Dentists’ perceptions and usability testing toward the implementation of the ISAC, a comprehensive oral cancer intervention in dental practices: a qualitative study in Jazan region, Saudi Arabia

The ISAC Paradigm to Tame Oral Cancer in Saudi Arabia: A Quasi-experimental Study

Late detection of oral cancer (OC) cases in Saudi Arabia is concerning. It reduces survival rate and complicates treatment. The ISAC intervention was developed to bridge the gaps observed in dentists' practice of OC examination and patient education. The ISAC stands for I, informing patients of OC screenings; S, screening for OC; A, advising high-risk patients to quit risk factors; and C, connecting patients to advanced services. This study tested the potential effect of the ISAC in influencing dentists' cognitive and behavioral skills, to enhance early detection and prevention of OC. A quasi-experimental study was conducted among dental interns (DIs) at dental setting to test the effect on comprehensive oral cancer examination score (COCE), awareness, self-efficacy, descriptive-norms, and self-reported behavior. Data were collected through triangulation of methods pre and post the intervention at two-months. Multiple linear mixed effects regression models were utilized for data analysis. Between October 2020 and April 2021, 47 DIs participated in the study. The final model showed the significant effects of time (ISAC) on COCE (95% CI = 25.12-29.42, P < .001). DIs had a significant improvement in awareness, self-efficacy, descriptive norms, and self-reported behavior. The findings showed promising effects of the intervention toward the early detection and prevention of OC. Dentists, dental organizations, and policymakers in areas with a high risk of OC could benefit from the current intervention which contributes to capacity building and improved community health. A pragmatic study with a robust design is needed to test the effectiveness of the intervention on a wider scale.

Optical Resolution Photoacoustic Microscopy Imaging in the Detection of Early Oral Cancer under Image Reconstruction Algorithm

This research was intended to explore the application value of photoacoustic imaging technology based on image intelligent iterative reconstruction algorithm in the detection and diagnosis of early oral cancer. An iterative algorithm model was constructed and systematically analyzed. The algorithm was used to debug the detection of B-scan images on the diameter of the imaging area. The results showed that the sensitivity of line-focused ultrasound detector was 86.72% and the specificity was 80.79%, while the sensitivity of the flat-field ultrasound detector was 63.15% and the specificity was 71.79%. The photoacoustic microscopy imaging technology can clearly observe the rich capillary network on human lips. A part of the vascular network at the depth of 100 μm, 500 μm, and 1000 μm grew out of the reticular capillaries and extended out of the loop-like capillaries, and the diameter gradually expanded. The imaging experiment of the sublingual capillary network in the human body showed that loop-like capillaries were observed, but there were some large blood vessels, which corresponded to the densely distributed blood vessel network under the tongue. The morphological changes of loop-like capillaries can be well observed by photoacoustic microscopy. In conclusion, the reconstructed photoacoustic microscopy imaging technology can realize high-resolution imaging of human oral capillaries and observe the morphological changes of loop-like capillaries, which had a certain application value for the early detection of oral cancer.

Process Evaluation of a Comprehensive Intervention for the Early Detection and Prevention of Oral Cancer: A Mixed Methods Study

Process evaluations help to understand and refine health interventions. The “ISAC” intervention targeted the enhancement of early detection and prevention of oral cancer (OC) through tobacco-cessation counseling, patient communications, and ISAC role-modeling. Over six months, throughout ISAC implementation in the Jazan region of Saudi Arabia, Linnan and Steckler’s process evaluation framework’s specified indicators were assessed, by mixed methods, on context, reach, dose delivered, dose received, fidelity, recruitment, and participant’s satisfaction. Findings showed that 47 of 80 (58.75%) eligible dentists were reached and received all components. Thirty-six (76.6%) participants reported reading all intervention materials, visited the ISAC website, scored high on the perceived quality of provided information (M = 4.62 ± 0.63), and provided support (M = 4.67 ± 0.57). The fidelity was scored high across all intervention components. Role-modeling of the ISAC had the highest satisfaction score (M = 9.77 ± 0.58 out of 10). High perceived-effects were reported in relation to feeling confident in performing OC examination and training patients on OC self-examination (3.95 ± 0.22). The intervention attained high implementation levels for dose delivered, dose received, and fidelity. The intervention delivery was associated with high satisfaction and perceived effects. Using multiple data sources enhanced the understanding of the implementation process and strengthened the validity of the study’s findings.