Effect combined learning on oral health self-efficacy and self-care behaviors of students: a randomized controlled trial

Effectiveness of a school-based educational intervention on oral health knowledge, attitudes, practices, and self-efficacy among female secondary school students: a randomized controlled trial

INTRODUCTION

Oral health is crucial during adolescence, yet many young individuals engage in suboptimal oral hygiene behaviors, contributing to oral health issues. While genetics may have some influence, lifestyle factors such as diet, preventive care, and oral hygiene practices play a more critical role in the development of dental caries. The World Health Organization recognizes oral health as a lifelong cornerstone of overall well-being. This study aimed to evaluate the effectiveness of a school-based educational intervention for improving oral health knowledge, attitudes, practices, and self-efficacy among female secondary school students in Kashan, Iran.

METHODS

This randomized controlled trial was conducted in 2023 with 80 female students aged 12 years from two public schools at Kashan. The participants were selected via cluster sampling and randomly assigned to either the intervention group (n = 40) or the control group (n = 40). Data were collected at baseline, one month postintervention, and three months postintervention via a standardized questionnaire administered to both groups. The intervention consisted of four weekly 90-minute educational sessions led by a dentist and a health education specialist, with a focus on oral health knowledge, attitudes, practices, and self-efficacy. Additionally, the intervention group received a digital educational booklet, while parents were provided with a checklist to monitor their children's tooth brushing and flossing behaviors. The control group did not receive any educational intervention or a checklist for tracking oral hygiene behaviors during the study period. Dental plaque levels were assessed via plaque-disclosing tablets (PDTs) at baseline and three months postintervention. Data analysis was performed via SPSS version 24, which employs the chi-square test, Wilcoxon test, Mann‒Whitney test, and Friedman test.

RESULTS

There was a significant difference between the intervention and control groups in all the measured variables after the intervention (p < 0.001). Postintervention, the intervention group demonstrated significant increases in mean scores for oral health knowledge (from 5.4 to 9.3), attitudes (from 55.6 to 62.1), self-efficacy (from 53.5 to 62.7), and practices (from 28.0 to 33.4) (p < 0.05). No significant changes were observed in the control group (p > 0.05). There was a significant difference between the intervention and control groups in all the measured variables after the intervention (p < 0.001). The average score of dental plaque was significantly different between the two groups (p < 0.001). The Wilcoxon test revealed that after the intervention, the test group had improved indicators, and the control group had increased dental plaque scores.

CONCLUSION

The educational intervention effectively enhanced oral health knowledge, attitudes, self-efficacy, and practices among female students. The incorporation of such interventions into school health programs may promote long-term improvements in oral health behaviors among adolescents.

TRIAL REGISTRATION

Clinical Trial Registry (IRCT code: IRCT20180827040889N1), registered on 27/01/2024.

Self-efficacy and healthy lifestyle behaviors as mediators between COVID-19 care knowledge and health status

The COVID-19 epidemic has affected the psychological well-being and daily life of college students, leading to a decrease in their quality of life. Health status can be influenced by a variety of factors. This study aims to assess the current health status of university students and explore the relationships among COVID-19 care knowledge, self-efficacy, healthy lifestyle behaviors, and health status and how these factors are influenced. Among the 1694 participants, 49.4% were male, 50.6% were female, and 82.2% were freshmen. The results revealed that health status across all dimensions decreased to some extent. COVID-19 care knowledge affected both physical and mental component summaries. The results suggest that improving COVID-19 care knowledge, strengthening self-efficacy, and promoting the development of healthy lifestyle behaviors can positively impact their health status. Here, we explore the health status of college students with COVID-19 infection and the factors and mechanisms that influence it to guide health interventions to better meet the challenges posed by future outbreaks.

The Effect of the Continuous Care Model on Oral Health, Self-Efficacy, and Self-Care in Patients With Head and Neck Cancer Undergoing Radiotherapy: A Study Protocol for a Quasi-Experimental Study

Background and Aims

Head and neck cancer, with its unique challenges, often involves radiotherapy as a primary treatment. This can lead to complications affecting patients' well-being. A continuous care model offers potential benefits, but its effectiveness requires validation through rigorous studies. This protocol aims to evaluate its impact on patients undergoing head and neck cancer radiotherapy, contributing to improved care strategies and well-being.

Methods

The study is a double-arm and parallel-group quasi experimental study in which a 4-week intervention will be compared with usual care. A total of 70 eligible patients with head and neck cancer who are undergoing radiotherapy will be recruited to the intervention or control group. The patients in the intervention group will receive a continues care model designed for head and neck cancer patients in four phases of Orientation, Sensitization, Control, and Evaluation. The primary outcomes include dental plaque and gingival index, which will be measured by an approved dentist using The Gingival and Quigley-Hein index. The secondary outcomes are Oral hygiene self-efficacy and Dental and Oral Health Self-Care Behavior which will be assessed by the Oral and Dental Health Self-Efficacy and Dental and Oral Health Self-Care Behavior Questionnaires. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests, including two-sample t-tests, Χ 2, analysis of covariance, or linear regression will be performed.

