Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial.
Early detection of cancer
Educational models
Mouth cancer
Primary prevention
Self-examination
Theory of planned behavior
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
17 May 2024
17 May 2024
Historique:
received:
10
01
2024
accepted:
30
04
2024
medline:
18
5
2024
pubmed:
18
5
2024
entrez:
17
5
2024
Statut:
epublish
Résumé
The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022. This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17. Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (β = 1.47), attitude (β = 0.66), subjective norm (β = 2.82), and perceived behavioral control (β = 1.19) in both groups (p < 0.001). The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer. The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).
Sections du résumé
BACKGROUND
BACKGROUND
The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022.
METHODS
METHODS
This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17.
RESULTS
RESULTS
Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (β = 1.47), attitude (β = 0.66), subjective norm (β = 2.82), and perceived behavioral control (β = 1.19) in both groups (p < 0.001).
CONCLUSIONS
CONCLUSIONS
The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer.
TRIAL REGISTRATION
BACKGROUND
The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).
Identifiants
pubmed: 38760829
doi: 10.1186/s12903-024-04315-5
pii: 10.1186/s12903-024-04315-5
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
577Subventions
Organisme : Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
ID : 1400-3-238-56966
Organisme : Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
ID : 1400-3-238-56966
Informations de copyright
© 2024. The Author(s).
Références
Oral health. Geneva: World Health Organization. 2023. https://www.who.int/news-room/fact-sheets/detail/oral-health .
Khani Jeihooni A, Jafari F. Oral cancer: epidemiology, prevention, early detection, and treatment. In: Gokul, Sridharan, editors. Oral cancer: current concepts and future perspectives. London: IntechOpen; 2022. https://doi.org/10.5772/intechopen.99236 .
doi: 10.5772/intechopen.99236
Cancer Today. Global Cancer Observatory. International Agency for Research on Cancer, Lyon. GLOBOCAN 2020. https://gco.iarc.fr/today/online-analysis-table .
Vatchala Rani RM, Manjunath BC, Bajpai M, Gupta P, Bhargava A, Kumar A. Is mouth self examination (MSE) a good tool for early detection of oral cancer? A review. Saudi J Oral Dent Res. 2021;6(4):160–5.
doi: 10.36348/sjodr.2021.v06i04.005
Chow LQ. Head and neck cancer. N Engl J Med. 2020;382(1):60–72.
pubmed: 31893516
doi: 10.1056/NEJMra1715715
Hashim D, Genden E, Posner M, Hashibe M, Boffetta P. Head and neck cancer prevention: from primary prevention to impact of clinicians on reducing burden. Ann Oncol. 2019;30:744–56.
pubmed: 30840052
pmcid: 6551449
doi: 10.1093/annonc/mdz084
The Crete Declaration on Oral Cancer Prevention 2005: A commitment to action. 2005. https://screening.iarc.fr/doc/orh_crete_declaration_april05.pdf .
Petersen PE. Oral cancer prevention and control: the approach of the World Health Organization. Oral Oncol. 2009;45:454–60.
pubmed: 18804412
doi: 10.1016/j.oraloncology.2008.05.023
Sankaranarayanan R, Ramadas K, Amarasinghe H, Subramanian S, Johnson N. Oral cancer: prevention, early detection, and treatment. In: Gelband H, Jha P, Sankaranarayanan R, Horton S, editors. Cancer: disease control priority. Washington, DC: The World Bank; 2015. pp. 85–99.
Shrestha G, Maharjan L. Mouth self-examination for prevention and control of oral cavity cancer. J Nepal Med Assoc. 2020;58(225):360–2.
doi: 10.31729/jnma.4910
Chaturvedi AK, Anderson WF, Lortet-Tieulent J, Curado MP, Ferlay J, Franceschi S, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol. 2013;31(36):4550–9.
pubmed: 24248688
pmcid: 3865341
doi: 10.1200/JCO.2013.50.3870
Bhargava S. Need of oral pre cancer awareness initiatives in India. Open Dent J. 2016;10:417–9.
pubmed: 27583052
pmcid: 4995523
doi: 10.2174/1874210601610010417
Montaño DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior: theory, research, and practice. San Francisco: Jossey-Bass/Wiley; 2015. pp. 95–124.
Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.
doi: 10.1016/0749-5978(91)90020-T
Lareyre O, Gourlan M, Stoebner-Delbarre A, Cousson-Gélie F. Characteristics and impact of theory of planned behaviour interventions on smoking behaviour: a systematic review of the literature. Prev Med. 2021;143:106327.
pubmed: 33227344
doi: 10.1016/j.ypmed.2020.106327
McEachan RRCh, Conner M, Taylor NJ, Lawton RJ. Prospective prediction of health-related behaviours with the theory of planned behaviour: a meta-analysis. Health Psychol Rev. 2011;5(2):97–144.
doi: 10.1080/17437199.2010.521684
Hardeman W, Johnston M, Johnston D, Bonetti D, Wareham N, Kinmonth AL. Application of the theory of planned behavior in behavior change interventions: a systematic review. Psychol Health. 2002;17(2):123–58.
doi: 10.1080/08870440290013644a
Kersten P, McCambridge A, Kayes NM, Theadom A, McPherson KM. Bridging the gap between goal intentions and actions: a systematic review in patient populations. Disabil Rehabil. 2015;37(7):563–70.
pubmed: 24999905
doi: 10.3109/09638288.2014.935874
Sniehotta FF, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long-term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35:565–76.
doi: 10.1002/ejsp.258
Cameron D, Epton T, Norman P, Sheeran P, Harris PR, Webb TL, et al. A theory-based online health behaviour intervention for new university students (U@Uni:LifeGuide): results from a repeat randomized controlled trial. Trials. 2015;16:555.
pubmed: 26643917
pmcid: 4672536
doi: 10.1186/s13063-015-1092-4
Zhao X, White K, Young R. A TPB-based smoking intervention among Chinese high school students. Subst Use Misuse. 2019;54(3):459–72.
pubmed: 30595056
doi: 10.1080/10826084.2018.1508298
Najafi S, Mohammadkhah F, Afzali Harsini P, Sohrabpour M, Khani Jeihooni A. Effect of educational intervention based on theory of planned behaviour on promoting preventive behaviours of oral cancer in rural women. BMC Womens Health. 2023;23:249.
pubmed: 37161434
pmcid: 10170798
doi: 10.1186/s12905-023-02411-2
Khani Jeihooni A, Razavi M, Kashfi SM, Ansari M, Gholami T. Effect of educational intervention based on the theory of planned behavior on preventing water pipe smoking in secondary school students. J Educ Community Health. 2020;7(1):13–21. [In Persian].
doi: 10.29252/jech.7.1.13
Fathi Y, Moeini B, Bazvand A, Barati M, Roshanaei G. The effectiveness of educational program based on theory of planned behaviour on preventing and decreasing tobacco smoking among post-secondary students. J Educ Community Health. 2016;3(2):54–61. [In Persian].
doi: 10.21859/jech-03028
Mohammadi Zeidi I, Pakpour Haji Agha A. Effectiveness of an educational intervention based on theory of planned behavior to reduce intentions to smoke among secondary school students. J Res Health. 2013;3(4):504–13.
Mohammadkhah F, Mardani Amirhajelu R, Bakhtiar M, Alempour Salemi S, Kevenjan M, Khani Jeihooni A. The effect of training intervention based on the theory of planned behavior on oral and dental health behaviors in pregnant women. BMC Oral Health. 2023;23:521.
pubmed: 37491230
pmcid: 10369690
doi: 10.1186/s12903-023-03239-w
Karimy M, Higgs P, Solayman Abadi Sh, Armoon B, Araban M, Rouhani MR, et al. Oral health behavior among school children aged 11–13 years in Saveh, Iran: an evaluation of a theory-driven intervention. BMC Pediatr. 2020;20:476.
pubmed: 33050893
pmcid: 7552527
doi: 10.1186/s12887-020-02381-6
Soltani S, Sharifirad Gh, Mahaki B, Ali Eslami A. The effect of oral health educational intervention program among mothers of children aged 1–6, based on the theory of planned behavior. J Dent Shiraz Univ Med Sci. 2020;21(4):292–9.
