Integration of Oral Health Interventions in the Health Promoting Schools Program in Iran: A Multi-Stakeholder Feasibility Assessment
Abstract
Objectives: Based on the recommendations of the World Health Organization, we investigated the feasibility of oral health interventions (OHIs) as part of Health Promoting Schools (HPS) program in Karaj city elementary schools.
Materials and Methods: OHIs were accepted to be integrated into the components of HPS program by using the nominal group technique (NGT) and semi-structured interviews. Three NGT meetings were held with the faculty members of the School of Dentistry, Tehran University of Medical Sciences, and Karaj elementary school health care providers. Semi-structured interviews were held with school health executives of the Ministry of Health and Medical Education. The expert panel edited the OHIs and corrected the fragmentations, overlaps, and duplications. OHIs were sent to 24 individuals in six multi-stakeholder groups (faculty members of pediatric dentistry and community oral health departments, elementary school administrators, executive managers of Ministry of Health and Medical Education, elementary school dean and school healthcare providers). They were asked to score the feasibility of each intervention on a scale of 0 to 10.
Results: Based on the mean score of feasibility (threshold: 8) the OHIs were divided into two groups of feasible and infeasible. Eighty-six interventions were feasible, with a total mean score of 8.83±0.59 out of 10. The highest feasibility score was related to “comprehensive school health education”.
Conclusion: Integration of OHIs in HPS program is acceptable and feasible. The results can help policy-makers support the integration of OHIs in HPS program and encourage them to implement the program at the national level.
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21. Alimondegari M, Banihashemi FS. The trend of changes in the unmarried population due to divorce in the general population and housing censuses of Iran: 1986-2016. Iran J Offic Statis Stud. 2020 Mar;30(2):503-18.
22. van Dijk PA, Miller D, Calder J, DiGiovanni CW, Kennedy JG, Kerkhoffs GM, et al. The ESSKA-AFAS international consensus statement on peroneal tendon pathologies. Knee Surg Sports TraumatolArthrosc. 2018 Oct;26(10):3096-107.
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24. Thapa B. Developing adolescent health-risk behavior instrument using Delphi method. Asian Pac. 2017;4:48-56.
25. Storms H, Claes N, Aertgeerts B, Van den Broucke S. Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire. BMC Public Health. 2017 Dec;17(1):475.
26. Petersen PE, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention-WHO recommendations for improved evidence in public health practice. Community Dent Health. 2004 Dec;21(4):319-29.
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28. Roberts E, McLeod N, Montemurro G, Veugelers PJ, Gleddie D, Storey KE. Implementing Comprehensive School Health in Alberta, Canada: the principal's role. Health Promot Int. 2016 Dec;31(4):915-24.
29. Thompson B, Cooney P, Lawrence H, Ravaghi V, Quinonez C. Cost as a barrier to accessing dental care: findings from a Canadian population-based study. J Public Health Dent. 2014 Aug;74(3):210-8.
30. Hardgraves VM, MitchellTV, Hanson CC, Simmer-Beck M. A qualitative analysis of oral health care needs in arkansas nursing facilities: the professional role of the dental hygienist. J Dent Hyg. 2014 Dec;88(6):353-63.
31. Amiresmaili M, Amini S, Shahravan A, Goudarzi R, Saberi-Anari SH. Avoidance dental visit, the impact of predictor factors: A cross-sectional study in Kerman, Iran. J Oral Health Oral Epidemiol. 2017 Dec;7(1):39-46.
32. Beigi MR, Shamshiri AR, Asadi-Lari M, Hessari H, Jafari A. A crossectional investigation of the relationship between complementary health insurance and frequency of dental visits in 15 to 64 years old of Tehran population, Iran, a secondary data analysis (urban HEART-2). BMC Health Serv Res. 2019 Dec;19(1):678.
33. Gannon A, Olson R, Cottrell L. Assessing the effectiveness of pre-school nutrition education: A pilot program. J Nutr Educ Behav. 2013 Sep;45(4):S11.
34. Kelishadi R, Ghatrehsamani S, Hosseini M, Mirmoghtadaee P, Mansouri S, Poursafa P. Barriers to physical activity in a population-based sample of children and adolescents in Isfahan, Iran. Int J PrevMed. 2010;1(2):131.
35. Greaney M, Hardwick CK, Mezgebu S, Lindsay AC, Roover ML, Peterson KE. Assessing the feasibility of a multi-program school-based intervention to promote physical activity and healthful eating in middle schools prior to wide-scale implementation. Am J Health Educ. 2007 Sep;38(5):250-7.
