Ju Xiangqun, Brennan David, Parker Eleanor, Mills Helen, Kapellas Kostas, Jamieson Lisa
Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.
Community Dent Oral Epidemiol. 2017 Oct;45(5):413-426. doi: 10.1111/cdoe.12305. Epub 2017 May 19.
To determine the effect of an oral health literacy intervention on oral health literacy-related outcomes among rural-dwelling Indigenous Australian adults.
A total of 400 Indigenous adults (203 intervention and 197 control participants) were recruited into a randomized controlled trial; a functional, context-specific oral health literacy interventions were developed and implemented by Indigenous staff. The intervention comprised five sessions, each lasting 1.5 hours, across a 1-year period. The primary outcome was oral health literacy as assessed by the HeLD-14 instrument, with secondary outcomes including the social impact of oral disease, and psychosocial and knowledge-related factors. Three scenarios were used in data analysis: (I) intention to treat; (II) as treated and; (III) adherence only. Multiple imputation (MI) was used to replace missing data.
The proportion reporting that "water with fluoride" was good increased in the intervention group within both crude and MI data analyses under the three scenarios. Other crude data analysis yielded no significant differences for either primary or secondary outcomes between intervention and control groups under the three scenarios. After MI, oral health literacy improved when assessed under scenario II (mean change=1.3, 95% CI: 1.1, 1.6). Improvements under three scenarios were also observed for the Oral Health Impact Profile (OHIP-14; mean change ranged from -0.7 to -3.8), sense of control (mean change ranged from 0.4 to 1.1), oral health-related fatalism (mean change ranged from -0.7 to -0.4) and perceived stress (mean change ranged from -2.1 to -1.1). The proportion reporting that "cordial was good" decreased in the intervention group from MI analysis under scenarios II and III.
A context-specific oral health literacy intervention was partially successful in improving oral health literacy and oral health literacy-related outcomes in this vulnerable population, but only after MI.
确定口腔健康素养干预对澳大利亚农村原住民成年人口腔健康素养相关结果的影响。
共招募400名原住民成年人（203名干预组参与者和197名对照组参与者）参与一项随机对照试验；由原住民工作人员开发并实施了一项功能性、针对特定情境的口腔健康素养干预措施。该干预措施在1年时间内包括五个环节，每个环节持续1.5小时。主要结果是通过HeLD - 14工具评估的口腔健康素养，次要结果包括口腔疾病的社会影响以及心理社会和知识相关因素。数据分析采用三种情况：（I）意向性分析；（II）实际治疗情况分析；（III）仅依从性分析。采用多重填补法（MI）替代缺失数据。
在三种情况下的原始数据分析和MI数据分析中，干预组中报告“含氟水有益”的比例均有所增加。在三种情况下，其他原始数据分析显示干预组和对照组在主要或次要结果方面均无显著差异。MI后，在情况II下评估时口腔健康素养有所改善（平均变化 = 1.3，95%置信区间：1.1，1.6）。在三种情况下，口腔健康影响量表（OHIP - 14；平均变化范围为 - 0.7至 - 3.8）、控制感（平均变化范围为0.4至1.1）、口腔健康相关宿命论（平均变化范围为 - 0.7至 - 0.4）和感知压力（平均变化范围为 - 2.1至 - 1.1）也有改善。在情况II和III的MI分析中，干预组中报告“甜酒有益”的比例有所下降。
针对特定情境的口腔健康素养干预在改善这一弱势群体的口腔健康素养及与口腔健康素养相关的结果方面取得了部分成功，但仅在采用MI后。
