Implementation of a behavioural change intervention to enhance oral health behaviours in elite athletes: a feasibility study

BMJ Open Sport Exerc Med. 2020 Jun 18;6(1):e000759. doi: 10.1136/bmjsem-2020-000759. eCollection 2020.

Abstract

Background: Poor oral health of elite athletes is common and is associated with negative performance impacts. There is a need for oral health promotion strategies that are effective within the elite sport environment.

Aim: To develop, implement and evaluate a pragmatic oral health promotion intervention that integrated the capability, opportunity, motivation and behaviour model of behavioural change into the knowledge transfer system for effective implementation of preventive interventions.

Methods: Repeated measures study. Athletes and support team together viewed one 10 min presentation and three 90 s information films. Athletes alone received oral health screening, personalised advice and an oral health toolkit. Outcome measures included: (1) oral health knowledge, athlete-reported performance impacts (Oslo Sports Trauma Research Centre, OSTRC score), use of oral hygiene aids, gingival inflammation (bleeding) score, recorded at baseline, 4-6 weeks and 12-16 weeks and (2) athlete feedback.

Results: We recruited 62 athletes; 44 (71%) male and 58 (93.5%) white British, 55 (88.7%) athletes completed the study. Mean knowledge score improved from 5.69 (1.59) to 6.93 (1.32) p<0.001. Mean OSTRC score reduced from 8.73 (14.54) to 2.73 (11.31) p<0.001. Athlete use of prescription strength fluoride toothpaste increased from 8 (12.9%) to 45 (80.4%) p<0.001. Athlete-reported use of interdental cleaning aids at least 2-3 x week increased from 10 (16.2%) to 21 (34%) p=0.013. Bleeding score remained unchanged.

Conclusion: This behavioural change intervention was successfully implemented within different elite sport environments. It was associated with an increase in athlete oral health knowledge, enhanced oral health behaviour, a reduction in self-reported performance impacts and high participant retention.

Keywords: behaviour; elite performance; implementation; sports & exercise medicine.