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Jiang N, Shi H, Zhao J, Zhang Y, Wang T, Cao H, Wang Q, Wang J, Xu X. Effects of social support on oral health behavior: Serial multiple-mediator model. Oral Dis 2024; 30:681-687. [PMID: 36520550 DOI: 10.1111/odi.14473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/13/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study investigates the serial multiple mediation of job stress and perceived behavioral control (PBC) in the relationship between social support and oral health behavior (OHB). MATERIALS AND METHODS This cross-sectional study was conducted in Minhang District, Shanghai, China, between July and November 2021. 559 Employees from 10 community health centers were recruited. A five-part survey was used to collect data on demographic characteristics, social support, job stress, PBC and OHB. Descriptive statistics, independent-sample t-test, Pearson's correlation analysis, ordinary least-squares regression and the bootstrap method were used to analyze data. RESULTS Social support was found to impact OHB through three significant mediation pathways: the pathway through job stress (point estimate = 0.033; 95%BC CI [0.004, 0.089]), the pathway through PBC (point estimate = 0.283; 95%BC CI [0.174, 0.416]), and the serial multiple mediating pathway through first job stress and then PBC (point estimate = 0.006; 95%BC CI [0.001, 0.019]). CONCLUSION This study indicates that job stress and PBC play a serial multiple-mediator role in the relationship between social support and OHB. To ensure the effectiveness of social support intervention on OHB, workplace managers and employees should strengthen the motivators that could promote the reduction of job stress and the improvement of PBC.
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Affiliation(s)
- Nan Jiang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - Hongyan Shi
- Dental Disease Prevention and Treatment Center of Minhang District, Shanghai, China
| | - Jie Zhao
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - Yuxin Zhang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - Ting Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - He Cao
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - Quqing Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - Jiwei Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
- Minhang Branch of Fudan University School of Public health, Shanghai, China
| | - Xiaoming Xu
- Dental Disease Prevention and Treatment Center of Minhang District, Shanghai, China
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Bapolisi WA, Bisimwa G, Merten S. Barriers to family planning use in the Eastern Democratic Republic of the Congo: an application of the theory of planned behaviour using a longitudinal survey. BMJ Open 2023; 13:e061564. [PMID: 36764708 PMCID: PMC9923293 DOI: 10.1136/bmjopen-2022-061564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVE In the Democratic Republic of the Congo, there is a low adherence of the population to the use of family planning (FP) due to various social barriers. This study aimed to understand the drives from social barriers to the use of FP in women in the Kivu, a region particularly affected by poverty and many years of conflicts. A theory of planned behaviour (TPB) using a generalised structural equation modelling has been applied to understand the complex sociocultural drivers to the intention and the ultimate decision to use FP. DESIGN Longitudinal study. SETTING A community-based approach was used to investigate FP use in the North and South-Kivu regions. PARTICIPANTS Overall, 1812 women 15 years and older were enrolled in the baseline study and 1055 were retrieved during the follow-up. PRIMARY AND SECONDARY OUTCOMES FP use and intention to use FP. RESULTS The mean age was 36±12.9 years, with a minimum of 15 years old and a maximum of 94 years old. Among sexually active participants, more than 40% used a modern contraceptive method at the last sexual intercourse. Education was positively and significantly associated with intention to use FP (β=0.367; p=0.008). Being married was positively and marginally significantly associated with intention to use FP (β=0.524: p=0.050). Subjective norms were negatively and significantly associated with intention to use FP (β=-0.572; p=0.003) while perceived control was positively associated with intention to use FP (β=0.578; p<0.0001). Education and perceived control were positively and significantly associated with the use of FP (respectively, β=0.422, p=0.017; and β=0.374; p=0.017), while Intention to use FP was positively and marginally significantly associated with the use of FP (β=0.583; p=0.052). CONCLUSION TPB helped understand sociocultural barriers to FP use and it can be useful to define adapted strategies in different contexts.
