A systematic review of randomized controlled trials of interventions to improve adherence among orthodontic patients aged 12 to 18

Aljabaa, Aljazi; McDonald, Fraser; Newton, Tim

doi:10.2319/031214-184.1

Cited by 24 publications

(23 citation statements)

References 9 publications

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“…IM was proven to be a suitable method for developing health promotion programs for various health issues [64-66]. In the field of orthodontics, authors did not describe the process of program development explicitly in their publications [41,42,48-50,67-71]. This limited opportunities for comparison.…”

Section: Discussionmentioning

confidence: 99%

A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach

Scheerman¹,

Empelen²,

Loveren³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundThe insertion of fixed orthodontic appliances increases the risk of dental caries, particularly in adolescents. Caries can be prevented through good oral health behavior. To support adolescents with fixed orthodontic appliances and for promoting oral health behavior, we developed a theory- and evidence-based mHealth program, the WhiteTeeth app.ObjectiveThe objective of our paper was to describe the systematic development and content of the WhiteTeeth app.MethodsFor systematic development of the program, we used the intervention mapping (IM) approach. In this paper, we present the results of applying the first 5 steps of IM to the design of an mHealth program: (1) identifying target behaviors and determinants through problem analysis, including a literature search, a survey study, and semistructured interviews, to explore adolescent oral health behavior during orthodontic therapy; (2) defining program outcomes and objectives; (3) selecting theoretical methods and translating them into practical strategies for the program design; (4) producing the program, including a pilot test with 28 adolescents testing the acceptability and usability of the WhiteTeeth app; and (5) planning implementation and adoption.ResultsOn the basis of our literature search, we identified fluoride use and control of dental plaque levels (eg, tooth brushing and proxy brush usage) as target behaviors for preventing caries. Next, we identified important and changeable determinants of oral health behavior that fitted the theoretical concepts of the Health Action Process Approach (HAPA) theory. The HAPA theory, the self-regulation theory, and the results of the semistructured interviews were used to define the program objectives, that is, the performance and change objectives. After defining the objectives, we identified multiple behavior change techniques that could be used to achieve these objectives, such as providing oral health information and feedback, prompting self-monitoring, coaching of set actions and coping plans, and sending reminders. We translated these methods into practical strategies, such as videos and a brushing timer. Next, we combined these strategies into a single program resulting in the WhiteTeeth app (which is available on both iTunes and Google Play stores as “Witgebit”). Adolescents with fixed orthodontic appliances and dental professionals were included in the development process to increase the success of implementation. The pilot test revealed that the app users appreciated and liked the app. The WhiteTeeth app can be integrated into current orthodontic care.ConclusionsIM allowed us to identify multiple techniques that have been shown to be the most effective in initiating behavior change, but have not yet been incorporated into existing orthodontic apps. The WhiteTeeth app contains all these techniques, which makes it a unique and promising home-based app for promoting oral health in adolescents with fixed orthodontic appliances.

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Section: Discussionmentioning

confidence: 99%

A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach

Scheerman¹,

Empelen²,

Loveren³

et al. 2018

JMIR Mhealth Uhealth

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“…Several systematic reviews and meta-analyses have found positive effects of interventions to reduce risk behavior among adolescents and young adults, including tobacco use [5-7], alcohol misuse [8-11], drug use [12,13], risky driving [8], and unsafe sex [14]; as well as interventions to promote health behaviors, such as use of contraception to prevent pregnancy [15-17], human papilloma virus (HPV) vaccination [18], oral health and hygiene [19,20], and nutrition and exercise promotion [21-23]. The widespread use of electronic communication technologies by young people, particularly the use of mobile phones and other mobile devices [24-26], presents new opportunities to intervene on risk and preventive behavior.…”

Section: Introductionmentioning

confidence: 99%

Texting and Mobile Phone App Interventions for Improving Adherence to Preventive Behavior in Adolescents: A Systematic Review

