Improving Oral Health Knowledge and Habits in People With Diabetes Through a Theory Guided WhatsApp Education Program

January 1, 2026 updated by: ILMA KIRAN, Dow University of Health Sciences

The Effectiveness of Educational Intervention Based on Health Belief Model Delivered Via WhatsApp on Oral Health Knowledge and Behaviors of Individuals With Type 2 Diabetes Mellitus; A Randomized Controlled Trial

The goal of this Educational interventional study is to test the usefulness of an educational program delivered through WhatsApp videos in increasing oral health knowledge and habits in people with Diabetes between the age of 18 and 65 years. The main question it aims to answer is:

Does a WhatsApp-based educational Program improve oral health knowledge and behaviors in people with diabetes, and is it more effective than education delivered through brochures? Participants in one group will receive educational videos through WhatsApp, while the other group receive a brochure containing oral health information. Researchers will then compare the groups to see if the intervention made a difference.

Participants will:

  • Fill a baseline questionnaire to assess their current knowledge and behaviors.
  • They then either participate in a one-month educational program delivered through WhatsApp, or receive an educational brochure.
  • Wait for 1 month after the program to allow for application of knowledge.
  • Fill a post intervention questionnaire to assess changes in knowledge and behavior.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The purpose of this study is to determine whether an educational intervention based on the Health Belief Model (HBM) and delivered through WhatsApp may improve diabetes patients' oral health behaviors and knowledge. This study is a randomized controlled trial (RCT) with two groups: an intervention group (WhatsApp-based education) and a control group (brochure-based education). Adults (18-65 years) with Type 2 Diabetes Mellitus from a diabetes clinic in Karachi were recruited. 98 participants (49 in each group) were selected through random allocation. The randomization process ensured that participants are evenly distributed between the groups based on key factors, specifically gender, educational level and duration of diabetes to reduce potential bias from these characteristics. This study was a single blinded study in which participants were not informed about the existence of two distinct groups. The WhatsApp based intervention consisted of 12 short educational videos, each approximately 3 to 5 minutes in duration, these videos were sent individually to each participant every alternate day from Monday to Friday, resulting in three videos per week over a period of one month, Reminders were sent the following day after each video to encourage engagement and sustain behavior change. Each week was focused on specific HBM constructs delivered through short, professionally scripted educational videos in Urdu. Each week was focused on specific HBM constructs. The control group received only an educational brochure.

A structured questionnaire was used to evaluate participants' knowledge and oral hygiene practices at two points: baseline (before intervention) and one-month post-intervention. The questionnaire was designed to measure HBM constructs (e.g. perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy), awareness of oral care and oral hygiene related behaviors. Data were analyzed using SPSS Version 27.

Study Type

Interventional

Enrollment (Actual)

98

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Sindh
      • Karachi, Sindh, Pakistan
        • National Institute of Diabetes & Endocrinology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18-65 years with a confirmed diagnosis of T2DM
  • Able to use WhatsApp for the study duration
  • Able to read and write in Urdu

Exclusion Criteria:

  • Edentulous
  • Individuals diagnosed with life-threatening diseases such as advanced cancer, end-stage renal disease, or severe cardiac failure
  • Diminished cognitive ability
  • Radiotherapy in head and neck region.
  • Planning to migrate during the study period.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Educational Brochure Group
Participants in this group receive oral health education through an educational brochure
Behavioral: Educational Brochure Group
The Educational brochure provides information on the relationship between Type 2 Diabetes Mellitus and oral health and recommended oral hygiene practices. No WhatsApp based videos are provided during the study period
Other: Health Belief Model Based WhatsApp Oral Health Education Program
Participants receive a Health Belief Model (HBM) based oral health education program through WhatsApp videos for four weeks.
Behavioral: Health Belief Model (HBM) Based WhatsApp Oral Health Education Program
The program includes short educational videos, weekly thematic content, reminders, and behavior-reinforcement messages aimed at enhancing oral health knowledge, HBM constructs, and oral hygiene behaviors among individuals with Type 2 Diabetes Mellitus.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Oral Health Knowledge Score
Time Frame: Baseline and 4 weeks after intervention
The participant's knowledge about the relationship between diabetes and oral health issues, will be assessed through a structured Questionnaire consisting of 10 binary items. (Yes = 1, No = 0). A total knowledge score ranging from 0 to 10 will be calculated by summing item responses, with higher scores indicating greater oral health knowledge. Pre- and post-knowledge scores will be compared, and cutoff scores will be calculated using the mean and Standard Deviation.
Baseline and 4 weeks after intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Health Belief Model Construct Scores
Time Frame: Baseline and 4 weeks after intervention
Health Belief Model constructs, including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action, will be assessed using a structured Questionnaire. Items will be measured on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Separate construct scores will be calculated by summing item responses within each domain, with higher scores indicating stronger beliefs or perceptions related to oral health behaviors.
Baseline and 4 weeks after intervention
Oral Hygiene Behavior Score
Time Frame: Baseline and 4 weeks after intervention
Participants' reported frequency and quality of oral health practices, including brushing, flossing, gingival health, and dental visits will be measured on a scale of 0(never) to 4(always) using a structured questionnaire. Higher scores indicate better oral hygiene-related behaviors. Pre- and post-intervention scores will be compared, and cutoff levels will be determined using the mean and standard deviation(SD).
Baseline and 4 weeks after intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Dow University of Health Sciences

Investigators

  • Principal Investigator: ILMA KIRAN, BDS, MPH, Dow University of Health Sciences

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 15, 2025

Primary Completion (Actual)

November 30, 2025

Study Completion (Actual)

November 30, 2025

Study Registration Dates

First Submitted

December 8, 2025

First Submitted That Met QC Criteria

January 1, 2026

First Posted (Actual)

January 7, 2026

Study Record Updates

Last Update Posted (Actual)

January 7, 2026

Last Update Submitted That Met QC Criteria

January 1, 2026

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB4057/DUHS/Approval/2025/294

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The study does not include a plan to make individual participant data (IPD) available due to privacy considerations and absence of participant consent for public data sharing.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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