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Affiliation(s)
- Wyvine Ansima Bapolisi
- Epidemiology, University of Basel Faculty of Science, Basel, Switzerland
- Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Ghislain Bisimwa
- Ecole Régionale de Santé Publique, Catholic University of Bukavu, Bukavu, South-Kivu, Congo (the Democratic Republic of the)
| | - Sonja Merten
- Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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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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Moore J, Turner LW, Stellefson M, Chaney BH. Dental Hygiene Behaviors among Young Adults: A Systematic Review of Surveys Using the Theory of Planned Behavior (TPB). AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2100847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Application of the extended theory of planned behavior to understand Chinese students' intention to improve their oral health behaviors: a cross-sectional study. BMC Public Health 2021; 21:2303. [PMID: 34923971 PMCID: PMC8684633 DOI: 10.1186/s12889-021-12329-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to develop and test an extended theory of planned behavior (TPB), which includes attitudes, subjective norms and perceived behavioral control, oral health knowledge, and past oral health behavior on the intention to improve oral health behaviors among primary school students in Shanghai, China. METHODS A school-based cross-sectional study was conducted with 414 students in the third-grade from 10 classes of Mingqiang Primary School located in Shanghai, China. Participants were recruited in October 2019. Data were collected through self-reported questionnaires, consisting of demographic characteristics, TPB variables, oral health knowledge and past oral health behaviors. Exploratory factor analysis was used to analyze TPB items. Pearson's correlation and hierarchical regression analyses were conducted to identify the associated factors of intention to improve oral health behaviors. RESULTS The study showed that among students in the third grade, attitudes, subjective norms, perceived behavioral control, and past oral health behaviors were associated with the intention to improve oral health behaviors. In the hierarchical regression analysis, age and sex were entered in Model 1 which significantly explained 3.00% of the variance (F = 6.26, p < 0.01). The addition of Model 2 variables of attitudes, perceived behavioral control, subjective norms, and oral health knowledge revealed that TPB variables explained 26.70% (F = 29.59, p < 0.01). For Model 3, the addition of past oral health behaviors accounted for a further 1% of variance, and the full model has accounted for 28.30% of the variance with the intention to improve oral health behaviors (F = 22.8, p < 0.01). Regression analyses supported that among the significant variables, perceived behavioral control had the largest beta weight, followed by subjective norms and past oral health behaviors. CONCLUSION The extended TPB model constructed in this study could be used to explain children's intentions to improve oral health behaviors. Children's oral health-related perceived behavioral control, subjective norms, and past oral health behaviors may serve as priority intervention targets in oral health promotion practices aimed at children.
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Reisine S, Schensul JJ, Salvi A, Grady J, Ha T, Li J. Oral health-related quality of life outcomes in a randomized clinical trial to assess a community-based oral hygiene intervention among adults living in low-income senior housing. Health Qual Life Outcomes 2021; 19:227. [PMID: 34583694 PMCID: PMC8477498 DOI: 10.1186/s12955-021-01859-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/08/2021] [Indexed: 11/19/2022] Open
Abstract
Background Quality of life outcomes have been used frequently in clinical trials of oral health interventions. This study assessed the effects of a randomized trial on oral health related quality of life comparing an individual-based oral hygiene intervention to a community-based intervention. Methods Participants were recruited from six low-income senior housing residences. Buildings were randomly assigned to receive the individual-based intervention followed by the community-based intervention or to receive the community-based intervention followed by the individual intervention. Participants’ oral hygiene was assessed at baseline (T0), one month after the first intervention (T1) and one month after the second intervention (T2) and six months after the T2 assessment (T3). Oral hygiene was measured by the Gingival Index (GI) and Plaque scores (PS). Surveys collected data on beliefs, attitudes, behaviors and self-reported health status at T0, T1 and T2. Only oral hygiene and quality of life, measured by the General Oral Health Assessment Index (GOHAI), was assessed at all time points. general linear mixed models (GLMM) were used to assess changes in GOHAI over time, the interaction of condition by time and the contribution of psychosocial, behavioral, health status and background variables to changes in GOHAI. Results 331 people completed T0 assessments; 306 completed T1; 285 completed T2 and 268 completed T3. Scores on GOHAI at T0 ranged from 10 to 48 with a mean of 39.7 (sd = 7.8) and a median of 42. At T1, mean GOHAI was 40.7 (sd = 8.2), at T2 mean GOHAI was 41.1 (sd = 7.8) and at T3, GOHAI was 42.3 (sd = 8.2). GLMM showed that GOHAI improved significantly from T0 to T3 (p = 0.01) but the time by intervention interaction was not significant indicating that both interventions were effective in improving GOHAI but one intervention was not better than the other. Ethnicity, health status, worries, self-efficacy, number of missing teeth and symptoms of dry mouth were related to improvements in GOHAI. Neither GI nor PS were related to GOHAI. Conclusions The participants reported relatively good oral health related quality of life which improved significantly over time. Improvement occurred among all participants regardless of condition, suggesting that either intervention would be effective in future studies. Trial Registry: Clinicaltrials.gov, Clinical Trials ID #NCT02419144; Title: A Bi-level Intervention to Improve Older Adult Oral Health Status; Registered 04/07/2015 URL: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005H9X&selectaction=Edit&uid=U0000KBK&ts=2&cx=-rajj5q
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Affiliation(s)
- Susan Reisine
- Division of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Jean J Schensul
- Institute for Community Research, Two Hartford Square West, Suite 100, 146 Wyllys St., Hartford, CT, 06106, USA
| | - Apoorva Salvi
- Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR, 97239, USA
| | - James Grady
- Department of Community Medicine, University of Connecticut School of Medicine, 195 Farmington Avenue, Farmington, CT, 06030, USA
| | - Toan Ha
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto St., Pittsburgh, PA, 15261, USA
| | - Jianghong Li
- Institute for Community Research, Two Hartford Square West, Suite 100, 146 Wyllys St., Hartford, CT, 06106, USA
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Schensul J, Reisine S, Salvi A, Ha T, Grady J, Li J. Evaluating mechanisms of change in an oral hygiene improvement trial with older adults. BMC Oral Health 2021; 21:362. [PMID: 34289839 PMCID: PMC8293549 DOI: 10.1186/s12903-021-01701-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/25/2021] [Indexed: 01/05/2023] Open
Abstract
Background This paper compares the relationship between theoretically-driven mechanisms of change and clinical outcomes across two different interventions to improve oral hygiene of older adults participating in a group randomized trial.
