at heightened risk of dental disease. This study aimed to determine if low self-efficacy was associated with poor self-rated oral health after adjusting for confounding among a convenience sample of pregnant women. METHODS We used self-reported data from 446 Australian women pregnant with an Aboriginal child (age range 14-43 years) to evaluate self-rated oral health, self-efficacy and socio-demographic, psychosocial, social cognitive and risk factors. Hierarchical entry of explanatory variables into logistic regression models estimated prevalence odds ratios (POR) and 95% confidence intervals (95% CI) for fair or poor self-rated oral health. RESULTS In an unadjusted model, those with low self-efficacy had 2.40 times the odds of rating their oral health as 'fair' or 'poor' (95% CI 1.54-3.74). Addition of socio-demographic factors attenuated the effect of low self-efficacy on poor self-rated oral health by 10 percent (POR 2.19, 95% CI 1.37-3.51). Addition of the psychosocial factors attenuated the odds by 17 percent (POR 2.07, 95% CI 1.28-3.36), while addition of the social cognitive variable fatalism increased the odds by 1 percent (POR 2.42, 95% CI 1.55-3.78). Inclusion of the behavioural risk factor 'not brushing previous day' attenuated the odds by 15 percent (POR 2.11, 95%CI 1.32-3.36). In the final model, which included all covariates, the odds were attenuated by 32 percent (POR 1.80, 95% CI 1.05, 3.08). CONCLUSIONS Low self-efficacy persisted as a risk indicator for poor self-rated oral health after adjusting for confounding among this vulnerable population.