Table 3.

Cognitive Interview Guide

Parent-Reported Oral Physical Health
Oral-Facial Appearance	My child’s teeth are: Please check all that apply	Bright white
		Some yellow
		Some green
		Some brown
		Some black
		How did you decide upon the color of your child’s teeth?
	My child’s teeth are:	Straight with no spaces
		Straight but with spaces
		Crooked or Crowded
		What were you thinking about when you selected your answer?
	When I look at my child’s teeth:	I am happy about how they look
		I feel they could look better
		I am unhappy with the way they look
		What were you thinking about when you selected your answer?
	Bad breath for my child is:	Always a problem
		Sometimes a problem
		Never a problem
		What were you thinking about when you selected your answer?
Oral Pain	Over the past year, did your child have pain in the teeth or mouth?	YES/NO.
	If YES, how often?	S/he had it once or twice over the school year
		S/he has it often during the year
		Sh/e has it every day or almost every day over the school year
		What were you thinking about when you selected your answer?
	Where was the pain? Please check all that apply	Mouth
		Teeth
		Jaw
		Face
		How did you decide upon your answer?
Parent-Reported Oral Mental Health
Dental Phobia	Did your child ever refuse to go to a dentist because s/he was afraid of: Please check all that apply	Getting needles
		Drilling
		Having your teeth pulled
		Having to keep your mouth opened for a long time
		Gagging or choking
		Feeling numb
		Feeling sick
		My dentist
		What were you thinking about when you selected your answer?
Dental Anxiety	Did your child ever worry about problems with his/her teeth?	YES/NO
	If YES, What did s/he worry about? Please check all that apply.	Teeth are going to give him or her pain
		Decayed or rotten teeth
		Teeth that don’t look good
		Teeth that are going to fall out
		Other
		What were you thinking about when you selected your answer?
	Have you avoided taking your child to the dentist because of your own concerns?	YES/NO
	If YES, What were they?	Use of needles by the dentist
		Drilling by the dentist
		Having the child’s teeth pulled
		Having the child keep his or her mouth opened for a long time
		Gagging or choking by the child
		The child feeling numb
		The child getting sick from the treatment
		I didn’t like the dentist
		What were you thinking about when you selected your answer?
Oral Health Beliefs and Behaviors
Developmental Outcomes	Good oral health is important to my child’s overall health?	Disagree
		Agree somewhat
		Strongly Agree
		Why?
	Good oral health is important for my child’s overall happiness?	Disagree
		Agree somewhat
		Strongly Agree
		Why?
Longevity	If I don’t help my child care for his/her teeth, his/her life will be:	Shorter by many years
		Shorter by a few years
		About the same
		Why?
Life Chances	If my child maintains good oral health, s/he will have a better chance of getting into college and having a successful career.	Disagree
		Agree Somewhat
		Agree Strongly
		What were you thinking about when you selected your answer?
Efficacy	By reminding my child to brush his/her teeth, it will help:	Improve his/her oral health
		Maintain his/her oral health
		Won’t make any difference to his/her oral health
		Why?
	When my child had a recent oral health problem:	I was able to take care of it myself
		I could not take care of it, and let it go at that
		I could not take care of it, and sought dental care
		My child did not have a recent oral health problem
		What were you thinking about when you selected your answer?
	I am able to make a difference to my child’s oral health	Disagree
		Agree Somewhat
		Agree Strongly
		How?
	I can do many things to prevent oral health problems in my child.	Disagree
		Agree Somewhat
		Agree Strongly
		What can you do?
	Before my child goes to sleep, I remind him/her to brush:	Always
		Sometimes
		Never
		What were you thinking about when you selected your answer?
General Well-Being	Thinking about the last week…
	Has your child been in a good mood?	Never
		Seldom
		Quite Often
		Very Often
		Always
		Why?
	Has life been enjoyable?	Not at all
		Slightly
		Moderately
		Very
		Extremely
		Why?
	Has your child had enough time for him/herself?	Never
		Seldom
		Quite Often
		Very Often
		Always
		Why?
	Has your child had fun with your friends?	Never
		Seldom
		Quite Often
		Very Often
		Always
		Why?
Parent-Reported Oral Social Health
Social Relationships	If my child’s teeth and mouth are unhealthy, his/her friends:	Will still hang out with him/her
		Will probably avoid him/her
		Will definitely avoid him/her
		What were you thinking about when you selected your answer?
Social Influences
Social Comparison - Peers	Compared to other kids my child’s age:	S/he has better oral health
		S/he has the same oral health
		S/he has worse oral health
		What were you thinking about when you selected your answer?
Social Network Influences	In addition to me, the most important influences on my child’s oral health are:	Friends
		Brothers and sisters
		Other family members
		Dentists
		Teachers
		Medical Providers
		What were you thinking about when you selected your answer?
	The most important social influence my child’s oral health is:	Role models on TV and movies
		Advertising and media messages
		Health education in school
		Why?