Methods Six low-income senior residences were paired and randomized into two groups. The first received a face to face counseling intervention (AMI) and the second, a peer-facilitated health campaign (three oral health fairs). Both were based on Fishbein’s Integrated Model. 331 participants were recruited at baseline and 306 completed the post-assessment one month after intervention. Clinical outcomes were Gingival Index (GI) and Plaque score (PS), collected by calibrated dental hygienists. Surveys obtained data on patient background characteristics and ten mechanisms of change including oral health beliefs, attitudes, norms and behaviors. GLMM was used to assess the effects of time, intervention arm, participant characteristics, intervention mechanisms and differences between the two interventions over time in relation to outcomes. Results At baseline, both groups had similar background characteristics. Both groups improved significantly in outcomes. Overall GI scores changed from baseline mean of 0.38 (SD = .032) to .26 (SD = .025) and PS scores changed from baseline mean of 71.4 (SD = 18%) to 59.1% (SD = 21%). T-tests showed that fears of oral disease, oral health intentionality, oral health norms, worries about self-management of oral health, flossing frequency and sugar control improved significantly in both interventions from baseline to post intervention. Oral health self-efficacy, perceived risk of oral health problems, oral health locus of control and brushing frequency improved significantly only in the counseling intervention. GLMM models showed that the significant predictors of GI improvement were intentionality to perform oral hygiene, locus of control, and improvement in frequency of brushing and flossing in association with the counseling intervention. Predictors of PS improvement were worries about oral hygiene self-management and fear of oral diseases, in association with the counseling intervention. In the reduced final models, only oral health locus of control (predicting GI) and fears of oral diseases (predicting PS) were significant in association with the counseling intervention. Locus of control, a key concept in oral hygiene interventions including the IM was the main contributing mechanism for GI improvement. Fear, an emotional response, drove improvement in PS, reinforcing the importance of cognitive/emotional mechanisms in oral hygiene interventions. Conclusions Though both groups improved in outcomes, GI and PS outcomes improved more in response to the counseling intervention than the campaign. The counseling intervention had an impact on more mechanisms of change than the campaign. Improvements in intervention mechanisms across both interventions however, suggest a closer examination of the campaign intervention impact on outcomes over time. Trial Registration: Clinicaltrials.gov NCT02419144, first posted April 17, 2015.
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Affiliation(s)
- Jean Schensul
- Institute for Community Research, 2 Hartford Square West, St. 100, Hartford, CT, 06117, USA.
| | - Susan Reisine
- University of Connecticut School of Dental Medicine, 263 Farmington Avenue, Farmington, CT, 06107, USA
| | - Apoorva Salvi
- Department of Emergency Medicine, School of Medicine, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Toan Ha
- University of Pittsburgh Medical Center, 2118 Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - James Grady
- University of Connecticut School of Medicine, 195 Farmington Avenue, Farmington, CT, 06107, USA
| | - Jianghong Li
- Institute for Community Research, 2 Hartford Square West, St. 100, Hartford, CT, 06117, USA
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Reisine S, Schensul JJ, Salvi A, Grady J, Ha T, Li J. Does sequencing matter? A cross-over randomized trial to evaluate a bi-level community-based intervention to improve oral hygiene among vulnerable adults. Community Dent Oral Epidemiol 2021; 50:270-279. [PMID: 34091935 DOI: 10.1111/cdoe.12663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate whether the cumulative effect of an individual-level intervention followed by a building-level intervention, both based on Fishbein's Integrated Model of Behavior Change, has a better effect on oral hygiene clinical outcomes than the sequence of the building-level intervention followed by the individual-level intervention; to determine the added effect of each intervention on the other; to identify the psychosocial mechanisms that might explain the differences. METHODS Six low-income senior housing complexes were enrolled in the study, and participants were recruited from these buildings. Buildings were randomly assigned to receive either the individual counselling intervention first followed by the building-level intervention, or the building-level intervention first followed by the individual intervention. Participants were assessed for gingival inflammation using the gingival index (GI) and plaque scores (PS) at T0, prior to the interventions, T1, about one month after each intervention and T2, about a month after the interventions switched and were completed. Data were collected on background moderators and cognitive/emotional/behavioural mediators in surveys administered at T0, T1 and T2. General linear mixed models were used to assess changes over time by condition and to analyse the effects of moderators and mediators over time. RESULTS Three hundred and thirty-one people completed T0; 306 completed T1 assessments (92.4% retention rate) and 285 completed T2 assessments (86.1% retention rate). All participants improved on GI and PS at T1 and T2 compared to T0. Those in the individual-level intervention condition improved more than those in the building-level condition. Those who were in the building-level intervention followed by the individual intervention continued to improve on GI from T1 to T2. Those in the individual-based intervention followed by the building intervention did not improve significantly from T1 to T2 but remained about the same. For PS, neither group improved significantly from T1 to T2. Several cognitive/behavioural variables significantly affected improvements in GI and PS. CONCLUSIONS Both interventions were successful in improving GI and PS. The building-level intervention did not provide much additional benefit when it followed the individual intervention although it may have had a sustaining effect. The findings on the cognitive/emotional/behavioural variables support the importance of these factors and should be considered when implementing oral hygiene interventions.
