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van Nes KA, van Loveren C, Luteijn MF, Slot DE. Health action process approach in oral health behaviour: Target interventions, constructs and groups-A systematic review. Int J Dent Hyg 2023; 21:59-76. [PMID: 36208281 PMCID: PMC10092238 DOI: 10.1111/idh.12628] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/18/2022] [Accepted: 10/02/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to systematically map the Health Action Process Approach (HAPA)-based interventions in dentistry in relation to the type of intervention, the target groups and the constructs of the HAPA model that are used in the study and to assess the clinical relevance of the studies. METHODS A search in the databases of the National Library of Medicine (MEDLINE-PubMed), PsychINFO and Cochrane-CENTRAL was conducted. A quality assessment to estimate the risk of bias and a qualitative descriptive analysis were performed. The overall gathered evidence was graded. RESULTS Ten randomized controlled trials and three observational studies thus in total 13 studies were included. Flossing was the targeted behaviour in ten studies. The target groups consisted of students, adolescents and dental patients. Overall, all nine HAPA constructs were used, but only one study used all HAPA constructs. Six studies presented the used behavioural change techniques according to the BCT taxonomy. Based on the number of the used constructs, only two studies were classified as HAPA intervention studies. The most frequently used constructs were action control as an intervention and behaviour as an outcome measure. The overall evidence was graded with moderate certainty. CONCLUSION In the majority of the studies, the targeted intervention was flossing and the population consisted of students, adolescents and dental patients. All studies used only a selection of the HAPA constructs. Therefore, only a minority of the studies can be considered real HAPA intervention studies.
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Affiliation(s)
- Karin Alexandra van Nes
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Cor van Loveren
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Michiel Fridthjof Luteijn
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
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DeFulio A, Rzeszutek M. Delay discounting, probability discounting, and interdental cleaning frequency. BMC Oral Health 2022; 22:315. [PMID: 35906557 PMCID: PMC9335449 DOI: 10.1186/s12903-022-02328-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Interdental cleaning is recommended by dentists but many people do not floss regularly. The health benefits of interdental cleaning are delayed, and sensitivity to delay is an important factor in many health behaviors. Thus, the present studies explore the relationship between frequency of flossing, and sensitivity to delayed and probabilistic outcomes.
Method Crowd-sourced subjects were recruited in two studies (n = 584 and n = 321, respectively). In both studies, subjects reported their frequency of flossing and completed delay discounting and probability discounting tasks. Discounting was measured with area under the curve, and linear regression was used to analyze the results. Results Findings show that higher levels of delay discounting were associated with less frequent flossing (p < 0.001, both studies). In contrast, probability discounting was not significantly associated with flossing frequency (ns, both studies). Conclusion The findings are consistent with prior studies involving other health behaviors such as attendance at primary care and medication adherence. Results suggest that interventions that reduce delay discounting may help promote regular interdental cleaning, and that delay discounting is a more robust predictor of health behaviors than probability discounting. In addition, interdental cleaning appears to be a reasonable target behavior for evaluating potentially generalizable behavioral health interventions. Thus, interventions that are successful in promoting oral health behaviors should be considered as candidates for evaluation in other health behavior domains. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02328-6.
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Affiliation(s)
- Anthony DeFulio
- Department of Psychology, Western Michigan University, 1903 W Michigan Ave., Mail Stop 5439, Kalamazoo, MI, 49008, USA.
