Applying the Theory of Planned Behavior to Evaluate the Effectiveness of an Oral Health Education Intervention on Adult Oral Self-care Behavior : Randomized Controlled Trial (RCT)
| Autor: | Jo-Hsin Lin, 林若新 |
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| Rok vydání: | 2018 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 106 Background: Dental plaque in the oral cavity comprises food residue, saliva, bacteria, and epithelial cells from the oral mucosa. When dental plaque accumulates to a certain degree, it erodes tooth enamel and causes dental caries. To prevent dental caries and gingivitis, the commonest oral care practice is regular toothbrushing. However, toothbrushing by itself is insufficient. By using dental floss, individuals can more thoroughly remove dental plaque. Gingivitis has a prevalence of 99.17% among the adult population of Taiwan. However, the percentage of adults using dental floss daily is considerably less than 10%. The participants in our experiment used planning sheets to enable them to generate a simulated scenario. The scenario simulation was employed to remind participants and have them incorporate a new behavior into their daily routine. Consequently, a regular flossing behavior was developed among the participants. Objective: To utilize the theory of planned behavior (TPB) as a fundamental oral health education intervention to study the effectiveness of the intervention on oral self-care behavior in adults. Methods: TPB and the planning sheet framework were adopted, and a randomized controlled trial was performed. The oral health education intervention was conducted on 330 adult patients aged 20–45 years who attended a dental clinic in Cianjin District, Kaohsiung, Taiwan. During the pretest, participants completed a self-administered questionnaire. Subsequently, the experimental group was provided with health care education on toothbrushing and dental floss use and was taught how to complete the planning sheet. By contrast, the control group was provided only with a health care education sheet on dental floss use. Two weeks after the intervention, the first post-test was conducted through a questionnaire. The used dental floss sets and planning sheets were retrieved from the experimental group, and new dental floss sets and planning sheets were provided. Four weeks after the first post-test, a second post-test was conducted, in which the two groups of patients reported on their dental floss use situation to complete the follow-up. Result: Significant differences were observed between the two groups’ dental floss use habits (P < .001). From the pretest to the post-test and from the pretest to the second post-test, the experimental group demonstrated a substantial increase in dental floss use (24.7% and 22.8%, respectively). The results of regression analysis of the TPB variables for intervention effectiveness revealed that compared with that of the control group, the immediate result for behavior belief of the experimental group was higher by a score of 9.27 (β = 9.27, 95% CI = 7.99, 10.55); the result for evaluation of the experimental group was higher by a score of 6.52 (β = 20.04, 95% CI = 17.33, 22.76); the result for the normative beliefs was higher by a score of 20.04 (β = 20.04, 95% CI = 17.33, 22.76); the result for the motivation to comply was higher by a score of 21.30 (β = 21.30, 95% CI = 18.46, 24.14); the result for the control beliefs was higher by a score of 13.92 (β =13.92, 95% CI = 12.00, 15.84); and the result for the perceived behavioral control was higher by a score of 8.22 (β = 8.22, 95% CI = 7.03,9.42). Conclusion: The results suggested that oral health education intervention increased the dental patients’ toothbrushing and dental floss use behaviors for self-care. The action planning and coping planning on the planning sheet effectively increased the patient’s behavioral beliefs, result evaluation, normative beliefs, motivation to comply, control beliefs, and perceived behavioral control, thereby increasing the patients’ confidence in using dental floss and promoting their dental floss use. Therefore, planning sheets, which represent a simple and low-cost intervention, may be utilized in clinical settings to promote oral health education in dental patients. |
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