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Affiliation(s)
- Susan Reisine
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | | | - Apoorva Salvi
- Oregon Health and Science University, Portland, OR, USA
| | - James Grady
- Department of Community Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Toan Ha
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - JiangHong Li
- Institute for Community Research, Hartford, CT, USA
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Determinants of intention to improve oral hygiene behavior among students based on the theory of planned behavior: A structural equation modelling analysis. PLoS One 2021; 16:e0247069. [PMID: 33630853 PMCID: PMC7906382 DOI: 10.1371/journal.pone.0247069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/29/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of oral hygiene behaviors (OHB) is very low among school children in Ethiopia. However, the determinants of student's readiness/intention to perform those behaviors have been remained unstudied. OBJECTIVE This study aimed to identify the determinants of oral hygiene behavioral intention (OHBI) among preparatory school students based on the theory of planned behavior (TPB). METHODS AND MATERIALS An institution-based cross-sectional study was conducted among 393 students. A 98-item self-administered questionnaire was used to evaluate oral hygiene knowledge (OHK), oral hygiene behavior (OHB), and OHBI based on TPB variables [attitude (ATT), subjective norms (SN) and perceived behavioral control (PBC)]. Descriptive statistics and structural equation modeling analysis (SEM) were employed to confirm relationships and associations among study variables. A p-value of less than 0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS A total of 393 students were participated with a response rate of 97.5%. The mean age of the participants (54% females) was 18 (± 1.3) with an age range of 16 to 24. The TPB model was well fitted to the data and explained 66% of the variance in intention. ATT (β = 0.38; 95% CI, (0.21, 0.64)), SN (β = 0.33; 95% CI, (0.05, 0.83)) and PBC (β = 0.29; 95% CI, (0.13, 0.64)) were significant predictors of OHBI, where ATT was the strongest predictor of OHBI. CONCLUSION The TPB model explained a large variance in the intention of students to improve their OHB. All TPB variables were significantly and positively linked to stronger intent, as the theory suggests. Furthermore, these results suggest that the model could provide a framework for oral hygiene promotion interventions in the study area. Indeed, these interventions should focus on changing the attitudes of students towards OHB, creation of positive social pressure, and enabling students to control over OHB barriers.
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Schensul JJ, Salvi A, Ha T, Grady J, Li J, Reisine S. Evaluating Cognitive/Emotional and Behavioral Mediators of Oral Health Outcomes in Vulnerable Older Adults. J Appl Gerontol 2020; 41:187-197. [PMID: 33292050 DOI: 10.1177/0733464820974920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Inconsistent outcomes of oral hygiene interventions require testable theories combining cognitive and behavioral domains to guide intervention and improve results. This article evaluates the integrated model as a cognitive-behavioral approach to improve oral health clinical outcomes in ethnically diverse low-income older adults. Baseline data from a clinical trial utilizing the integrative model (IM) model evaluated predictors of gingival index (GI) and plaque score (PS). Individual logistic regression was performed for all predictors in relation to GI and PS. Multiple logistic regression was performed with significant predictors of GI and PS only. Greater locus of control and more brushing predicted lower GI; greater locus of control predicted lower PS. Both cognitive and behavioral domains impact GI, requiring more prolonged effort for improvement while locus of control, a cognitive variable, predicts PS, immediately improved by daily brushing/flossing. A streamlined IM including locus of control and tooth brushing should improve oral hygiene of low-income older adults.
