Development of a secondary school-based digital behaviour change intervention to improve tooth brushing

Zoe Marshman; Sarab El-Yousfi; Ian Kellar; Donna Dey; Mark Robertson; Peter Day; Ivor Chestnutt; Sue Pavitt; Mariana de Araujo; Nicola Innes

doi:10.1186/s12903-021-01907-3

Development of a secondary school-based digital behaviour change intervention to improve tooth brushing

BMC Oral Health. 2021 Oct 22;21(1):546. doi: 10.1186/s12903-021-01907-3.

Authors

Zoe Marshman¹, Sarab El-Yousfi¹, Ian Kellar², Donna Dey³, Mark Robertson⁴, Peter Day⁵, Ivor Chestnutt⁶, Sue Pavitt⁵, Mariana de Araujo⁴, Nicola Innes⁷

Affiliations

¹ School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK.
² School of Psychology, University of Leeds, Lifton Place, Leeds, LS2 9JT, UK.
³ School of Education and Social Work, University of Dundee, Nethergate, Dundee, DD1 4HN, UK.
⁴ School of Dentistry, University of Dundee, Park Place, Dundee, DD6 8EF, UK.
⁵ School of Dentistry, University of Leeds, Leeds, LS2 9LU, UK.
⁶ School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK.
⁷ School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK. InnesN@cardiff.ac.uk.

Abstract

Background: Dental caries in adolescents remains a significant public health problem with few oral health promotion interventions aimed at reducing dental caries in secondary school-aged students. Previous oral health and mobile health (mHealth) research has suggested the need for the development of a school-based behaviour change intervention incorporating a digital component. This study aimed to describe the development process of a behaviour change intervention to improve the oral health of students aged 11-16 years attending secondary schools in the UK.

Methods: A six-step process was used to develop the complex intervention informed by behaviour change theory and involving students, young people, parents and teachers in the process. The steps were: (1) identifying the target behaviours, namely tooth brushing with a fluoride toothpaste (2) identifying the theoretical basis and developing the causal model (3) reviewing the relevant literature and developing the logic model (4) designing the intervention with young people, parents and school staff (5) specifying the intervention content and (6) translating this content into features of the intervention and piloting.

Results: The resultant intervention included a quality-assured classroom-based session (CBS) (guided by a lesson plan and teaching resources), delivered by school teachers which was embedded within the school curriculum. This CBS was followed by a series of (Short Message Service) SMS texts delivered twice daily to student's mobile telephones with the content, duration and timing of the messages informed by involvement of students and young people.

Conclusions: An intervention to improve the oral health of secondary school students through improved tooth brushing was rigorously developed based on behaviour change theory and work with young people, parents and school staff. Further research is needed to evaluate the outcomes and processes involved following the delivery of this intervention. BRIGHT Trial Trial Registration ISRCTN12139369.

Keywords: Behaviour change; Oral health; Text messages; Young people.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Dental Caries* / prevention & control
Health Behavior
Humans
Parents
Schools
Toothbrushing*