36. Barber SE, Jackson C, Hewitt C, Ainsworth HR, Buckley H, Akhtar S, et al. Assessing the feasibility of evaluating and delivering a physical activity intervention for pre-school children: a pilot randomised controlled trial. Pilot Feasibility Stud. 2016 Dec;2(1):1-13.
37. Woynarowska-Sołdan M. Implementation trial of school staff health promotion: Polish experiences. Health Promot Int.2019 Oct;34(5):e47-58.
38. Lauria-Horner BA, Kutcher S, Brooks SJ. The feasibility of a mental health curriculum in elementary school. Can J Psychiatry. 2004Mar;49(3):208-11.
39. Evans SW, Mullett E, Weist MD, Franz K. Feasibility of the MindMatters school mental health promotion program in American schools. J Youth Adolesc. 2005 Feb;34(1):51-8.
40. Aydin NG. A national study: School counselor involvement in school, family and community partnerships with linguistically diverse families(Doctoral dissertation, The University of Iowa). July 2011.
2. Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, et al. The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database Syst Rev. 2014Apr;(4):Cd008958.
3. Kwan SY, Petersen PE, Pine CM, Borutta A. Health-promoting schools: an opportunity for oral health promotion. Bulletin of the World Health organization. 2005 Sep;83:677-85.
4. Offices UGA. Oral health: dental disease is a chronic problem among low-income populations. Washington, DC: Report to Congressional Requesters 2000 April.
5. Jackson SL, Vann WF, Jr., Kotch JB, Pahel BT, Lee JY. Impact of poor oral health on children's school attendance and performance. Am J Public Health. 2011 Oct;101(10):1900-6.
6. Vozza I, Guerra F, Marchionne M, Bove E, Corridore D, Ottolenghi L. A multimedia oral health promoting project in primary schools in central Italy. Annali di stomatologia. 2014 Jul;5(3):87.
7. Honkala S. World Health Organization approaches for surveys of health behaviour among schoolchildren and for health-promoting schools. Med PrincPract. 2014 April;23 Suppl 1:24-31.
8. Mukoma W, Flisher AJ. Evaluations of health promoting schools: a review of nine studies. Health Promot Int. 2004 Sep;19(3):357-68.
9. Jones JT, Furner, Matthew. Health-promoting schools: a healthy setting for living, learning and working: World Health Organization. http://www.who.int/iris/handle/10665/63868 1998.
10. Yusof ZY, Jaafar N. Health promoting schools and children's oral health related quality of life. Health Qual Life Outcomes. 2013 Dec;11(1):1-9.
11. Croucher R, Rodgers AI, Humpherson WA, Crush L. The "spread of effect' of a school based dental health education project. Community Dent Oral Epidemiol. 1985Apr;13(4):205-7.
12. Kwan S, Petersen P. WHO Information Series on School Health, Document Eleven. Oral Health Promotion: An Essential Element of a Health-Promoting School. Geneva. WHO. 2003.
13. Shahhosseini Z, Simbar M, Ramezankhani A. Characteristics of health-promoting schools from Iranian adolescents' point of view. Int J Adolesc Med Health. 2016 May;28(2):155-60.
14. Nouri MFAB RP, Riyahi L. The effect of the impact of health promoting program on environmental indicators in elementary schools of Tabriz in academic year 2013-2014. Eur Online JNat. 2014 Dec;3(3 (s):363.
15. Wang D, Stewart D. The implementation and effectiveness of school-based nutrition promotion programmes using a health-promoting schools approach: a systematic review. Public Health Nutr. 2013 Jun;16(6):1082-100.
16. Sartipizadeh M, Yazdi-Feyzabadi V, Sakha MA, Zarrin A, Bazyar M, Moghadam TZ, Zandian H. Evaluating the health promoting schools in Iran: across-sectional study. Health Educ. 2021 Jan;121(2):125-139.
17. Fathi B, Allahverdipour H, Shaghaghi A, Kousha A, Jannati A. Challenges in developing health promoting schools' project: application of global traits in local realm. Health PromotPerspect. 2014Jul;4(1):9-17.
18. World Health Organization. Integrated health services-what and why? Making Health Systems Work, Technical Brief No. 1 Geneva. World Health Organization. 2008.
19. Sahal N, Reintjes R, Eltayeb E, Aro A. Feasibility of implementing recommendations to improve communicable diseases surveillance-a modified Delphi study. Afr health Sci. 2011;11(3):93-9.
20. Organization WH. Oral health promotion: an essential element of a health-promoting school. 2003.
21. Alimondegari M, Banihashemi FS. The trend of changes in the unmarried population due to divorce in the general population and housing censuses of Iran: 1986-2016. Iran J Offic Statis Stud. 2020 Mar;30(2):503-18.