Lin JH, Huang YK, Lin KD, Hsu YJ, Huang WF, Huang HL. Randomized controlled trial on effects of a brief clinical-based intervention involving planning strategy on self-care behaviors in periodontal patients in dental practice. Int J Environ Res Public Health. 2019;16:3838.
pubmed: 31614535
pmcid: 6843768
doi: 10.3390/ijerph16203838
Malik NAb, Yatim SM, Lam OLT, Jin L, McGrath CPJ. Effectiveness of a web-based health education program to promote oral hygiene care among stroke survivors: randomized controlled trial. J Med Internet Res. 2017;19(3):e87.
doi: 10.2196/jmir.7024
Makvandi Z, Karimi-Shahanjarini A, Faradmal J, Bashirian S. Evaluation of an oral health intervention among mothers of young children: a clustered randomized trial. J Res Health Sci. 2015;15(2):88–93.
pubmed: 26175290
Hung LC, Kung PT, Lung CH, Tsai MH, Liu SA, Chiu LT, et al. Assessment of the risk of oral cancer incidence in a high-risk population and establishment of a predictive model for oral cancer incidence using a population-based cohort in Taiwan. Int J Environ Res Public Health. 2020;17(2):665.
pubmed: 31968579
pmcid: 7014279
doi: 10.3390/ijerph17020665
Self-examination. Mouth Cancer Foundation: Awareness and Support. https://www.mouthcancerfoundation.org/self-examination/ .
Martins AME, de Souza B, Haikal JGS, Paula DS, de Ferreira AMB, Pordeus EF. Prevalence of oral cancer self-examination among elderly people treated under Brazil’s Unified Health System: household health survey. Cien Saude Colet. 2015;20(4):1085–98.
pubmed: 25923620
doi: 10.1590/1413-81232015204.00542014
Lopez Jornet P, Gomez Garcia FJ, Lucero Berdugo M, Parra Perez F, Pons-Fuster Lopez A. Mouth self-examination in a population at risk of oral cancer. Aust Dent J. 2015;60(1):59–64.
pubmed: 25721279
doi: 10.1111/adj.12274
Lee H, Ho PSh W, WCh H, Lee CY, Huang CH. Effectiveness of a health belief model intervention using a lay health advisor strategy on mouth self-examination and cancer screening in remote aboriginal communities: a randomized controlled trial. Patient Educ Couns. 2019;102:2263–9.
pubmed: 31300183
doi: 10.1016/j.pec.2019.07.001
Dhanapriyanka M, RDFC K, Jayasekara P. Effectiveness of health promotion intervention on the knowledge and selected practices related with oral cancer among a group of vulnerable youth in Sri Lanka. BMC Public Health. 2023;23:1355.
pubmed: 37452326
pmcid: 10349418
doi: 10.1186/s12889-023-16298-z
Singh K, Sharma D, Kaur M, Gauba K, Thakur JS, Kumar R. Effect of health education on awareness about oral cancer and oral self-examination. J Edu Health Promot. 2017;6:27.
doi: 10.4103/jehp.jehp_82_15
Sharma M, Romas JA. Theoretical foundations of health education and health promotion. Massachusetts: Jones and Bartlett; 2008.
Warnakulasuriya S. Significant oral cancer risk associated with low socioeconomic status. Evid Based Dent. 2009;10:4–5.
pubmed: 19322216
doi: 10.1038/sj.ebd.6400623
Sadeghi R, Zanjari N. The spatial inequality of development in the 22 districts of Tehran metropolis. Social Welf Q. 2017;17(66):149–84. [In Persian].
Ajzen I. Constructing a TPB questionnaire: conceptual and methodological considerations. 2002. https://docplayer.net/21387809-Constructing-a-tpb-questionnaire-conceptual-and-methodological-considerations.html .
Lawshe CH. A quantitative approach to content validity. Pers Psychol. 1975;28(4):563–75.
doi: 10.1111/j.1744-6570.1975.tb01393.x
Waltz CF, Bausell RB. Nursing research: design, statistics, and computer analysis. Philadelphia: W.B. Saunders Company; 1981.
Fitzmaurice GM, Laird NM, Ware JH. Applied longitudinal analysis. New Jersey: John Wiley & Sons, Inc; 2011.
doi: 10.1002/9781119513469
Mack C, Su Z, Westreich D. Managing missing data in patient registries: Addendum to registries for evaluating patient outcomes: a user’s guide. USA: Agency for Healthcare Research and Quality; 2018.
Ford PJ, Farah CS. Early detection and diagnosis of oral cancer: strategies for improvement. J Cancer Policy. 2013;1:e2–7.
doi: 10.1016/j.jcpo.2013.04.002
Scott SE, Grunfeld EA, Auyeung V, McGurk M. Barriers and triggers to seeking help for potentially malignant oral symptoms: implications for interventions. J Public Health Dent. 2009;69(1):34–40.
pubmed: 18662249
doi: 10.1111/j.1752-7325.2008.00095.x