Effects of health-promoting school strategy on dental plaque control and preventive behaviors in schoolchildren in high-caries, rural areas of Taiwan: a quasi-experimental design

Abstract

Background We evaluated the effects of health-promoting school (HPS) strategy on plaque control and behavior change in high-caries schoolchildren in Taitung, Taiwan. Methods A quasi-experimental design was adopted; six intervention schools (intervention group [IG]) and six comparison schools (comparison group [CG]) were selected from elementary schools with higher-than-average caries rates (> 68%). The IG was selected using cluster sampling, and the CG was selected to match the IG. In total, the IG and CG groups included 166 and 174 children each. The selected schools implemented the HPS framework for 3 months in the 2019 academic year. An oral examination of dental plaque was administered, and a self-administered questionnaire regarding knowledge, attitude, self-efficacy, and behaviors was distributed at baseline and at 2-week follow-up. A linear and logistic regression model using generalized estimating equations (GEEs) was used to analyze the differences between baseline and the follow-up data. Results Compared with the CG, the IG had a greater reduction in plaque index among second graders (β = − 0.36) and plaque control record scores among second, fourth, and sixth graders (β = − 27.48, − 26.04, and − 18.38, respectively). The IG also exhibited a greater increase at follow-up with respect to oral health–related knowledge among second graders and fourth graders (β = 1.46 and β = 0.92, respectively), attitude toward oral hygiene behaviors among sixth graders (β = 1.78), and self-efficacy regarding flossing for sixth graders (β = 1.43). Sixth graders in the IG were significantly more likely to brush before sleeping (adjusted odds ratio [aOR] = 2.99) and use fluoride toothpaste (aOR = 5.88) than those in the CG. Conclusions The HPS strategy was effective in reducing dental plaque and promoting preventing behaviors in rural high-caries schoolchildren.

Development and evaluation of the “Toothbrushing Timer with Information on Toothbrushes” application: A prospective cohort pilot study

“…The results of previous studies showed that the oral health practice scores of an intervention group who received oral health education increased, in line with our results (Bonabi et al, 2019;Haque et al, 2016). In this study, the participants showed an increase in tooth-brushing time and in tendency of self-efficiency toward thorough toothbrushing cleanly after the intervention at T1 compared to T0, and similar results were observed by Haque et al (2016) and Wei et al (2021).…”

“…To date, several reports have used a questionnaire regarding oral health practice and self‐efficacy in oral hygiene to evaluate the efficacy of oral health education (Bonabi et al, 2019 ; Haque et al, 2016 ; Kumar et al, 2022 ; Wei et al, 2021 ). The results of previous studies showed that the oral health practice scores of an intervention group who received oral health education increased, in line with our results (Bonabi et al, 2019 ; Haque et al, 2016 ).…”

“…The questionnaire for the present study was designed according to Haque et al ( 2016 ) and Wei et al ( 2021 ) to estimate the oral health practice and self‐efficacy related to oral hygiene. It contained the following eight items divided into two main categories: Oral health practice : (1) Frequency of toothbrushing (times per day) (maximum score: 3, minimum score: 1; once: 1, twice: 2, three or more times: 3).…”

Salud oral en la adolescencia: Relación entre conocimiento, actitud y práctica de cepillado dental

“…Resultados similares fueron observados en estudios previos, como el realizado por Borges-Yáñez, Castrejón-Pérez e Irigoyen (2017) en escolares de 6 a 13 años, donde un programa de cepillado dental supervisado mejoró las condiciones de higiene oral y redujo la placa dental, lo que respalda la importancia de la supervisión activa en el cuidado oral de los niños. Del mismo modo, Wei et al (2021) evaluaron una estrategia escolar de promoción de la salud que logró reducir la placa dental, mejorar el conocimiento sobre salud oral y aumentar la autoeficacia en higiene oral en escolares.…”

Do Right, Be Bright: A Protocol on the Development of an Inter-Professional Health Intervention Model for Pre-School Children Through a Community-Based Service-Learning Initiative

“…In areas where children are suffering from various conditions, converging multiple interventions onto a single platform allows for maximizing efficiency, the scale of impact and sustainability. 15 The HPS framework has been employed to implement oral health interventions in several countries such as Taiwan, 16 the United Kingdom, 17 and Canada. 18 In Malaysia, the school health program under the Ministry of Health is a comprehensive and systematic program carried out in government schools.…”