| | - Mark Rzeszutek
- Department of Psychology, Western Michigan University, 1903 W Michigan Ave., Mail Stop 5439, Kalamazoo, MI, 49008, USA.,University of Kentucky College of Medicine, Lexington, USA
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Rogers AA, Willumsen T, Strømme H, Johnsen JAK. Top-down self-regulation processes as determinants of oral hygiene self-care behaviour: A systematic scoping review. Clin Exp Dent Res 2022; 8:807-826. [PMID: 35396799 PMCID: PMC9382055 DOI: 10.1002/cre2.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 02/03/2022] [Accepted: 02/11/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives Understanding the psychological mechanisms that moderate oral hygiene self‐care behavior is anticipated to benefit efforts to change such behavior. Top‐down self‐regulatory (TSR) processes represent one group of relatively unexplored, yet potentially influential, moderating factors. This systematic scoping review aims to explore whether there is evidence that TSR processes moderate oral hygiene self‐care engagement within the current literature. Methods CINAHL, The Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus, and Web of Science databases were searched up to April 2020 for articles that compared measures of TSR processes (such as self‐monitoring, inhibitory control, and task switching) to oral hygiene self‐care behavior, or tested interventions that aimed to change or support TSR processes. Results The search returned 6626 articles, with 25 included in the final sample. Weak evidence supported both the role of TSR processes as moderators of interdental cleaning and the value of interventions targeting self‐monitoring of interdental cleaning behavior. Overall, methodological limitations rendered the findings somewhat inconclusive, with an absence of objective assessments of TSR capacity, and little focus on TSR processes as moderators of intervention effects. Conclusions The inconclusive, but reasonably promising, findings point to the value of continuing to apply TSR processes within studies of oral hygiene behavior. Exploring why interdental cleaning appears more reliant on TSR processes than toothbrushing, employing objective neuropsychological assessment, and measuring TSR constructs within interventions targeting TSR processes, are encouraged. As a scoping review, the study hopes to generate interest and serve as a starting point for further investigation.
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Affiliation(s)
- Adam A Rogers
- Institute of Clinical Dentisty, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Institute of Clinical Dentisty, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Strømme
- University of Oslo Library, University of Oslo, Oslo, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
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Santos-Puerta N, Peñacoba-Puente C. Pain and Avoidance during and after Endodontic Therapy: The Role of Pain Anticipation and Self-Efficacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031399. [PMID: 35162422 PMCID: PMC8834740 DOI: 10.3390/ijerph19031399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/31/2021] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Noelia Santos-Puerta
- Ph.D Program for Health Science, Rey Juan Carlos Doctoral College, C/Quintana, 2, 28008 Madrid, Spain;
| | - Cecilia Peñacoba-Puente
- Department of Psychology, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-4888-864
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Smith SR, Kroon J, Schwarzer R, Hamilton K. Social-cognitive predictors of parental supervised toothbrushing: An application of the health action process approach. Br J Health Psychol 2021; 26:995-1015. [PMID: 33656231 DOI: 10.1111/bjhp.12516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND We examined the social cognition determinants of parental supervised toothbrushing guided by the health action process approach (HAPA). METHODS In a prospective correlational survey study, participants (N = 185, 84.3% women) completed HAPA social cognition constructs at an initial time point (T1), and 12 weeks later (T2) self-reported on their parental supervised toothbrushing behaviour, toothbrushing habit, and action control. RESULTS Structural equation models exhibited adequate fit with the data when past behaviour and habit were either excluded or included. Intention, self-efficacy, planning, and action control were predictors of parental supervised toothbrushing; intention predicted action planning and coping planning; and self-efficacy and attitude were predictors of intention. Indirect effects of social cognition constructs through intentions, and intentions through planning constructs were also observed. Inclusion of past behaviour and habit attenuated model effects. CONCLUSION Results indicate that parental supervised toothbrushing is a function of motivational and volitional processes. This knowledge can be used to inform behaviour change interventions targeting parental supervised toothbrushing.
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Affiliation(s)
- Stephanie R Smith
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia
| | - Jeroen Kroon
- School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Ralf Schwarzer
- Department of Psychology, Freie Universität Berlin, Germany.,SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Kyra Hamilton
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia
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Scheerman JFM, Hamilton K, Sharif MO, Lindmark U, Pakpour AH. A theory-based intervention delivered by an online social media platform to promote oral health among Iranian adolescents: a cluster randomized controlled trial. Psychol Health 2019; 35:449-466. [PMID: 31621423 DOI: 10.1080/08870446.2019.1673895] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: Based on the Health Action Process Approach, we tested the efficacy of a theory-based program using an online social media platform (Telegram) to promote good oral hygiene behaviour among Iranian adolescents.Design: A three-arm randomized-controlled trial design was used, consisting of an adolescent only intervention group (A group; n = 253), an adolescent and mother intervention group (A + M group; n = 260), and a control group (n = 278).Main outcome measures: Psychosocial variables, toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index.Results: Increases in adolescent toothbrushing at the one- and six-month follow-ups in both intervention groups compared to the control group were observed. Adolescents in the A + M group showed significant greater improvements in their toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index scores than adolescents in the A group. Improvements to toothbrushing social cognitions were also observed.Conclusions: Current results support the use of the theory-based program delivered by Telegram in improving good oral hygiene behaviour and oral health outcomes among Iranian adolescents. Involving mothers in an intervention can confer additional benefits for adolescent oral health.
