Fig. 1

MySmileBuddy program theoretical model. This figure presents the theoretical model that is used to guide the MySmileBuddy Program intervention and analysis of causal pathways through which the intervention exerts (or fails to exert) an influence on targeted behaviors. Mediators included are drawn from MySmileBuddy’s foundation in Social Cognitive Theory and the Health Belief Model. Social Cognitive Theory is based on a wide range of motivating and facilitating determinants. This theory provides extensive guidance on translating motivation into action through its emphasis on action self-efficacy and facilitating determinants. It emphasizes that individuals and their environments mutually influence each other, and so the environment must also be addressed. Health Belief Model focuses on the motivational determinants and the benefits and barriers to taking action and self-efficacy. It is useful for audiences and settings where the emphasis is on health. The included motivational determinants bolster parents’ motivation through increasing perceived threat of caries (both perceived susceptibility and seriousness) and promoting positive outcome expectations. Facilitating determinants are influenced by CHW efforts to increase parents’ ability to act on their motivation by demonstrating skills, enhancing self-efficacy to perform these skills, providing access to tooth brushes and toothpaste, and action goal setting. In addition to these psychosocial theories, three broad evidence-based targets from the Science of Behavior Change (SOBC) program relevant to understanding mechanisms to predict whether participants are successful at action goal setting, are included