Effect of a hospital-based oral health-education program on Iranian staff: evaluating a theory-driven intervention

BACKGROUND: Tooth decay and periodontitis are among the most prevalent dental diseases globally with adverse effects on an individual’s general health. Recently the prevalence of dental caries has decreased significantly, but caries epidemiology remains a major problem in dental public health. This study investigated the impact of an oral health education intervention on Theory of Planned Behavior (TPB) variables, and whether changes in these variables persisted and were associated with changes in identified oral health behaviors at 2-month follow-up. METHODS: This descriptive pre/post test study was conducted with 160 staff in the Baqiyatallah Hospital in Tehran. Six hospital wards were selected using a randomized multi-stratified sampling frame. The size for each cluster was calculated as 22 with each ward being allocated to either the intervention or the control arm of the study. Self-report questionnaires were used to evaluate socio-demographic factors, dental attendance as well as the constructs of the augmented TPB model (attitudes, subjective norms, perceived behavioral control intentions). The intervention was an educational program based on TPB constructs delivered via direct training to half the participants. The control group was provided with usual training only. The independent-samples T-test, Repeated-Measures one-way ANOVA, and matched T-test with the significance level set at p < 0.05 were applied. RESULTS: Findings revealed significant variations between the two groups immediately after the educational intervention concerning the attitudes, subjective norms, perceived behavioral control, intentions to seek treatment, oral health behavior as well as decayed, missing, and filled teeth and bleeding on probing (p<0.001). Two months after the intervention, except for the brushing construct (p = 0.18), the differences between the two groups were all statistically significant (p<0.001). CONCLUSION: Our findings affirm the positive effect an oral health education program has on enhancing the attitudes, subjective norms, perceived behavioral control, intentions and behavior of staff in this hospital. The results of our study confirm that developing and applying an educational intervention in accordance with the theory of planned behavior can lead to significant changes in the knowledge, attitudes, and behavior of hospital staff regarding preventing tooth decay.