Badawy¹,

Kuhns²

2017

JMIR Mhealth Uhealth

205

176

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BackgroundMany preventable behaviors contribute to adolescent mortality and morbidity. Non-adherence to preventive measures represents a challenge and has been associated with worse health outcomes in this population. The widespread use of electronic communication technologies by adolescents, particularly the use of text messaging (short message service, SMS) and mobile phones, presents new opportunities to intervene on risk and preventive risk behavior, but little is known about their efficacy.ObjectiveThis study aimed to systematically evaluate evidence for the efficacy of text messaging and mobile phone app interventions to improve adherence to preventive behavior among adolescents and describe intervention approaches to inform intervention development.MethodsThis review covers literature published between 1995 and 2015. Searches included PubMed, Embase, CENTRAL, PsycINFO, CINAHL, INSPEC, Web of Science, Google Scholar, and additional databases. The search strategy sought articles on text messaging and mobile phone apps combined with adherence or compliance, and adolescents and youth. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. Two reviewers independently screened titles and abstracts, assessed full-text articles, and extracted data from articles that met inclusion criteria. Included studies reflect original research—experimental or preexperimental designs with text messaging or mobile phone app interventions—targeting adherence to preventive behavior among adolescents (12-24 years old). The preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines were followed for reporting results, and findings were critically appraised against the Oxford Centre for Evidence-based Medicine criteria.ResultsOf 1454 records, 19 met inclusion criteria, including text messaging (n=15) and mobile phone apps (n=4). Studies targeted clinic attendance, contraceptive use, oral health, physical activity and weight management, sun protection, human papillomavirus (HPV) vaccination, smoking cessation, and sexual health. Most studies were performed in the United States (47%, 9/19), included younger adolescents (63%, 12/19), and had sample size <100 (63%, 12/19). Although most studies were randomized controlled trials (RCTs; 58%, 11/19), only 5 followed an intent-to-treat analysis. Only 6 of 19 studies (32%) incorporated a theoretical framework in their design. Most studies reported good feasibility with high acceptability and satisfaction. About half of the included studies (42%, 8/19) demonstrated significant improvement in preventive behavior with moderate standardized mean differences. As early efforts in this field to establish feasibility and initial efficacy, most studies were low to moderate in quality. Studies varied in sample size and methods of preventive behavior adherence or outcome assessment, which prohibited performing a meta-analysis.ConclusionsDespite the promising feasibility and acceptability of text messaging and mobile phone a...

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“…Few clinical evaluations of compliance exist in the literature. [24] The validity and reliability of Richter's clinical compliance evaluation form nor the modified form have been well established. A ceiling effect was observed with the MCCE and the patients in this study.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Rewards on Orthodontic Patient Compliance

Ardeshna

Hendler²,

Jiang

2018

J Indian Orthod Soc

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Context: Successful orthodontic treatment requires patient compliance with respect to oral hygiene, appliance wear, and appliance and appointment maintenance. Aims: This prospective, nonrandomized clinical study aimed to determine if orthodontic patients' compliance could be improved if they were offered material rewards. Subjects and Methods: Data were gathered from 35 patients with a mean age of 14.0 years over a nine appointment period. Compliance was measured for a three appointment baseline phase followed by a six appointment reward phase when both intermediate and final rewards were offered to patients who achieved the desired scores. The patients served as their own control. Compliance was measured in four categories (oral hygiene, removable appliance wear, fixed appliance maintenance, and appointment punctuality) using the modified clinical compliance evaluation form, at each appointment. Compliance scores from the baseline phase (prescore) were compared to the scores from the reward phase (postscore). Results: Paired sample t-tests revealed no statistically significant difference in pre-and postscores. Postscores were found to have no correlation with intermediate and final rewards. Conclusions: This study concluded that tangible rewards did not significantly improve orthodontic patient compliance. Furthermore, age and gender did not significantly affect compliance scores.

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A systematic review of randomized controlled trials of interventions to improve adherence among orthodontic patients aged 12 to 18

Cited by 24 publications

References 9 publications

A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach

A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach

Texting and Mobile Phone App Interventions for Improving Adherence to Preventive Behavior in Adolescents: A Systematic Review

The Effect of Rewards on Orthodontic Patient Compliance

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