School-based strategies for oral health education of adolescents- a cluster randomized controlled trial

BMC Oral Health

Ayyaz Ali Khan¹  Muhammad Irfanullah Siddiqui²  Abdul Haleem¹ 

[1]Department of Oral Health Sciences, Federal Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, 54600, Pakistan

[2]Department of Community Medicine and Pilgrims, Umm Al-Qura University, Makkah Al-Mukarrama, 7607, Saudi Arabia

关键词: Dentist-led;    Teacher-led;    Peer-led;    Oral diseases;    Prevention;    Oral health promotion;    Dental health education;    Oral health education;   

Others  :  1126294
DOI  :  10.1186/1472-6831-12-54

 received in 2012-03-29, accepted in 2012-12-11,  发布年份 2012

【 摘 要 】

Background

Oral health education (OHE) in schools has largely been imparted by dental professionals. Considering the substantial cost of this expert-led approach, the strategies relying on teachers, peer-leaders and learners themselves have also been utilized. However the evidence for comparative effectiveness of these strategies is lacking in the dental literature. The present study was conducted to compare the effectiveness of dentist-led, teacher-led, peer-led and self-learning strategies of oral health education.

Methods

A two-year cluster randomized controlled trial following a parallel design was conducted. It involved five groups of adolescents aged 10-11 years at the start of the study. The trial involved process as well as four outcome evaluations. The present paper discusses the findings of the study pertaining to the baseline and final outcome evaluation, both comprising of a self-administered questionnaire, a structured interview and clinical oral examination. The data were analyzed using Generalized Estimating Equations.

Results

All the three educator-led strategies of OHE had statistically higher mean oral health knowledge (OHK), oral health behavior (OHB), oral hygiene status (OHS) and combined knowledge, behavior and oral hygiene status (KBS) scores than the self-learning and control groups (p<0.001). The mean OHK, OHS and KBS scores of the three educator-led strategies did not differ significantly. The peer-led strategy was, however, found to have a significantly better OHB score than the respective score of the teacher-led strategy (p<0.05). The self-learning group had significantly higher OHB score than the control group (p<0.05) but the OHK, OHS and KBS scores of the two groups were not significantly different.

Conclusions

The dentist-led, teacher-led and peer-led strategies of oral health education are equally effective in improving the oral health knowledge and oral hygiene status of adolescents. The peer-led strategy, however, is almost as effective as the dentist-led strategy and comparatively more effective than the teacher-led and self-learning strategies in improving their oral health behavior.

