An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial

Hormoz Sanaeinasab; Mohsen Saffari; Hassan Taghavi; Aliakbar Karimi Zarchi; Fatemeh Rahmati; Faten Al Zaben; Harold G Koenig

doi:10.1186/s12903-022-02132-2

An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial

BMC Oral Health. 2022 Mar 27;22(1):94. doi: 10.1186/s12903-022-02132-2.

Authors

Hormoz Sanaeinasab^{1

2}, Mohsen Saffari^{3

4}, Hassan Taghavi⁵, Aliakbar Karimi Zarchi^{1

6}, Fatemeh Rahmati¹, Faten Al Zaben⁷, Harold G Koenig^{7

8

9}

Affiliations

¹ Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
² Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
³ Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Saffari.ches@gmail.com.
⁴ Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran. Saffari.ches@gmail.com.
⁵ Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.
⁶ Department of Epidemiology and Biostatistics, Baqiyatallah University of Medical Sciences, Tehran, Iran.
⁷ Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁸ Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
⁹ School of Public Health, Ningxia Medical University, Yinchuan, China.

Abstract

Background: Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children.

Methods: A total of 112 children ages 6-12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student's t-test and analysis of covariance.

Results: All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = - 0.9 to - 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups.

Conclusion: An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

Keywords: Behavior; Dental caries; Gingival health; Health education; Oral health.

Publication types

Randomized Controlled Trial

MeSH terms

Child
Dental Caries* / prevention & control
Health Behavior
Health Belief Model
Health Knowledge, Attitudes, Practice
Humans
Oral Health