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Affiliation(s)
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Psychology, Curtin University, Perth, Australia
| | | | - Ulrika Lindmark
- Department of Natural Science and Biomedicine, Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Lee ASY, Standage M, Hagger MS, Chan DKC. Sport injury prevention in-school and out-of-school? A qualitative investigation of the trans-contextual model. PLoS One 2019; 14:e0222015. [PMID: 31490982 PMCID: PMC6730904 DOI: 10.1371/journal.pone.0222015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/20/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate junior secondary school students' experiences and perspectives of in-school and out-of-school sport-safety, with a particular focus on the meaning and content that they applied to the motivational and social cognitive factors of sport injury prevention. DESIGN Focus-group interview. METHOD Participants were 128 junior secondary school students (Form 1 to Form 3) aged between 12 and 16 years from two secondary schools. We organised focus-group interviews by class (group size = six to nine students). Seventeen groups completed semi-structured interviews regarding their experience, beliefs, and motives for injury prevention in-school and out-of-school. We analysed data by thematic content analysis using a typological approach. RESULTS Higher order themes (N = 7) including in-school and out-of-school motives and social cognitive factors and associated lower-order themes (N = 16), emerged from the analysis corresponding to constructs from trans-contextual model tenets. CONCLUSIONS The current study is the first qualitative study to explore junior secondary school students' experience and perspectives on sport injury prevention, using trans-contextual model as a framework for investigation. The findings contribute to a better understanding on their motivational and social cognitive factors in adopting sport injury prevention. The content of the theme behavior also indicated the inadequacy of students' knowledge of effective sport injury prevention techniques, and underscored the importance of sport safety education.
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Affiliation(s)
- Alfred S. Y. Lee
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Martyn Standage
- Department for Health, University of Bath, Bath, United Kingdom
| | - Martin S. Hagger
- Department of Psychological Sciences, University of California, Merced, California, United States of America
| | - Derwin K. C. Chan
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong Special Administrative Region, China
- School of Psychology, Curtin University, Perth, Australia
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Judah G, Gardner B, Kenward MG, DeStavola B, Aunger R. Exploratory study of the impact of perceived reward on habit formation. BMC Psychol 2018; 6:62. [PMID: 30572936 PMCID: PMC6302524 DOI: 10.1186/s40359-018-0270-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 11/21/2018] [Indexed: 11/11/2022] Open
Abstract
Background Habits (learned automatic responses to contextual cues) are considered important in sustaining health behaviour change. While habit formation is promoted by repeating behaviour in a stable context, little is known about what other variables may contribute, and whether there are variables which may accelerate the habit formation process. The aim of this study was to explore variables relating to the perceived reward value of behaviour – pleasure, perceived utility, perceived benefits, and intrinsic motivation. The paper tests whether reward has an impact on habit formation which is mediated by behavioural repetition, and whether reward moderates the relationship between repetition and habit formation. Methods Habit formation for flossing and vitamin C tablet adherence was investigated in the general public following an intervention, using a longitudinal, single-group design. Of a total sample of 118 participants, 80 received an online vitamin C intervention at baseline, and all 118 received a face-to-face flossing intervention four weeks later. Behaviour, habit, intention, context stability (whether the behaviour was conducted in the same place and point in routine every time), and reward variables were self-reported every four weeks, for sixteen weeks. Structured equation modelling was used to model reward-related variables as predictors of intention, repetition, and habit, and as moderators of the repetition-habit relationship. Results Habit strength and behaviour increased for both target behaviours. Intrinsic motivation and pleasure moderated the relationship between behavioural repetition and habit. Neither perceived utility nor perceived benefits predicted behaviour nor interacted with repetition. Limited support was obtained for the mediation hypothesis. Strong intentions unexpectedly weakened the repetition-habit relationship. Context stability mediated and for vitamin C, also moderated the repetition-habit relationship. Conclusions Pleasure and intrinsic motivation can aid habit formation through promoting greater increase in habit strength per behaviour repetition. Perceived reward can therefore reinforce habits, beyond the impact of reward upon repetition. Habit-formation interventions may be most successful where target behaviours are pleasurable or intrinsically valued. Electronic supplementary material The online version of this article (10.1186/s40359-018-0270-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gaby Judah
- Department of Surgery and Cancer, Imperial College London, QEQM Building, St Mary's Hospital Campus, Praed Street, London, W2 1NY, UK.