Conclusion

In conclusion, this study aims to evaluate the impact of a continuous care model on head and neck cancer patients undergoing radiotherapy. Findings will contribute to enhancing care strategies and well-being in this population.

Ethics and Dissemination

The trial has been approved by the Research Ethics Committees of Zahedan University Of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals.

The effect of educational intervention based on self-efficacy theory on promoting adolescent oral health behaviors through mobile application: a randomized controlled trial study

BACKGROUND

Oral health is so important for the adolescent age group that the World Health Organization has listed oral health as a lifelong prerequisite for maintaining public health; Therefore, this research was carried out with the aim of the effect of educational intervention based on self-efficacy theory on the promotion of behaviors related to oral health of adolescents through mobile application.

METHODS

In this clinical trial, 80 adolescents aged 13-15 years from Shushtar city were selected using a random cluster sampling method and assigned to either the test or control group. The data collection tools included a standard questionnaire for measuring Oral health behavior (awareness, attitude, behavior) and a standard questionnaire for measuring self-efficacy (self-efficacy in brushing teeth, self-efficacy in using dental floss, and self-efficacy in visiting the dentist), as well as demographic characteristics. Training was provided to the test group via a mobile application for 3 weeks. During the intervention, the control group did not receive any training. Questionnaires were distributed in both groups immediately after the intervention, as well as one month and three months post-intervention, and data were collected. In accordance with research ethics, at the end of the study, the educational content was provided to the control group. Collected data were analyzed using SPSS 22 software and Mann-Whitney and Friedman non-parametric tests.

RESULTS

The findings showed that the educational intervention through the mobile application was effective in improving the average scores of awareness, attitude, self-efficacy in brushing teeth, flossing, visiting the dentist, and the behavior of adolescents regarding oral health behaviors, and this statistical difference was significant compared to before the educational intervention (P < 0.05), while no change was observed in the control group (p > 0.05).

CONCLUSION

Considering that adolescents aged 13-15 years are the age of starting behavioral habits, including oral health behaviors, and on the other hand, their interest in using technology and virtual spaces is high, it is suggested that part of the education of this age group should be designed and implemented in the platform of mobile application.

CLINICAL TRIAL

Registration in Iran Clinical Trial Center with ID code (IRCT20200120046204N1) Date of.

REGISTRATION

2018-02-25.

Social support, oral health knowledge, attitudes, practice, self-efficacy and oral health-related quality of life in Chinese college students

Oral health is crucial for health-related quality of life. However, the research on the factors affecting oral health status is not comprehensive enough. This investigation aimed to evaluate the multifaceted determinants of college students' oral health status and explore the impact of social support, oral health literacy, attitudes, behaviors, and self-efficacy on OHRQoL. By surveying 822 students from a university. Baseline data included sociodemographics (gender, age), social support (MSPSS scale), oral health self-efficacy (SESS scale), oral health knowledge, attitudes, and practices (KAP questionnaire), and OHRQoL (OHIP-14 scale). Based on social cognitive theory, partial least squares structural equation modeling (PLS-SEM) and fuzzy set qualitative comparative analysis (fsQCA) were used to examine the relationship between the study variables. PLS-SEM results showed that knowledge, attitude, and practice predicted OHRQoL through self-efficacy. FsQCA results showed that the combination of different variables was sufficient to explain OHRQoL. The conclusion was that self-efficacy plays an important role and the combination of high-level knowledge, positive attitudes, and strong self-efficacy was important in improving OHRQoL. The results of this study provided a reference for the oral health strategy planning of college students in China.

Using the Extended Theory of Planned Behavior to Assess Adults' Intentions of Preventive Dental Care

Objective

The objective of this study was to test an extended theory of planned behavior (TPB) that includes attitudes, subjective norms and self-efficacy, sociodemographic variables, dental beliefs and insurance on the intention to seek preventive dental care among adults in Makkah, Saudi Arabia.

Materials and Methods

This cross-sectional study was conducted on 397 Saudi adults living in Makkah. Data were collected through a self-administered online questionnaire. Structural equation modeling was performed to analyze the various factors that affect the likelihood of people seeking dental care.

Results

The results of the study revealed that perceived norms (estimate = 0.14; P = 0.004) and self-efficacy (estimate = 0.22; P < 0.001) were associated with the likelihood of people getting preventive dental care. However, attitudes showed no effect on the likelihood of people seeking dental care. The study also explained that the relationship between the beliefs of people and the intention to receive preventive care was moderated by subjective norms and perceived behavioral control (indirect effect t = 0.089, P < 0.001).

Conclusion

The study's results revealed that an integrative model of behavior prediction could be used to design effective interventions and strategies to enhance the likelihood of individuals seeking preventive dental care. In particular, these strategies should focus on enhancing subjective norms and self-efficacy.

