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Zhang Y, Gao X, Zhu H, Sun S, Contento IR, Koch PA, Yu H. Lipid-focused dietary education intervention in pregnant women: study protocol for an open-label, parallel, randomised, intervention study addressing adverse pregnancy outcomes in China. BMJ Open 2024; 14:e076911. [PMID: 38176858 PMCID: PMC10773410 DOI: 10.1136/bmjopen-2023-076911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The incidence of infants who are large-for-gestational-age (LGA) is on the rise in China, and its detrimental effects on health have received increasing attention. Diet-based interventions have the potential to reduce adverse birth outcomes, particularly in decreasing the occurrence of LGA infants. We aim to evaluate the effect of lipid-focused diet education based on the theories of behaviour change in pregnant women on maternal and offspring outcomes through a randomised controlled trial. METHODS AND ANALYSIS We have designed an open-label, parallel, multicentre randomised controlled trial in collaboration with three hospitals in Beijing, China.Pregnant women will be recruited before reaching 12 weeks of gestation and will be randomised in a 1:1:1 ratio into three arms: (1) online education arm, (2) pregnancy nutrition checklist and 'one-page flyer' arm and (3) routine antenatal education. The primary outcome LGA will be recorded at birth. Demographic information, physical activity, sleep and medical history will be collected through questionnaires and case cards prior to enrolment. Questionnaires will also be used to collect dietary behaviours and psychosocial factors of pregnant women at enrolment, at 24-28 weeks and 34-36 weeks of gestation. Additionally, information on breastfeeding and complementary food supplementation for infants and young children will be obtained through questionnaires. Physical development indicators of children and taste tests will be assessed 3 years after delivery. ETHICS AND DISSEMINATION The study has received ethical approval from the Capital Medical University Ethics Committee and other collaborating study centres. Informed consent will be introduced to pregnant women, and their consent will be obtained. The findings will be reported in relevant national and international academic conferences and peer-reviewed publications. TRIAL REGISTRATION NUMBER ChiCTR2300071126.
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Affiliation(s)
- Yadi Zhang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Xiaoge Gao
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Haiyan Zhu
- Department of Obstetrics and Gynecology, Capital Medical University, Beijing, China
| | - Shengzhi Sun
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Isobel R Contento
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Pamela Ann Koch
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
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Khairinisa S, Darwita RR, Maharani DA, Setiawati F. Application of the extended theory of planned behavior to predict dentist intention and behavior in providing caries preventive care for preschool children. BMC Oral Health 2023; 23:970. [PMID: 38057815 PMCID: PMC10702071 DOI: 10.1186/s12903-023-03694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Various studies show a gap between evidence-based recommendations and the preventive practice of dentists. This study aimed to create and assess an extended Theory of Planned Behavior (TPB) model on dentists' intentions to do caries preventive measures and related barriers experienced by dentists. METHODS A total of 362 general dentists from 34 Indonesian provinces were included in this study. A self-administered online questionnaire consisted of three sections: dentist characteristics and practice pattern, TPB questionnaire, and dentist perceived behavior regarding preventive care for pediatric patients. The questionnaire was distributed and the data was analyzed through structural equation modeling. RESULTS TPB's extended version is a fit and relevant model, explaining 55.3% of dentists' intentions to undertake preventive procedures and 17.8% of preventive practices. Perceived behavioral control was the most powerful predictor of intention (44.2%) and practice (8.8%), while parental barriers were the most significant barrier to provide preventive care (18.9%). CONCLUSION Extending the TPB by taking barriers from multiple stakeholders as a consideration has a higher predictive level for preventive practices. Each barrier should be addressed through oral health programs and policies, and dentists must be taught to overcome these barriers (through formal or continuing education) in order to maximize caries prevention strategies.
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Affiliation(s)
- Safira Khairinisa
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia
| | - Risqa Rina Darwita
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia
| | - Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia
| | - Febriana Setiawati
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta, 10430, Indonesia.