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, AH2.12, Addison House, Guy's Campus, London, SE1 1UL, UK
| | | | - Bianca DeStavola
- UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK
| | - Robert Aunger
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Scheerman JFM, van Empelen P, van Loveren C, van Meijel B. A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach. JMIR Mhealth Uhealth 2018; 6:e163. [PMID: 30120085 PMCID: PMC6119215 DOI: 10.2196/mhealth.9626] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 12/23/2022] Open
Abstract
Background The insertion of fixed orthodontic appliances increases the risk of dental caries, particularly in adolescents. Caries can be prevented through good oral health behavior. To support adolescents with fixed orthodontic appliances and for promoting oral health behavior, we developed a theory- and evidence-based mHealth program, the WhiteTeeth app. Objective The objective of our paper was to describe the systematic development and content of the WhiteTeeth app. Methods For systematic development of the program, we used the intervention mapping (IM) approach. In this paper, we present the results of applying the first 5 steps of IM to the design of an mHealth program: (1) identifying target behaviors and determinants through problem analysis, including a literature search, a survey study, and semistructured interviews, to explore adolescent oral health behavior during orthodontic therapy; (2) defining program outcomes and objectives; (3) selecting theoretical methods and translating them into practical strategies for the program design; (4) producing the program, including a pilot test with 28 adolescents testing the acceptability and usability of the WhiteTeeth app; and (5) planning implementation and adoption. Results On the basis of our literature search, we identified fluoride use and control of dental plaque levels (eg, tooth brushing and proxy brush usage) as target behaviors for preventing caries. Next, we identified important and changeable determinants of oral health behavior that fitted the theoretical concepts of the Health Action Process Approach (HAPA) theory. The HAPA theory, the self-regulation theory, and the results of the semistructured interviews were used to define the program objectives, that is, the performance and change objectives. After defining the objectives, we identified multiple behavior change techniques that could be used to achieve these objectives, such as providing oral health information and feedback, prompting self-monitoring, coaching of set actions and coping plans, and sending reminders. We translated these methods into practical strategies, such as videos and a brushing timer. Next, we combined these strategies into a single program resulting in the WhiteTeeth app (which is available on both iTunes and Google Play stores as “Witgebit”). Adolescents with fixed orthodontic appliances and dental professionals were included in the development process to increase the success of implementation. The pilot test revealed that the app users appreciated and liked the app. The WhiteTeeth app can be integrated into current orthodontic care. Conclusions IM allowed us to identify multiple techniques that have been shown to be the most effective in initiating behavior change, but have not yet been incorporated into existing orthodontic apps. The WhiteTeeth app contains all these techniques, which makes it a unique and promising home-based app for promoting oral health in adolescents with fixed orthodontic appliances.
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Affiliation(s)
- Janneke Francisca Maria Scheerman
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Cluster Oral Hygiene, Department of Health, Sports & Welfare, Inholland University, Amsterdam, Netherlands.,Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Pepijn van Empelen
- Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Cor van Loveren
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Berno van Meijel
- Cluster Nursing, Department of Health, Sports & Welfare, Inholland University, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Medical Center, Amsterdam, Netherlands.,Parnassia Psychiatric Institute, The Hague, Netherlands
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