Psychosocial stress within the household has been associated with how often children brush their teeth. Community health worker (CHW) programs that address psychosocial challenges in vulnerable communities have likewise been connected to shifts in various health behaviors. Examine longitudinal changes in psychosocial factors and explore the relationship between these factors and the dose of community health worker (CHW) intervention received among families living in urban Chicago. A total of 420 families were enrolled from 10 community clinics and Infants, Children and 10 Women (WIC) centers across Cook County, Illinois, to take part in a clinical trial. At baseline, 12 months and 6 months, research staff gathered caregiver-reported psychosocial measures—including family functioning, and levels of depression, anxiety, social support, and social functioning—as well as details about the CHW-delivered oral health visits, such as the number of visits, topics covered, and child participation. After each home visit, CHWs documented their field observations concerning the household setting, social conditions, stressors, and available supports. Across the sample, participants generally reported psychosocial measures that aligned with population-average levels on nearly all indicators, and these values remained stable throughout the study period. Social functioning was the only domain rated below average, with scores of 32.0 (6.9), 32.1 (6.7), and 32.7 (6.9) at baseline, 6 months, and 12 months, respectively, compared to a population mean of 50 (SD = 10). No notable differences in social functioning over time were detected based on the number of CHW visits received (control group and those receiving 0–4 visits). CHW field notes, however, highlighted a variety of psychosocial stressors linked to economic hardship, language challenges, and immigration-related issues. The finding that psychosocial measures appeared average and remained stable over time—despite CHW field notes indicating substantial stressors related to poverty, limited support, immigration challenges, and language barriers—suggests that our study may not have effectively captured key social determinants influencing oral health behaviors, or that measurement limitations may have led to inaccurate reporting. Upcoming research will use a broader set of tools to evaluate psychosocial elements such as social support, anxiety, depression, trauma, functioning, and resilience within this urban population. In addition, we plan to examine neighborhood-level indicators of distress and resilience to more fully integrate the social ecological framework into understanding child oral health behaviors.
