الفهرس 
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Abstract
Background: Early childhood caries (ECC) is a highly prevalent health condition affecting young children in Egypt. Parental supervised brushing of children’s teeth is recommended during the preschool years, and thus, multiple interventions have already been developed to promote this oral hygiene behaviour, guided by various behavioral modification theories. However, the interventions are usually assessed as a package in randomized clinical trials (RCTs), without assessing the effectiveness of each separate component. Through the use of the Multi-phase Optimization Strategy (MOST) consisting of three distinct phases namely preparation, optimization and evaluation phases, the efficacy of each separate component can be assessed, and an optimized behavioural intervention can be developed, within specified key constraints. In the current study, MOST approach is proposed, to engineer an oral health behavior modification intervention, guided by the Theory of planned behavior (TPB).
Aim: To develop an optimized behavior modification intervention that fits within a predefined optimization objective using the MOST framework, to increase the engagement of mothers in brushing their pre-school children’s teeth. Behavioral change of mothers will be assessed via one clinical indicator which is the percent reduction of plaque index of their children.
Materials and Methods: Only the first two phases of the MOST strategy will be carried out in the current study. The first phase of this study will be the preparation phase. This comprises the development of a conceptual framework and conducting a feasibility/ pilot qualitative study consisting of three intervention components: Motivational interviewing (MI), Oral health promotion messages (OHPm), and Storytelling (ST). The second phase of the study is the optimization phase which constitutes a factorial trial of the three selected intervention components (MI, OHPm and ST). Each component will be set at two levels: yes (the intervention is applied) vs no (the intervention is not applied).
Analysis: The descriptive data will be collected and analyzed using SPSS version 25. A linear regression model will be used to assess the effect of the intervention components on percent reduction in plaque index. The selection of the combination of intervention components that will make up the new multi-component “optimized” intervention will follow procedures outlined in Collins et al.
Keywords: MOST, optimization trial, preparation phase, oral hygiene, motivational interviewing, storytelling, behavioural intervention, oral health promotion.