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Mohammadkhah F, Amirhajelu RM, Bakhtiar M, Salemi SA, Kevenjan M, Jeihooni AK. The effect of training intervention based on the theory of planned behavior on oral and dental health behaviors in pregnant women. BMC Oral Health 2023; 23:521. [PMID: 37491230 PMCID: PMC10369690 DOI: 10.1186/s12903-023-03239-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/19/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Pregnancy is a transient physiological condition that causes adverse oral and dental consequences. The present study aimed to determine the effect of a training intervention based on the theory of planned behavior on oral and dental behaviors in pregnant women. METHODS This quasi-experimental study was conducted on 140 pregnant women (70 in the intervention group and 70 in the control group) supported by comprehensive health centers on the outskirts of Shiraz, Iran, in 2019-2020. The sampling was performed in each center by a simple random method. The tool included a demographic characteristics questionnaire, a questionnaire based on the theory of planned behavior, a self-care behavior questionnaire, and checklists for recording DMFT(Decayed, Missing due to caries, and Filled Teeth(DMFT)) and dental plaque indices. The questionnaires were completed before and 3 months after the intervention by both groups. The intervention group received six 50-min training sessions. The data were analyzed using SPSS 22, the chi-squared test, independent t-test, paired t-test, and descriptive statistics (p < 0.05). RESULTS The mean ages of the intervention and control groups were 32.28 ± 6.14 and 31.84 ± 6.71, respectively. The results showed that the average scores of all constructs of the theory of planned behavior, dental plaque indices (PI), and MDFT in the intervention group significantly changed after the intervention (p < 0.001). CONCLUSION According to the results, training based on the theory of planned behavior was effective on dental and oral health behaviors in pregnant women and improved the clinical results of their self-care behaviors. Therefore, training sessions will increase the knowledge of pregnant women, and providing timely consultations and examinations can be helpful and effective in developing oral and dental health behaviors in pregnant women.
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Affiliation(s)
- Fatemeh Mohammadkhah
- Department of Community Health, Child Nursing and Aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | | | - Maryam Bakhtiar
- Department of Dental Public Health, School of Dental, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saina Alempour Salemi
- Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Kevenjan
- Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, 7153675541, Iran.
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Rajeh MT, Alutaibi AR, Al-Badah AA, Alsubhi AS, Alluhaybi MM. Using the Extended Theory of Planned Behavior to Assess Adults' Intentions of Preventive Dental Care. J Int Soc Prev Community Dent 2023; 13:141-147. [PMID: 37223450 PMCID: PMC10202253 DOI: 10.4103/jispcd.jispcd_217_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/04/2023] [Accepted: 03/16/2023] [Indexed: 05/25/2023] Open
Abstract
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.
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Affiliation(s)
- Mona Talal Rajeh
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Xu Q, Hou X, Xiao T, Zhao W. Factors Affecting Medical Students’ Continuance Intention to Use Mobile Health Applications. J Multidiscip Healthc 2022; 15:471-484. [PMID: 35300179 PMCID: PMC8921670 DOI: 10.2147/jmdh.s327347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background With the dramatic growth in smartphones, mobile health applications (apps) in the field of healthcare or medicine, which are characterized by strong operability, flexibility and interactivity, provide a supplementary approach to medical learning. The aims of this study were to awaken medical students to pay more attention to the learning function of mobile health app and gain deeper insight into our understanding of the factors influencing medical students’ mobile health apps continuance intention for enhancing practical utilization. Methods A cross-sectional survey was conducted with a self-designed questionnaire administered to medical students at Chongqing Medical University. Data were collected from 450 participants from March to April 2019. SPSS V.25 was used for the descriptive statistical analysis of the results. Smart PLS 3.2.7 was used to construct a structural equation modelling framework to estimate the influencing factors of medical students’ continuance intention to use mobile health apps. Results The external characteristics of mobile health apps had a positive influence on perceived ease of use (β = 0.378, P < 0.001). Perceived ease of use had a positive impact on perceived usefulness (β = 0.573, P < 0.001). Perceived ease of use (β = 0.195, P = 0.011), perceived usefulness (β = 0.450, P < 0.001) and subjective norms (β = 0.255, P < 0.001) had a positive impact on attitude towards using mobile health apps. Additionally, perceived usefulness (β = 0.202, P < 0.001) and attitude (β = 0.730, P < 0.001) had a remarkable influence on continuance intention. Furthermore, the mediating effect of attitude between perceived usefulness and continuance intention was significant (β = 0.329, P < 0.001). Conclusion Both perceived usefulness and attitude have a significant effect on medical students’ mobile health apps continuance intention. So, we suggest apps providers and developers evoking and maintaining users’ interest in mobile health apps and perfecting apps’ features from various aspect. Also, more attention should be paid on social relationship to introduce medical students to familiarize mobile health apps and strengthen adhesiveness of medical students.
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Affiliation(s)
- Qian Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Medical Informatics Library, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiaorong Hou
- College of Medical Informatics, Chongqing Medical University, Chongqing, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Tingchao Xiao
- Department of Medical Informatics Library, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Wenlong Zhao
- College of Medical Informatics, Chongqing Medical University, Chongqing, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Wenlong Zhao, College of Medical Informatics Chongqing Medical University, Chongqing, People’s Republic of China, Tel +86 23 6571 4682, Email
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