Objectives. The aim of this study was to examine caregivers’ refusal of preventive medical and dental care for children.Methods. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs).Results. The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05).Conclusions. Caregiver refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children.
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机译：目标。这项研究的目的是检查护理人员对儿童预防性医疗和牙科护理的拒绝。根据牙科记录和看护者的自我报告，估计了华盛顿州3家牙科诊所接受治疗的儿童的局部氟化物拒绝使用率。对1024个看护者进行了60个项目的调查，以评估免疫与局部拒绝氟化物之间的关联。修改后的Poisson回归模型用于估计患病率（PRR）。根据牙科记录，局部拒绝氟的患病率为4.9％，而根据护理者的自我报告，则为12.7％。免疫拒绝率为27.4％。在回归模型中，免疫拒绝与局部氟化物拒绝显着相关（牙科记录PRR = 1.61； 95％置信区间[CI] = 1.32，1.96； P <.001；照顾者自我报告PRR = 6.20; 95％CI = 3.21，11.98； P ＜0.001。 35岁以下的照料者比老年照料者拒绝接种疫苗和局部使用氟化物的可能性要高得多（P <0.05）。照顾者拒绝免疫与局部拒绝氟化物有关。未来的研究应确定与照顾者拒绝预防护理有关的行为和社会因素，目的是开发多学科策略以帮助照顾者为儿童做出最佳的预防护理决策。
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