The Role of Repetition and Reinforcement (by peer group) in Oral Health Education Program as a Base for Health Belief Model (HBM) among Iranian Primary schools Students -Cluster Randomized Controlled Trial

Background and Aim: Peer group have been shown to play a key role in the sustainability of the effect of Oral Health Education (OHE) programs. The present study aimed to evaluate the repetition and reinforcement by the peer group in an OHE program based on Health Belief Model for primary students.Methods: The present research was based on a cluster randomized controlled trial study. The population was selected from fifth-grade female students in Tehran in 2017. Accordingly, three schools in district 14 were randomly selected as the sample. The students were randomly divided into two intervention and one control groups. The first group received OHE by School-Nurse (SN) and reinforcement by peer group (SNP). The second group received OHE only by SN without any reinforcement. The intervention groups received four OHE sessions. All of the groups were received the pre- and post- test. Then, they were exposed to post-intervention after 3 and 6 months. The data were collected by using the researcher-made questionnaire based on the two constructs of the HBM. In addition, Plaque Disclosing Tablets (PDTs) were used for determining Dental Plaque (DP). Finally, repeated measure ANOVA for data analysis.Results: Perceived benefits and self-efficacy in the SNP and SN groups were significantly different after four-OHE session, compared to their baseline (3 0.01) and control group. In addition, the difference was constant after six-month follow up (P<0.05). Further, the Oral Health Behavior (OHB) in the three groups were significantly different after six-PRQWK IROORZ XS (3 0.01). 2+% LQFUHDVHG significantly 6 months after the intervention, compared to the SN and control groups (p < 0.01). However, dental plaque (DP) in SNP group reduced significantly by four OHE sessions, compared to the amount in SN and control groups after 3 and 6 months (3 0.01). However, DP increased significantly in the control group, compared to the baseline in the intervention (P<0.01).Conclusion: The Health Ambassador Students (HAS) plays a key role in the success of a theory-based intervention in schools by using repetition and reinforcement strategy.

Keywords:

Repeated and reinforced oral health education , Dental health education , Peer group , School- nurse , Dental plaque