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Affiliation(s)
| | | | - Toan Ha
- University of Connecticut School of Medicine, Farmington, USA
| | - James Grady
- University of Connecticut School of Medicine, Farmington, USA
| | - Jianghong Li
- Institute for Community Research, Hartford, CT, USA
| | - Susan Reisine
- University of Connecticut School of Dental Medicine, Farmington, USA
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Özyemişci N, Turgut Çankaya Z. Effect of a motivational video on flossing behaviour: A pilot study. Int J Dent Hyg 2020; 19:201-208. [PMID: 33215814 DOI: 10.1111/idh.12480] [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: 03/25/2020] [Revised: 10/11/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Nuran Özyemişci
- Dental Prosthesis Technology Program, Vocational School of Health Services, Hacettepe University, Ankara, Turkey
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Corbella S, Tramontano F, Zotti B, Muzzarelli M, Alberti A, Francetti L. Influence of teeth anatomical characteristics on the efficacy of manual toothbrushing manoeuvres. Saudi Dent J 2020; 32:337-342. [PMID: 33132661 PMCID: PMC7588504 DOI: 10.1016/j.sdentj.2019.10.008] [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: 06/21/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of the study was to investigate the efficacy of two toothbrushing techniques on the amount of plaque accumulation and to evaluate how the changes were correlated to the anatomical characteristics of the anterior maxillary arch. Methods Thirty subjects of both genders were included, they were asked not to brush for 12 h. Afterwards, they were asked to manually brush the left side of their maxillary arch with the modified Bass technique and the right side adopting the roll technique. The comparison of photographs taken before and after the manoeuvres, using a plaque disclosing agent, allowed the researchers to measure the changes in plaque accumulation measured using the Quigley and Hein plaque scoring classification. Linear regression analysis was used to evaluate the correlation between such changes and the teeth and arch anatomical characteristics. Results A mean reduction of 9.6 ± 5.2% considering both arches after brushing was observed. The changes in plaque accumulation were not different between the two techniques. The length of the line obtained joining the contact point between the central incisors and the contact point between the second premolar and the first molar on the left side and the distance between that line and the lateral incisor on the same side positively correlated to the decrease in the plaque scores (P = 0.046 and P = 0.044, respectively). Conclusion Both tested techniques were effective in plaque removal in the anterior maxillary arches. However, the research for the anatomical factors influencing the amount of efficacy of the toothbrushing manoeuvres was inconclusive. We can hypothesise that the adoption of one adequate technique could be more important than the teeth characteristics.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Oral Surgery, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Beatrice Zotti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Martina Muzzarelli
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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13
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Schensul JJ, Salvi A, Ha T, Reisine S, Li J, Moni Y. Building a new scale to measure worries about oral hygiene self-management in vulnerable older adults. Gerodontology 2020; 37:361-373. [PMID: 32410346 DOI: 10.1111/ger.12471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 03/18/2020] [Accepted: 04/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This paper describes a new scale to measure worries about self-management of oral hygiene in low-income older adults. BACKGROUND Oral hygiene that prevents oral diseases and worsening of chronic conditions improves with instruction, but other cognitive/emotional factors impede oral hygiene practice especially among older adults. Many scales measure dental anxiety, but none measures oral hygiene self-management worries. MATERIALS AND METHODS Formative research with diverse older adults 55-95 in low-income housing identified scale items. A 23-item scale was tested in a pilot intervention study (n = 84) and formalised with a new sample (N = 331). RESULTS In both studies, PCA/factor analysis produced two subscales: (a) worries about cleaning teeth and (b) consequences of cleaning. Chronbach's alpha coefficient evaluated internal consistency, and Pearson's r and Kendall tau/Spearman's rho evaluated scale predictability, convergent and divergent validity. The scale and subscales showed good internal consistency in both studies (over 0.90) and stability T0 0.90; T1: 0.90). In the larger sample, statistically significant correlations between the scale, subscales; plaque score, and similar scales (perceived risk of oral health problems, and fears of oral diseases) demonstrated convergent validity. For divergent validity, the worries scale, not the GOHAI, a similar scale measuring oral health life quality, was associated with Plaque Score. Each scale was associated with different mediators suggesting different constructs. CONCLUSION The overall scale has good internal consistency, test-retest reliability, predictability and convergent and divergent validity. It captures a psycho-emotional construct useful in oral health research and hygiene education with older adults.
