Application of transtheoretical model to assess the compliance of chronic periodontitis patients to periodontal therapy

Dental cleaning behavior and related factors among hemodialysis patients in the West of Iran: A cross-sectional study

OBJECTIVES

Oral health-related behaviors in hemodialysis patients are reduced, potentially leading to adverse consequences. The aim of the present study was to evaluate dental cleaning behavior (DCB) and related factors among hemodialysis patients.

METHODS

This cross-sectional study was carried out in Sanandaj city, in the west of Iran in 2022. Using the census method, 115 hemodialysis patients from the dialysis center of Tohid Hospital were recruited. Data were gathered by a three-section questionnaire. The first section included demographic characteristics, the second section involved variables related to the health belief model (HBM), and the third section assessed stages of DCB change based on the trans-theoretical model. Analysis of data was done by assessing frequency, descriptive and inferential statistics such as t test, correlation coefficient, and regression.

RESULTS

Only 26.1% of participants reported DCB, defined as tooth brushing at least twice daily; 30.4% were in the precontemplation stage, 26.1% in contemplation, and 17.4% in the preparation stage. Perceived self-efficacy was lower among patients who did not perform DCB. The odds of DCB increased with perceived self-efficacy (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.19-1.92, p < .05), cues to action (OR = 1.63, 95% CI = 1.03-2.55, p < .05), and decreased with perceived barriers (OR = 0.68, 95% CI = 0.47-0.97, p < .01).

CONCLUSIONS

DCB of patients on hemodialysis requires improvement. Perceived self-efficacy, cues to action, and perceived barriers constructs of the HBM should be considered in interventional programs targeting to increase oral health as well as in future research in the field.

Theory-based behavioral change interventions to improve periodontal health

Periodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand patient psychology and promote self-care and treatment compliance. In addition to their uses in classifying, explaining and predicting oral hygiene practices, behavioral models have been adopted in the design of oral hygiene interventions from individual to population levels. Despite the growing focus on behavioral modification in dentistry, the currently available evidence in the field of periodontology is scarce, and interventions have primarily measured changes in patient beliefs or performance in oral hygiene behaviors. Few studies have measured their impact on clinical outcomes, such as plaque levels, gingival bleeding and periodontal pocket reduction, which serve as indicators of the patient's disease status and quality of oral self-care. The present narrative review aims to summarize selected literature on the use of behavioral models to improve periodontal outcomes. A search was performed on existing behavioral models used to guide dental interventions to identify their use in interventions measuring periodontal parameters. The main models were identified and subsequently grouped by their underlying theoretical area of focus: patient beliefs (health belief model and cognitive behavioral principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioral change (health action process approach model, theory of planned behavior and client self-care commitment model); and self-monitoring (self-regulation theory). Key constructs of each model and the findings of associated interventions were described. The COM-B model, a newer behavioral change system that has been increasingly used to guide interventions and policy changes, is discussed with reference to its use in oral health settings. Within the limitations of the available evidence, interventions addressing patient beliefs, motivation, intention and self-regulation could lead to improved outcomes in periodontal health. Direct comparisons between interventions could not be made due to differences in protocol design, research populations and follow-up periods. The conclusions of this review assist clinicians with implementing psychological interventions for oral hygiene promotion and highlight the need for additional studies on the clinical effects of behavioral model-based interventions.

Multiple Unhealthy Behaviors Share Equivalent Profiles of Readiness for Change in Patients with Type 2 Diabetes

Few studies have considered more than one behavior, despite the tendency towards multiple behaviors, and there are none that have focused on a Latino population. We determined the concurrence of four unhealthy behaviors related to glycemic control and identified common cognitive factors at advanced stages of readiness for change in patients with type 2 diabetes treated in primary care. A cross-sectional study was carried out during August–December 2018 in northeastern Mexico. We consecutively included patients between 20 and 70 years who were without medical contraindication, physical impediment against exercise, pregnancy and edentulism, among other selection criteria (n = 407). Stages of behavior were measured according to the Transtheoretical Model. Pros, cons, self-efficacy, susceptibility, and severity data were collected by interview. Statistical analysis consisted of descriptive statistics and multiple logistic regression. A total of 36.7% exhibited more than one unhealthy behavior in precontemplation or contemplation (no interest or some interest in changing consumption of refined sugars and saturated fats, exercise, or oral hygiene behavior). Cons (p < 0.05) and self-efficacy (p < 0.001) were common to all four unhealthy behaviors, independent of potential confounders. Studies like ours facilitate the recognition of individuals with multiple unhealthy behaviors who share equivalent profiles of readiness for change before implementing public health programs.

Effect of a motivational video on flossing behaviour: A pilot study

OBJECTIVES

Motivational interviews used for health behavioural change requires several sessions and expert consultations. A practical method is needed to promote oral hygiene habits. The aim of the study was to develop a video as a new motivational intervention method combining several health behaviour change theories to improve flossing behaviour.

METHODS

A questionnaire about individual psychosocial characteristics was conducted to 30 volunteer dental patients. Plaque index (PI) scores were calculated and a video about flossing was shown the patients. The second PI measurements were performed after 2 months. The video including flossing instructions and expressions of performers acting dental patients was produced to test as a motivational method. Cues used in the video were generated according to health behaviour change theories and models under the supervision of an expert team. Content validity ratio (CVR) and content validity index (I-CVI) of the video and reliability of the questionnaire was determined. First and second PI scores were compared to assess the effect of the video. Correlation between answers of the questionnaire and PI changes were tested.

RESULTS

The average I-CVIs of the video was 0.93, CVR of video items was 1, I-CVIs of 5 items was 80% and of 10 was 100%. Cronbach's alpha of the questionnaire was 0.93. PI scores significantly decreased after 2 months (p < 0.001).

CONCLUSION

A single session motivational intervention via a video based on health psychological models and theories was efficacious in improving oral hygiene and flossing behaviour in the short term.

The Process Of Farmers' Occupational Health Behavior by Health Belief Model: Evidence From Iran

Farm work is considered among the highest risk jobs throughout the world. Occupational health behavior is a critical factor that influences agricultural job-related injuries and diseases. Yet, while educational programs have been set up to encourage farmers to behave more safely, many of these programs do not sufficiently take into account the factors that induce farmers to exhibit risky behavior. The present study aimed to explore the factors underpinning farmers' occupational health behavior using the Health Belief Model (HBM). The study was conducted using aquestionnaire survey of 382 farmers representative of the farmers of Kermanshah province, Iran. The face and content validity of the questionnaire was confirmed by apanel of experts in occupational health, and its reliability by apilot study establishing internal consistency measured by Cronbach's alpha. The results showed that four dimensions of the HBM (perceived susceptibility, perceived benefits, cues to action, and perceived self-efficacy) influence farmers' occupational health behavior (FOHB), with the theoretical model accounting for 54.9% of the variance of FOHB. The findings confirm the potential of the HBM to explain FOHB and the relevance of using the theory in studying farmers' protective behaviors such as the use of chemical pesticides, protection against sunlight, protection of hearing, etc.