22. van Dijk PA, Miller D, Calder J, DiGiovanni CW, Kennedy JG, Kerkhoffs GM, et al. The ESSKA-AFAS international consensus statement on peroneal tendon pathologies. Knee Surg Sports TraumatolArthrosc. 2018 Oct;26(10):3096-107.
23. Howell AM, Burns EM, Hull L, Mayer E, Sevdalis N, Darzi A. International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process. BMJ QualSaf. 2017 Feb;26(2):150-63.
24. Thapa B. Developing adolescent health-risk behavior instrument using Delphi method. Asian Pac. 2017;4:48-56.
25. Storms H, Claes N, Aertgeerts B, Van den Broucke S. Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire. BMC Public Health. 2017 Dec;17(1):475.
26. Petersen PE, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention-WHO recommendations for improved evidence in public health practice. Community Dent Health. 2004 Dec;21(4):319-29.
27. World Health Organization. Local action: Creating health promoting schools. 2000.
28. Roberts E, McLeod N, Montemurro G, Veugelers PJ, Gleddie D, Storey KE. Implementing Comprehensive School Health in Alberta, Canada: the principal's role. Health Promot Int. 2016 Dec;31(4):915-24.
29. Thompson B, Cooney P, Lawrence H, Ravaghi V, Quinonez C. Cost as a barrier to accessing dental care: findings from a Canadian population-based study. J Public Health Dent. 2014 Aug;74(3):210-8.
30. Hardgraves VM, MitchellTV, Hanson CC, Simmer-Beck M. A qualitative analysis of oral health care needs in arkansas nursing facilities: the professional role of the dental hygienist. J Dent Hyg. 2014 Dec;88(6):353-63.
31. Amiresmaili M, Amini S, Shahravan A, Goudarzi R, Saberi-Anari SH. Avoidance dental visit, the impact of predictor factors: A cross-sectional study in Kerman, Iran. J Oral Health Oral Epidemiol. 2017 Dec;7(1):39-46.
32. Beigi MR, Shamshiri AR, Asadi-Lari M, Hessari H, Jafari A. A crossectional investigation of the relationship between complementary health insurance and frequency of dental visits in 15 to 64 years old of Tehran population, Iran, a secondary data analysis (urban HEART-2). BMC Health Serv Res. 2019 Dec;19(1):678.
33. Gannon A, Olson R, Cottrell L. Assessing the effectiveness of pre-school nutrition education: A pilot program. J Nutr Educ Behav. 2013 Sep;45(4):S11.
34. Kelishadi R, Ghatrehsamani S, Hosseini M, Mirmoghtadaee P, Mansouri S, Poursafa P. Barriers to physical activity in a population-based sample of children and adolescents in Isfahan, Iran. Int J PrevMed. 2010;1(2):131.
35. Greaney M, Hardwick CK, Mezgebu S, Lindsay AC, Roover ML, Peterson KE. Assessing the feasibility of a multi-program school-based intervention to promote physical activity and healthful eating in middle schools prior to wide-scale implementation. Am J Health Educ. 2007 Sep;38(5):250-7.
36. Barber SE, Jackson C, Hewitt C, Ainsworth HR, Buckley H, Akhtar S, et al. Assessing the feasibility of evaluating and delivering a physical activity intervention for pre-school children: a pilot randomised controlled trial. Pilot Feasibility Stud. 2016 Dec;2(1):1-13.
37. Woynarowska-Sołdan M. Implementation trial of school staff health promotion: Polish experiences. Health Promot Int.2019 Oct;34(5):e47-58.
38. Lauria-Horner BA, Kutcher S, Brooks SJ. The feasibility of a mental health curriculum in elementary school. Can J Psychiatry. 2004Mar;49(3):208-11.
39. Evans SW, Mullett E, Weist MD, Franz K. Feasibility of the MindMatters school mental health promotion program in American schools. J Youth Adolesc. 2005 Feb;34(1):51-8.
40. Aydin NG. A national study: School counselor involvement in school, family and community partnerships with linguistically diverse families(Doctoral dissertation, The University of Iowa). July 2011.
| Issue | Vol 18 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v18i43.8015 | |
| Keywords | ||
| Health Promotion; Public Policy; Health Care Reform; School Health Services; Public Health | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Beigi M, Gholami M, Jafari A. Integration of Oral Health Interventions in the Health Promoting Schools Program in Iran: A Multi-Stakeholder Feasibility Assessment. Front Dent. 2021;18.