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Affiliation(s)
| | - Apoorva Salvi
- Institute for Community Research, Hartford, Connecticut
| | - Toan Ha
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Susan Reisine
- University of Connecticut School of Dental Medicine, Farmington, Connecticut
| | - Jianghong Li
- Institute for Community Research, Hartford, Connecticut
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14
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Lee J, Han DH, Kim H, Park SY. Factors related to children's tooth-brushing at different ages: an application of the theory of planned behavior. PSYCHOL HEALTH MED 2020; 26:228-241. [PMID: 32233784 DOI: 10.1080/13548506.2019.1683870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Tooth-brushing is one of the most important health behaviors to teach children considering potentially serious ramifications of poor dental health. However, children's tooth-brushing behavior is affected by various developmental factors. The aim of this cross-sectional study was to investigate factors related to the tooth-brushing behavior of children adopting the Theory of Planned Behavior. A preliminary elicitation study with 33 primary school students identified underlying beliefs related to tooth-brushing intentions. This data was analysed, synthesized, and incorporated into the development of survey items for three age-appropriate, closed-ended questionnaires administered to 709 primary public school students. Path analyses using structural equation modelling were used to discover the structural relationships among the direct and indirect determinants of tooth-brushing behaviors, and path estimates and the model fit were calculated. Social recognition, peer influence, self-motivating strategies, and cognitive aspects of tooth-brushing were found to become more influential in facilitating behavioral intention with age. In the path models, the tooth-brushing behavioral intention was significantly related to perceived behavioral control rather than behavioral beliefs and normative beliefs. Subjective norms were found to become more significant as children matured. This result suggests that education to improve children's tooth-brushing behavior needs be appropriate to the developmental stage of children.
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Affiliation(s)
- Jihyun Lee
- Dental Education Major, Seoul National University School of Dentistry , Seoul, Korea.,Dental Research Institute, Seoul National University , Seoul, Korea
| | - Dong-Hun Han
- Dental Research Institute, Seoul National University , Seoul, Korea.,Department of Preventive and Social Dentistry, Seoul National University School of Dentistry , Seoul, Korea
| | - Hyungsin Kim
- Dental Research Institute, Seoul National University , Seoul, Korea
| | - Shin-Young Park
- Dental Education Major, Seoul National University School of Dentistry , Seoul, Korea.,Dental Research Institute, Seoul National University , Seoul, Korea
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15
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Ho MH, Rita Chang HC, Lin YK, Traynor V, Tsai HH, Buckwalter K, Liu MF, Chang CC. Application of the Integrated Behavioral Model to oral self-care behavior of community-dwelling middle-aged and older people in Taiwan. Public Health Nurs 2019; 36:726-734. [PMID: 31348558 DOI: 10.1111/phn.12646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/22/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study evaluated the Integrated Behavioral Model and examined oral self-care behavior of community-dwelling middle-aged and older people. DESIGN A cross-sectional design was used. SAMPLE Purposive sampling was employed to recruit middle and older age community-dwelling individuals, with research locations in public health centers in northern Taiwan. MEASUREMENTS Structured questionnaires comprised: participant demographics, oral health literacy, oral self-care attitude, self-efficacy, intention, and behavior, and significant others' perceptions and beliefs as well as environmental constraints. The Model verification was evaluated by path analysis. RESULTS Two hundred and sixty-three participants (N = 263) completed the questionnaire survey. Results identified significant direct effects of the independent variables of oral health care literacy, intention of oral self-care, and perception of environmental constraints on the dependent variable of oral self-care behavior; and significant indirect effects on attitude of oral self-care, perception of significant other beliefs, self-efficacy of oral self-care. CONCLUSION Public health nurses work with the whole community and can potentially improve the oral self-care behavior of middle-aged and older adults by enhancing their oral health knowledge, maintaining their positive attitudes, assisting acceptance of recognition and support from others, increasing their ability to perform oral self-care, reducing environmental constraints, and thereby enhancing their oral self-care awareness.
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Affiliation(s)
- Mu-Hsing Ho
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.,School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Yen-Kuang Lin
- Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Hung-Huey Tsai
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Megan F Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.,College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
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16
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Sanaei Nasab H, Yazdanian M, Mokhayeri Y, Latifi M, Niksadat N, Harooni J, Armoon B. The role of psychological theories in oral health interventions: A systematic review and meta-analysis. Int J Dent Hyg 2019; 17:142-152. [PMID: 30702796 DOI: 10.1111/idh.12386] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/10/2019] [Accepted: 01/25/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In the present study, we attempted to assess how psychological theories (health belief model [HBM], theory of planned behaviour [TPB], social cognitive theory [SCT], clinical theories [CT] and other theories [OT]) influence oral health interventions. METHODS PubMed, Scopus, Cochrane and Web of Knowledge databases from 2000 to 2017 were searched. We defined psychological theories based on five subgroups: (A) HBM, (B) TPB, (C) SCT, (E) CT and (F) OT. RESULTS From the 156 identified studies, 19 studies based on PICO were included. Our findings indicated that the standardized mean difference (SMD) of HBM was 0.37 (95% CI: 0.24, 0.51), which was statistically significant in improving oral health. The SMD of SCT was not significant (0.05 [95% CI: -0.33, 0.44]) in improving oral health. The SMD of TPB was significant (1.66 [95% CI: 1.06, 2.27]) in improving oral health. The SMD of CT (-4.6 [95% CI: -6.49, -2.71]) and OT (2.93 [95% CI: 1.55, 4.32]) revealed significant differences in improving oral health. CONCLUSION The current meta-analysis showed that in general, psychological interventions that used OT, CT, HBM and TPB were effective in enhancing oral health status, and interventions that used SCT did not have an effect on improving oral health status. Oral health care providers who work with patients to take methods and improve behaviours that are related to appropriate oral health need to comprehend their applicability and strengths.
