Abstract: The primary aim of the dissertation was to develop and evaluate a smartphone app, the WhiteTeeth app, designed to promote good oral health behaviour and oral hygiene among adolescent orthodontic patients between the ages of 12 and 16. The app's development and evaluation was guided methodically by intervention mapping (IM). Development thus starts with an analysis of the health problem and the identification of the psychosocial factors and health behaviour related to it. To identify the psychosocial factors underlying oral health behaviour in our target group, a systematic literature review with meta-analysis was conducted,a cross-sectional clinical study and semi-structured interviews. Then, to target these psychosocial factors and facilitate continuous behavioural support, various behaviour-changing techniques were incorporated into the app. The app provides feedback on users' oral health behaviour and allows users to evaluate and monitor their behaviour. Finally, a randomised controlled trial was conducted. This showed that the app had improved oral hygiene in adolescent orthodontic patients after 12 weeks.
LINK
In BMC Oral Health verscheen het volgende artikel van Inholland-docente en promovenda Janneke Scheerman (en collega’s). Background: Adolescents with fixed orthodontic appliances are at high risk of developing dental caries. To date, new smartphone technologies have seldom been used to support them in the preventive behavior that can help prevent dental caries. After an intervention-mapping process, we developed a smartphone application (the WhiteTeeth app) for preventing dental caries through improved oral-health behavior and oral hygiene. The app, which is intended to be used at home, will help adolescents with fixed orthodontic appliances perform their oral self-care behavior. The app is based on the Health Action Process Approach (HAPA) theory, and incorporates several behavior-change techniques that target the psychosocial factors of oral-health behavior. This article describes the protocol of a randomized controlled trial (RCT) to evaluate the effects of the WhiteTeeth app on oral-health behavior and oral-hygiene outcomes (presence of dental plaque and gingival bleeding) compared with those of care as usual, in patients aged 12–16 with fixed orthodontic appliances.
ABSTRACT Objective: To evaluate the effectiveness of the WhiteTeeth mobile app, a theory-based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients. Methods: In this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check-ups: at baseline (T0), at 6-week follow-up (T1), and at 12-week follow-up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n=67). The control group received usual care only (n=65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al-Anezi and Harradine plaque Index); and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behavior and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed model analyses to determine the intervention effects. Results: At 6-week follow-up, the intervention led to a significant decrease in gingival bleeding (B=-3.74; 95%CI -6.84 to -0.65), and an increase in the use of fluoride mouth rinse (B=1.93; 95%CI 0.36 to 3.50). At 12-week follow-up, dental plaque accumulation (B=-11.32; 95%CI -20.57 to -2.07) and the number of sites covered. Conclusions: The results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.
LINK