Association of oral health knowledge, self-efficacy and behaviours with oral health-related quality of life in Chinese primary school children: a cross-sectional study

OBJECTIVE

Achieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This study aimed to explore the inter-relations between these oral health behaviour-related factors and OHRQOL in primary school children.

METHODS

In this cross-sectional study, 651 children in grades 2 and 3 were recruited in October 2020 from two primary schools in Minhang District, Shanghai, China. Data were collected through self-reported questionnaires, consisting of demographic characteristics, oral health knowledge, self-efficacy, oral health behaviours and OHRQOL. Pearson's correlation analyses were used to analyse the relationship between study variables. Structural equation models were used to test the inter-relations between OHRQOL and oral health behaviour-related factors.

RESULTS

Four hypothetical structural equation models were tested and one of them was selected as the most appropriate model, which explained 15.0% of the variance in OHRQOL. This selected model showed that oral health behaviours were directly related to OHRQOL. Oral health knowledge was indirectly associated with OHRQOL through both self-efficacy and oral health behaviours. Self-efficacy was directly associated with OHRQOL or was indirectly associated with OHRQOL through oral health behaviours.

CONCLUSION

This study revealed a pathway of association between children's oral health knowledge and their OHRQOL, in which children's oral health self-efficacy and behaviours had indirect effects. This provides a basis for understanding the mechanism of oral health promotion interventions to improve children's OHRQOL and helps to identify direct or indirect intervention targets.

Design and evaluation of two educational media in the form of animation and games to promote the cutaneous leishmaniasis prevention behaviors in adolescent female

BACKGROUND

Cutaneous leishmaniasis (CL) has social and psychological effects on different groups, especially adolescents and young girls in 98 countries of the world, in addition to the economic burden. Therefore, it is necessary to apply effective methods for CL prevention. In this study, educational messages were designed based on Extended Parallel Process Model in both forms of animation and game, whose effect on the cutaneous leishmaniasis prevention behaviors was evaluated in adolescent female students.  METHODS: This experimental study was carried out from January to September 2021 on 275 adolescent female students in Isfahan province, Iran. Cluster sampling method was used, and then the students were randomly divided into three groups, namely animation education, game education, and control groups. The educational intervention was performed with two new media in the form of animation and games. The data collected before and two months after the education through a valid and reliable researcher-made questionnaire were analyzed in SPSS24 software using statistical tests of ANOVA, Chi-square, paired t and analysis of covariance (ANCOVA).

RESULTS

The mean age of the participants was 14.07 ± 0.94. The mean scores of behavior in the animation group (60.60 ± 23.00), the game group (61.70 ± 22.05), and the control group (66.13 ± 24.62) were not significantly different prior to the education. However, after the education, there was a significant difference between the animation (80.66 ± 17.62) and game groups (82.58 ± 19.07) and the control group (69.79 ± 23.29) (P < 0.001). The mean scores of model constructs following the intervention (susceptibility, severity, response efficacy, and perceived self-efficacy) significantly increased in the animation and game groups compared to that in the control group (P < 0.05).

CONCLUSION

The results showed that if educational programs contain a combination of threat and efficiency messages, CL-preventive behaviors in adolescents increase. Providing similar educational content with both game and animation methods indicated that both methods had an almost same effect. Although animation production is more costly, it has the advantage of being used in periods and for other adolescents.

Pain and Avoidance during and after Endodontic Therapy: The Role of Pain Anticipation and Self-Efficacy

Background: Pain anticipation has been identified as a predictor of pain and avoidance with respect to endodontic therapy. Self-efficacy is also key to the development and maintenance of health behaviors and achieve patient adherence to treatment. However, the role of self-efficacy has not been studied yet in endodontic treatment. Methods: This study was conducted on 101 patients who needed root canal therapy. They had to fill a questionnaire before treatment registered pain anticipation and self-efficacy; during and after treatment were registered pain intensity and avoidance. Results: Pain anticipation explained pain during (Beta = 0.51, t = 5.82, p ≤ 0.001, [0.34, 0.69]) and after treatment (Beta = 0.38, t = 4.35, p ≤ 0.001, [0.21, 0.55]). Self-efficacy did not have an influence in pain values. Pain anticipation explained avoidance during (Beta = 0.51, t = 3.60, p ≤ 0.001, [0.23, 0.80]) and after treatment (Beta = 0.62, t = 4.29, p ≤ 0.001, [0.33, 0.91]). Self-efficacy had a significant role in avoidance during treatment (Beta = 0.12, t = 2.19, p ≤ 0.03, [0.01, 0.23]) with a strong moderation relationship between pain anticipation and avoidance when self-efficacy was medium (Beta = 0.44, t = 3.24, p = 0.002, [0.17, 0.72]) or high (Beta = 0.84, t = 3.5, p ≤ 0.001, [0.37, 1.33]). Self-efficacy was not significant respect to avoidance after treatment. Conclusions: Self-efficacy is an important variable in endodontic therapy due to their moderating effect between pain anticipation and avoidance behavior during the procedure. It is necessary to improve the results of root canal therapy and reduce patient’s avoidance in order to take into account this variable.