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Affiliation(s)
- Hormoz Sanaei Nasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Yaser Mokhayeri
- School of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Marzieh Latifi
- Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin Niksadat
- Department of Public Health, Faculty of Health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.,Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Student Research Committee, Tehran, Iran
| | - Javad Harooni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Bahram Armoon
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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17
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Folgerts O, Buunk-Werkhoven YAB, Batenburg R. Periodontal screening during an oral public health promotion campaign: a study among health consumers. Int Dent J 2019; 69:289-294. [PMID: 30714140 DOI: 10.1111/idj.12475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Diseases such as periodontal disease and halitosis have a negative impact on both the economy and the quality of life worldwide; thus, poor oral health has become a public health concern. The aim of this study was to characterise the oral health status of visitors to a public health consumer's exhibition using demographic and social characteristics and consumers' periodontal health condition. METHODS During this cross-sectional study in 2010-2014, 1,223 visitors completed a questionnaire. The periodontal condition of 760 participants was screened by dental hygienists of the Dutch Dental Hygienists' Association using the Dutch Periodontal Screening Index (DPSI). RESULTS A total of 1,029 visitors with a mean age of 45.38 years were included. The numerically lowest mean level of DPSI (2.59) occurred in 2014, whereas the numerically highest mean of DPSI (3.67) occurred in 2012. Each year, the DPSI scores were not normally distributed and were significantly higher for men than for women. Significant differences between DPSI score and age and between DPSI score and education were observed. CONCLUSION Differences in DSPI score related to age and education were found. This means that specific groups of people with poorer oral health, mostly elderly or less-educated people, may need adjusted target interventions to prevent oral diseases. Insights into the benefits of public awareness and the development of optimally targeted interventions are needed for oral health promotion and the prevention of oral diseases.
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Affiliation(s)
- Oddy Folgerts
- Independent Researcher, Amsterdam, The Netherlands.,Dutch Dental Hygienists' Association (Nederlandse Vereniging van Mondhygiënisten; NVM-mondhygiënisten), Utrecht, The Netherlands
| | | | - Ronald Batenburg
- Netherlands Institute for Health Services RESEARCH; NIVEL, Utrecht, The Netherlands
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18
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Patel J, Kulkarni S, Doshi D, Reddy BS, Reddy MP, Buunk-Werkhoven YA. Determinants of oral hygiene behaviour among patients with moderate and severe chronic periodontitis based on the theory of planned behaviour. Int Dent J 2019; 69:50-57. [DOI: 10.1111/idj.12413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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19
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Ghaffari M, Rakhshanderou S, Ramezankhani A, Noroozi M, Armoon B. Exploration of brushing behavior among university students in Iran: a qualitative research. Int J Adolesc Med Health 2018; 32:/j/ijamh.ahead-of-print/ijamh-2017-0115/ijamh-2017-0115.xml. [PMID: 29369811 DOI: 10.1515/ijamh-2017-0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/10/2017] [Indexed: 11/15/2022]
Abstract
Background Currently, it is estimated that 40% of the Iranian population is less than 20 years old, and in the academic year of 2011-2012 about 4 million students of that age were educated. The general assessment of the outcomes of oral health programs and investigating determinants is substantial for developing future plans of oral health. This study was done with the aim of exploring brushing behavior among university students of Iran to specify and understand the important determinants of oral health behavior. Methods A qualitative research method was used. This study was conducted between August and November 2016 in Shahid Beheshti University. Maximum variation sampling was used among university attendees and 44 students with more than 2 years of study duration were selected to be included in the research. Semi-structured interviews were employed for data gathering. All of the recorded interviews and notes were accurately evaluated and data analysis was performed based on the content analysis. Results As a result of the interview analysis 16 main categories emerged: Religious Beliefs, Perceived Benefits, Perceived Barriers, Habitation, Salience of Behavior, Education, Subjective Norms, Peer Pressure, Observational Learning, Knowledge, Perceived Susceptibility, Perceived Severity, Outcome Expectation, Skills, Perceived Self-efficacy, and Perceived Behavioral Control. Codes of sub-theme and theme were identified in the study. Conclusion This present study provides additional evidence with respect to the religious beliefs and the impact of religious instructions in brushing among students. Salience of brushing behavior has been described as one of the structures in an integrated behavioral model. Despite earlier studies suggesting, that peer pressure only plays a role on children's brushing behavior, our study showed that peer pressure is effective on adults as well.
