Armoon Bahram, Yazdanian Mohsen, Higgs Peter, Nasab Hormoz Sanaei
Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR, Iran.
BMC Med Educ. 2021 Jan 6;21(1):17. doi: 10.1186/s12909-020-02435-4.
Tooth decay and periodontitis are among the most prevalent dental diseases globally with adverse effects on an individual's general health. Recently the prevalence of dental caries has decreased significantly, but caries epidemiology remains a major problem in dental public health. This study investigated the impact of an oral health education intervention on Theory of Planned Behavior (TPB) variables, and whether changes in these variables persisted and were associated with changes in identified oral health behaviors at 2-month follow-up.
This descriptive pre/post test study was conducted with 160 staff in the Baqiyatallah Hospital in Tehran. Six hospital wards were selected using a randomized multi-stratified sampling frame. The size for each cluster was calculated as 22 with each ward being allocated to either the intervention or the control arm of the study. Self-report questionnaires were used to evaluate socio-demographic factors, dental attendance as well as the constructs of the augmented TPB model (attitudes, subjective norms, perceived behavioral control intentions). The intervention was an educational program based on TPB constructs delivered via direct training to half the participants. The control group was provided with usual training only. The independent-samples T-test, Repeated-Measures one-way ANOVA, and matched T-test with the significance level set at p < 0.05 were applied.
Findings revealed significant variations between the two groups immediately after the educational intervention concerning the attitudes, subjective norms, perceived behavioral control, intentions to seek treatment, oral health behavior as well as decayed, missing, and filled teeth and bleeding on probing (p<0.001). Two months after the intervention, except for the brushing construct (p = 0.18), the differences between the two groups were all statistically significant (p<0.001).
Our findings affirm the positive effect an oral health education program has on enhancing the attitudes, subjective norms, perceived behavioral control, intentions and behavior of staff in this hospital. The results of our study confirm that developing and applying an educational intervention in accordance with the theory of planned behavior can lead to significant changes in the knowledge, attitudes, and behavior of hospital staff regarding preventing tooth decay.
龋齿和牙周炎是全球最普遍的牙科疾病，对个人总体健康有不利影响。最近，龋齿的患病率显著下降，但龋齿流行病学仍是牙科公共卫生领域的一个主要问题。本研究调查了口腔健康教育干预对计划行为理论（TPB）变量的影响，以及这些变量的变化在2个月随访时是否持续存在并与所确定的口腔健康行为变化相关。
本描述性前后测研究在德黑兰巴奇亚塔拉医院的160名工作人员中进行。使用随机多分层抽样框架选择了六个医院病房。每个群组的规模计算为22，每个病房被分配到研究的干预组或对照组。采用自填问卷评估社会人口学因素、就诊情况以及扩展TPB模型的构成要素（态度、主观规范、感知行为控制、意图）。干预措施是基于TPB构成要素的教育项目，通过直接培训传授给一半的参与者。对照组仅接受常规培训。应用独立样本t检验、重复测量单因素方差分析和配对t检验，显著性水平设定为p<0.05。
研究结果显示，教育干预后立即在两组之间发现了关于态度、主观规范、感知行为控制、寻求治疗的意图、口腔健康行为以及龋失补牙数和探诊出血方面的显著差异（p<0.001）。干预两个月后，除刷牙这一构成要素外（p = 0.18），两组之间的差异均具有统计学意义（p<0.001）。
我们的研究结果证实了口腔健康教育项目对改善该医院工作人员的态度、主观规范、感知行为控制、意图和行为具有积极作用。我们的研究结果证实，根据计划行为理论制定和应用教育干预措施可导致医院工作人员在预防龋齿的知识、态度和行为方面发生显著变化。
