The Effect of an Educational Intervention on Oral Health Literacy, Knowledge, and Behavior in Iranian Adolescents: A Theory-Based Randomized Controlled Trial

Abstract

Introduction. Oral health is one of the most important issues in public health. Most educational interventions, as the primary prevention strategy, are focused on increasing information and knowledge and are not usually effective. Therefore, the present study is aimed at determining the effect of theory-based education on oral health behavior and its psychological determinants including dental health literacy. Method. This randomized controlled educational trial was conducted in two girls’ high schools that were selected by multistage cluster sampling and were divided into an intervention and a control group. Literacy, knowledge, oral health behavior, dental plaque index, and constructs of the protection motivation theory were evaluated before and one month after four training sessions. Finally, the data were entered into the SPSS 19 software and were analyzed using the chi-square test, independent t -test, and Mann–Whitney test at the significant level of 0.05. Result. Before the intervention, there was no significant difference between the intervention and control groups regarding the mean scores of knowledge, behavior, and oral health literacy; plaque index; and protection motivation theory constructs. After the educational intervention, however, the means of these variables were significantly improved in the intervention group compared to the controls ( p < 0.05 ). Conclusion. The study findings were in favor of the effectiveness of the theory-based educational intervention in improving the knowledge, literacy, and behavior related to oral health. Yet, further research is suggested to determine the effectiveness of such an intervention in male students as well as in populations with different socioeconomic and cultural statuses.

Health literacy among adolescents and young adults in the Eastern Mediterranean region: a scoping review

“…The target population comprised individuals aged 10–25 years. One study targeted only young men31 whereas 1o studies included only women 32–41. The other studies included both male and female adolescents and young adults.…”

“…The identified studies used various types of health literacy related to the following health topics: general health31 32 34 35 42–67; nutrition68–82; non-communicable diseases (NCDs)36 63; HIV83 84; e-health39 85–91; media92; physical health93 94; oral health38 95; medical96; disability67 97 98; mental health37 40 41 99–108; suicide109 110; and depression 33 111. These studies used 36 scales to measure health literacy, and these scales can be grouped into three categories: newly developed scales66 77 82 86 93 98; newly adapted and translated scales33 40 41 43 54 55 64 69 83 96 100 111; and previously adapted and translated scales 34 35 38 39 44–46 49 51–53 56–59 62 65 67 68 71–73 76 78–80 85 87–89 91 95 97 103 104 107–110 112 113…”

“…Among the nine studies that used health literacy-related educational interventions,32 34 38 40 56 62 78 83 99 four studies tested the effectiveness of the interventions, with health literacy as the main outcome 38 56 78 83. A study conducted in Tunisia83 used peer-led education to improve HIV-related health literacy, knowledge, risk perception and preventive behaviours.…”

“…Finally, in Iran, an intervention was conducted among adolescents that provided 1-hour educational sessions on oral health literacy four times per week. The curriculum and materials used in this intervention were based on the protection motivation theory 38. This theory-based educational intervention increased oral health literacy and health-related behaviours.…”

“…Moreover, these studies had a risk of bias in the outcome assessment because the outcome assessors were not blinded to the intervention status (online supplemental table 6). 32 34 83 Two randomised controlled trials were evaluated, one of which raised concerns related to missing data and selection of reported results 38. Finally, two42 106 out of the three qualitative studies included in this review were of good quality.…”