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Affiliation(s)
- Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Health Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Bahram Armoon
- Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Ab Malik N, Mohamad Yatim S, Lam OLT, Jin L, McGrath C. Factors influencing the provision of oral hygiene care following stroke: an application of the Theory of Planned Behaviour. Disabil Rehabil 2017; 40:889-893. [PMID: 28129510 DOI: 10.1080/09638288.2016.1277397] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to examine "intention to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior. MATERIALS AND METHODS A large scale survey of 13 centers in Malaysia was conducted involving 806 nurses in relation to oral hygiene care intentions and practices. In addition, information on personal and environmental factors was collected. RESULTS The response rate was 95.6% (778/806). The domains of the Theory of Planned Behavior were significantly associated with general intention to perform oral hygiene care: attitudes (β = 0.21, p < 0.001), subjective norms (β = 0.38, p < 0.001), perceived behavior control (β = 0.04, p < 0.001); after controlling for personal and environmental factors. Approximately two-thirds (63.4%, 493) reported the performance of some form of oral hygiene care for patients. This behavior was associated with general intention scores (OR =1.13, 95%CI =1.05-1.22, p <0.01), controlling for other factors. Knowledge scores, training, access to oral hygiene guidelines and kits, as well as working ward type were identified as key factors associated with intention and practice of oral hygiene care. CONCLUSION The Theory of Planned Behavior provides understanding of "intention to" and "performance of" oral hygiene care to stroke patients. Several provider and environmental factors were also associated with intentions and practices. This has implications for understanding and improving the implementation of oral hygiene care in stroke rehabilitation. Implications for Rehabilitation Oral hygiene care is crucial for stroke patients as it can prevent oral health problems and potentially life threatening events (such as aspiration pneumonia). Despite oral hygiene care being relative simple to perform, it is often neglected during stroke rehabilitation. A large-scale national survey was conducted to understand "intentions to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior social cognition model. These study findings may have implications and use in promoting oral hygiene care to stroke patients:i) by understanding the pathways and influences to perform oral hygiene care.ii) to conduct health promotion and health education based on behavioral models such as Theory of Planned Behavior.
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Affiliation(s)
- Normaliza Ab Malik
- a Faculty of Dentistry , The University of Hong Kong , Hong Kong , China.,b Faculty of Dentistry , Universiti Sains Islam Malaysia , Kuala Lumpur , Malaysia
| | - Saari Mohamad Yatim
- c Department of Medical Rehabilitation , Hospital Serdang , Kajang , Malaysia
| | - Otto L T Lam
- a Faculty of Dentistry , The University of Hong Kong , Hong Kong , China
| | - Lijian Jin
- a Faculty of Dentistry , The University of Hong Kong , Hong Kong , China
| | - Colman McGrath
- a Faculty of Dentistry , The University of Hong Kong , Hong Kong , China
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Ebrahimipour S, Ebrahimipoiur H, Alibakhshian F, Mohamadzadeh M. Effect of education based on the theory of planned behavior on adoption of oral health behaviors of pregnant women referred to health centers of Birjand in 2016. J Int Soc Prev Community Dent 2016; 6:584-589. [PMID: 28032052 PMCID: PMC5184394 DOI: 10.4103/2231-0762.195514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/31/2016] [Accepted: 12/12/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Oral health of pregnant women is very important because of the adverse effects of pregnancy on the oral hard and soft tissues and vice versa. The aim of this study was to evaluate the effect of education on oral health behaviors of pregnant women based on the theory of planned behavior in Birjand. MATERIALS AND METHODS This quasi-experimental study was carried out among 150 pregnant women admitted to health centers, who were selected using simple sampling (75 females in each case and control group). Educational program through face-to-face training was performed in the case group, and the control group received only usual training through leaflet distribution. Data were collected using a questionnaire and analyzed by the Statistical Package for the Social Sciences version 18 software at 0.05 significance level. RESULTS The most frequent age group was 26-30 years. Before the intervention, the mean scores of knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention, and performance of the intervention and control groups showed no significant difference (P ≥ 0.05). After the intervention, the average of all scores in the intervention group showed significant increase compared to the control group (P ≤ 0.05). CONCLUSION Face-to-face training using the theory of planned behavior has positive impact on oral health behaviors of pregnant women. Accordingly, training sessions in order to raising awareness and positive attitude and controlling healthcare behaviors can improve oral health behaviors of pregnant women.
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Affiliation(s)
- Sediqe Ebrahimipour
- Department of Endodontics, Faculty of Dentistry and Dental Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hossein Ebrahimipoiur
- Management and Social Determinant of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fateme Alibakhshian
- Department of Endodontics, Faculty of Dentistry and Dental Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Marzieh Mohamadzadeh
- Ashkhane Health Center, North Khorasan University of Medical Science, North Khorasan, Iran
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