Trail registration

SRCTN39391017

【 授权许可】

   
2012 Haleem et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Khan AA: Oral health in Pakistan- a situation analysis. Pakistan: Ministry of Health, Government of Pakistan and World Health Organization; 2004.
• [2]Christensen LB, Petersen PE, Bhambal A: Oral health and oral health behavior among 11-13 year-olds in Bhopal, India. Community Dent Health 2003, 20:153-158.
• [3]Hamasha AA, Albashaireh Z: Periodontal treatment need of the 6th grade Jordanian pupils. Int J Paediatr Dent 2006, 16:181-185.
• [4]Prabhu NT, Warnakulasuriya K, Gelbier S, Robinson PG: Betel quid chewing among Bangladeshi adolescents living in East London. Int J Peadiatr Dent 2001, 11:18-24.
• [5]Shah SM, Merchant AT, Luby SP, Chotani RA: Addicted school children: prevalence and characteristics of areca nut chewers among primary school children in Karachi. Pakistan. J Paediatr Child Health 2002, 38:507-510.
• [6]Watt RG, Marinho VC: Does oral health promotion improve oral hygiene and gingival health? Periodontol 2005, 37:35-47.
• [7]Craft M, Croucher R, Dickinson J, James M, Clements M, Rodgers AI: Natural Nashers: a programme of dental health education for adolescents in schools. Int Dent J 1984, 34:204-213.
• [8]Petersen PE, Peng B, Tai B: Fan Ml: Effect of a school-based oral health education programme in Wuhan City, Peoples Republic of China. Int Dent J 2004, 54:33-41.
• [9]Nyandindi U, Palin-Palokas T, Milen A, Robison V, Kombe N, Mwakasagule S: Participation, willingness and abilities of school-teachers in oral health education in Tanzania. Community Dent Health 1994, 11:101-104.
• [10]Mellanby AR, Rees JB, Tripp JH: Peer-led and adult-led school health education: a critical review of available comparative research. Health Educ Res 2000, 15:533-545.
• [11]Cuijpers P: Peer-led and adult-led school drug prevention: a meta-analytic comparison. J Drug Educ 2003, 32:107-119.
• [12]Whitley E, Ball J: Statistic review 4: Sample size calculations. Crit Care 2002, 6:335-341. http//ccforum.com/content/6/4/335 webcite BioMed Central Full Text
• [13]Hemming K, Girling AJ, Stich AJ, March J, Lilford RJ: Sample size calculations for cluster randomized controlled trials with a fixed number of clusters. BMC Med Res Methodol 2011, 11:102-112. BioMed Central Full Text
• [14]Parcel GS, Baranowski T: Social learning theory and health education. Health Educ 1981, 12:14-18.
• [15]Levine R, Stillman-Lowe C: Scientific Basis of Oral Health Education. London: British Dental Journal; 2009.
• [16]Petersen PE: Oral cancer prevention and control- the approach of the World Health Organization. Oral Oncol 2009, 45:454-460.
• [17]Gupta PC, Bhonsle RB, Mehta FS, Pindborg JJ: Mortality experience in relation to tobacco chewing and smoking habits from a 10-year follow-up study in Ernakulam District. Kerala. Int J Epidemiol 1984, 13:184-187.
• [18]Haleem A, Khan AA, Siddiqui MI: A simplified dental examination for detection of cavitated carious lesions in school setting. Community Dent Oral Epidemiol 2009, 37:276-283.
• [19]Haleem A, Nadeem MB, Khalil MK, Asaad JM, Khan AA, Siddiqui MI: A simplified examination for detecting dental caries, plaque, gingivitis and calculus in school children- a longitudinal study. JPDA 2009, 18:167-173. http://jpda.com.pk/ webcite
• [20]Liang KY, Zeger SL: Longitudinal data analysis using generalized linear models. Biometrika 1986, 73:13-22.
• [21]Redmond CA, Blinkhorn FA, Kay K, Davies RM, Worthington HV, Blinkhorn AS: A cluster randomized controlled trial testing the effectiveness of a school-based dental health education program for adolescents. J Pub Health Dent 1999, 59:12-17.
• [22]Brown LF: Research in dental health education and health promotion: A review of the literature. Health Educ Q 1994, 21:83-102.
• [23]Kay E, Locker D: A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health 1998, 15:132-144.
• [24]Penland L: A decade of dental health education: review of the 1970s. Dent Hyg (Chic) 1982, 56:16-18. 20-2
• [25]Flanders RA: Effectiveness of dental health education programs in schools. JADA 1987, 114:239-242.
• [26]Schou L, Locker D: Oral Health: A review of the effectiveness of health education and health promotion. Amsterdam: Dutch Centre for Health Promotion and Health education; 1994.
• [27]Kay E, Locker D: Is dental health education effective- a systematic review of current evidence. Community Dent Oral Epidemiol 1996, 24:231-235.
• [28]Sprod A, Anderson R, Treasure E: Effective oral health promotion. Literature review. Cardiff: Health Promotion Wales; 1996.
• [29]Kay E, Locker D: A systematic review of the effectiveness of health promotion aimed at improving oral health. London: Health Education Authority; 1997.
• [30]Laiho M, Honkala E, Nyyssönen V, Milen AI: Three methods of oral health education in secondary schools. Scand J Dent Res 1993, 101:422-427.
• [31]Hodge HC, Holloway PJ, Bell CR: Factors associated with tooth brushing behavior in adolescents. Br Dent J 1982, 152:49-51.
• [32]Schou L, Currie C, Queen D: Using a ‘life style’ perspective to understand tooth brushing behaviour in Scottish school children. Community Dent Oral Epidemiol 1990, 18:230-234.
• [33]Oakley E, Demaine L, Warnakulasuriya S: Areca (betel) nut chewing habit among high-school children in the commonwealth of the Northern Mariana Islands (Micronesia). Bull World Health Organ 2005, 83:656-660.
• [34]Ashley FP, Sainsbury RH: The effect of a school-based plaque control programme on caries and gingivitis. A 3-year study in 11 to 14-year-old girls. Br Dent J 1981, 20:41-45.
• [35]Andlaw RJ: Oral hygiene and dental caries: a review. Int Dent J 1978, 28:1-6.