Family behavior theory-based intervention via mobile messaging to improve oral health of adolescents: study protocol for a cluster randomized controlled trial

Pei Liu, May Chun Mei Wong, Gillian Hiu Man Lee, Cynthia Kar Yung Yiu, Edward Chin Man Lo, Pei Liu, May Chun Mei Wong, Gillian Hiu Man Lee, Cynthia Kar Yung Yiu, Edward Chin Man Lo

Abstract

Background: Due to some unique physical, social and psychological features in the adolescent population, adolescents can be a time of heightened caries activity and periodontal disease. Oral health-related behaviors can be modified to improve oral health status. The family networks and the built environment can promote or inhibit health behaviors. The aim of this study is to implement and evaluate a behavior theory-based, integrated family intervention via mobile messaging to improve oral health of adolescents.

Methods: This is a three-arm parallel-design cluster-randomized controlled trial. This trial will allocate 12 local secondary schools (clusters) in Hong Kong to three test or comparison groups with a ratio 1:1:1. The enrolled Form II to IV students (ages 12 to 15) will be eligible for participation. The intervention to three study groups will be (i) Health Belief Model (HBM)-based mobile messaging to the adolescents and their parents, which will consist of several blocks of HBM-based messages and reinforcement during 24 weeks; (ii) same HBM-based messaging to adolescents only; and (iii) delivering e-version of oral health education pamphlets to adolescents. The primary outcome will be caries increment 2 years post-intervention. Changes in oral health self-efficacy and behaviors, oral hygiene, and gingival status will be the secondary outcomes.

Discussion: No school dental care service is available to secondary school students in Hong Kong. This study will be the first to test a theory-driven and family-engaged preventive intervention among adolescents in Hong Kong. Findings will contribute to developing a low-cost, feasible, and efficient oral health preventive program for adolescents.

Trial registration: ClinicalTrials.gov NCT05448664 . Registered on 7 July 2022.

Keywords: Health Belief Model; adolescents; family-level intervention; mHealth; oral health; primary prevention.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

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Fig. 1
Schedule of enrolment, interventions, and assessments

References

    1. World Health Organization . Oral health surveys: basic methods. 5 2013.
    1. American Academy on Pediatric Dentistry . Adolescent Oral Health Care. The Reference Manual of Pediatric Dentistry. 2017. pp. 233–240.
    1. 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.
    1. Tsai C, Raphael S, Agnew C, McDonald G, Irving M. Health promotion interventions to improve oral health of adolescents: a systematic review and meta-analysis. Community Dent Oral Epidemiol. 2020;48(6):549–560. doi: 10.1111/cdoe.12567.
    1. Janz NK, Becker MH. Health Educ Q. 1984;11:1–47. doi: 10.1177/109019818401100101.
    1. Sanaei Nasab H, Yazdanian M, Mokhayeri Y, Latifi M, Niksadat N, Harooni J, et al. The role of psychological theories in oral health interventions: a systematic review and meta-analysis. Int J Dent Hyg. 2019;17(2):142–152. doi: 10.1111/idh.12386.
    1. Xiang B, Wong HM, McGrath CPJ. The efficacy of peer-led oral health programs based on Social Cognitive Theory and Health Belief Model among Hong Kong adolescents: a cluster-randomized controlled trial. Transl Behav Med. 2022;12(3):423–432. doi: 10.1093/tbm/ibab142.
    1. Hall A, Cole-Lewis H, Bernhardt J. Mobile Text Messaging for Health: A Systematic Review. Annu Rev Public Health. 2015;36:393–415. doi: 10.1146/annurev-publhealth-031914-122855.
    1. Zotti F, Dalessandri D, Salgarello S, Piancino M, Bonetti S, Visconti L, et al. Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients. Angle Orthod. 2016;86(1):101–107. doi: 10.2319/010915-19.1.
    1. Scheerman JFM, van Meijel B, van Empelen P, Verrips GHW, van Loveren C, Twisk JWR, et al. The effect of using a mobile application (“WhiteTeeth”) on improving oral hygiene: A randomized controlled trial. Int J Dent Hyg. 2020;18(1):73–83. doi: 10.1111/idh.12415.
    1. Li X, Xu ZR, Tang N, Zhu XL, Zhou T, Zhao ZH. Effect of intervention using a messaging app on compliance and duration of treatment in orthodontic patients. Clin Oral Investig. 2016;20(8):1849–1859. doi: 10.1007/s00784-015-1662-6.
    1. Christensen P. The health-promoting family: a conceptual framework for future research. Soc Sci Med. 2004;59(2):377–387. doi: 10.1016/j.socscimed.2003.10.021.
    1. Castilhoa ARF, Mialheb FL, Barbosac TS, Puppin-Rontanid RM. Influence of family environment on children’s oral health: a systematic review. J Pediatr. 2013;89(2):116–123. doi: 10.1016/j.jped.2013.03.014.
    1. Glanz K, Rimer K, Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice. 4 2008.
    1. Kiresuk TJ, Smith A, Cardillo JE. Goal attainment scaling: Applications, theory, and measurement. Hillsdale: Lawrence Erlbaum Associates, Inc; 1994.
    1. Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, et al. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Commun Dent Oral Epidemiol. 2007;35(3):170–178. doi: 10.1111/j.1600-0528.2007.00347.x.
    1. Wu L, Gao X, Lo CM, Ho MY, et al. Motivational Interviewing to Promote Oral Health in Adolescents. J Adolesc Health. 2017;61(3):378–384. doi: 10.1016/j.jadohealth.2017.03.010.
    1. Wu L. Motivational interviewing to promote oral health in adolescents: a randomized controlled trial. (E-thesis) 2017.
    1. Hajian-Tilaki K. Sample size estimation in epidemiologic studies. Caspian J Intern Med. 2011;2:289–298.
    1. Hemming K, Eldridge S, Forbes G, Weijer C, Taljaard M. How to design efficient cluster randomised trials. BMJ. 2017;358:j3064. doi: 10.1136/bmj.j3064.
    1. Hox JJ, Moerbeek M, Van de Schoot R. Multilevel analysis: techniques and applications. New York: Routledge; 2010.
    1. Xiang B, Wong HM, Cao W, Perfecto AP, Mcgrath CPJ. Development and validation of the Oral health behavior questionnaire for adolescents based on the health belief model (OHBQAHBM) BMC Public Health. 2020;20(1):701–705. doi: 10.1186/s12889-020-08851-x.
    1. Department of Health, Hong Kong SAR . Oral Health Survey. 2011.
    1. Lu HX, Wong CM, Lo CM, McGrath CPJ. Trends in oral health from childhood to early adulthood: a life course approach. Community Dent Oral Epidemiol. 2011;39(4):352–360. doi: 10.1111/j.1600-0528.2011.00611.x.
    1. World Health Organization . The World Oral Health Report 2003: Continuous improvement of oral health in the 21st century - the approach of the WHO Global Oral Health Programme. 2003.

Source: PubMed

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