Effectiveness of an Intervention for Oral Health Promotion of Disadvantaged Women
Oral health intervention for low SES women
,
Abstract
Objectives: Community health volunteers (CHVs) are expected to empower the population, particularly women, for a better health status. This study aimed to assess the effectiveness of an intervention by CHVs for oral health promotion of disadvantaged women.
Materials and Methods: This quasi-experimental study recruited 22 CHVs (n=11 in each group) and 216 women (n=108 in each group) from two health centers in disadvantaged neighborhoods in Zahedan, Iran, in 2020. CHVs received a training package, including a flip chart and a dental model in the intervention group, while the control group received a conventional lecture-based training. Next, CHVs trained women in these areas. The women's oral health literacy (OHL) and oral health behaviors were evaluated using the Oral Health Literacy-Adult Questionnaire (OHL-AQ). The plaque index (PI) was determined through clinical oral examinations. Data were collected before and at 6 weeks after the intervention. Generalized estimating equation (GEE) and Chi-square test were utilized for data analysis using SPSS version 25 (alpha=0.05).
Results: All women completed the study, and had a mean age of 26.7 ± 5.03 years. GEE revealed a significant increase in OHL score (P<0.001), and a significant reduction in PI (P=0.03) of the intervention group compared to the control group. The Chi-square test indicated a significant improvement in oral health behavior of the participants in the intervention group (P=0.02).
Conclusion: The oral health educational program delivered by CHVs significantly improved the OHL and behavior of disadvantaged women, suggesting that such programs can effectively promote oral health in disadvantaged populations.
1. Naghdi A, Zare S. Slum dwelling as a threat to sustainable urban development and health. Urban Stud. 2012;1:125-46.
2. Farid M, Tizvir A, Fashi Z. Health care status of residents of the slum areas of Karaj 2015. Alborz Univ Med J. 2017 Nov;6(4):276-82.
3. World Health Organization. Good practices in delivery of primary health care in urban settings. 2012.
4. Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, Sartori J, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet. 2017 Feb 4;389(10068):547-558.
5. Bakhtiari A, Takian A, Sayari AA, Bairami F, Tabrizi JS, Mohammadi A, et al. Design and deployment of health complexes in line with universal health coverage by focusing on the marginalized population in Tabriz, Iran. J. Med. Spirit. Cultiv. 2017;25(4):213-32.
6. Khayat S, Dolatian M, Fanaei H, Navidian A, Mahmoodi Z, Kasaeian A. Study of lifestyle, the most important challenge and its related factors in suburban women. J Health. 2021 Jan;11(5):652-63.
7. Sahab DA, Bamashmous MS, Ranauta A, Muirhead V. Socioeconomic inequalities in the utilization of dental services among adults in Saudi Arabia. BMC Oral Health. 2022 Apr 21;22(1):135.
8. Watt RG, Venturelli R, Daly B. Understanding and tackling oral health inequalities in vulnerable adult populations: from the margins to the mainstream. Br Dent J. 2019 Jul;227(1):49-54.
9. Tomar SP, Kasar PK, Tiwari R. Study of oral hygienic practices and oral health status among school children in Jabalpur, Madhya Pradesh: a cross-sectional study. Int J Community Med Public Health. 2016 Feb;3(2):403-7.
10. Ali R, Ahmad R, Ul Haq HS, Khan RS, Hassan R, Siddiqui AA. Knowledge and attitudes regarding oral hygiene among urban slum dwellers in Pakistan. Int J Contemp Med Res. 2018;5(8):3-7.
11. Patel AB, Shah RR, Ramanuj VB. Comparative study of oral hygienic practices and oral health status among people residing in urban and urban slum of Ahmedabad municipal corporation. Int J Community Med Public Health. 2017 Jun;4(6):2181-5.
12. Mukanga B, Sakala K, Nyirenda TH, Daka V, Mulenga D. Oral health knowledge, attitude and practices among adolescents in Choma District of Zambia. Med J Zambia. 2022 Nov;49(2):118-27.
13. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005 Sep;83(9):661-9. Epub 2005 Sep 30.
14. Horowitz AM, Kleinman DV. Oral health literacy: the new imperative to better oral health. Dent Clin North Am. 2008 Apr;52(2):333-44, vi.
15. Adams RJ, Stocks NP, Wilson DH, Hill CL, Gravier S, Kickbusch I, et al. Health literacy--a new concept for general practice? Aust Fam Physician. 2009 Mar;38(3):144-7.
16. Sahbaei F NN, Keshavarz N, Tohidi M. Practice of the health volunteers in Iran. J. Med. Counc. Islam. Repub. Iran. 2016;34(2):157–162.
17. Hoodfar H. Activism under the radar. Volunteer women health workers in Iran. Middle East Rep. 2009 Mar;250:56-8.
18. Alami A, Nedjat S, Majdzadeh R, Rahimi Foroushani A, Hoseini SJ, Malekafzali H. Factors influencing women's willingness to volunteer in the healthcare system: evidence from the Islamic Republic of Iran. East Mediterr Health J. 2013 Apr;19(4):348-55.
19. Allen WC. Overview and evolution of the ADDIE training system. Adv Dev Hum Resour. 2006 Nov;8(4):430-41.
20. Smith PL, Ragan TJ. Instructional design. 3rd ed. Hoboken (NJ): John Wiley & Sons; 2005.
21. Watson SI, Sartori J, Ndugwa R, Caiaffa W, Haregu T, Capon A, et al. Improving the health and welfare of people who live in slums. Lancet. 2017 Feb 4;389(10068):559-570..
22. Fathi M. Oral health book. 1st ed. Tehran: Ministry of Health and Medical Education of Iran; 2001.
23. Chow SC, Shao J, Wang H, Lokhnygina Y. Sample size calculations in clinical research. 2nd ed. Boca Raton (FL): Chapman & Hall/CRC; 2008.
24. Kaveh S, Najafi A, PourAlimohammadi N, Tabatabae S. Effect of a menopausal health training led by health volunteers on community women's knowledge an interventional study. Tolooebehdasht. 2013 Mar;11(4):135-49.
25. Patel SR, Margolies PJ, Covell NH, Lipscomb C, Dixon LB. Using Instructional Design, Analyze, Design, Develop, Implement, and Evaluate, to Develop e-Learning Modules to Disseminate Supported Employment for Community Behavioral Health Treatment Programs in New York State. Front Public Health. 2018 May 7;6:113.
26. Naghibi Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Determinants of oral health: does oral health literacy matter? ISRN Dent. 2013;2013:249591. .
27. Silness J, loe H. Periodontal disease in pregnancy. Ii. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964 Feb;22:121-35.
28. Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Oral health literacy and information sources among adults in Tehran, Iran. Community Dent Health. 2013 Sep;30(3):178-82.
29. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health. 2011 Feb 7;10:9.
30. Hardin JW, Hilbe JM. Generalized estimating equations. 2nd ed. Boca Raton (FL): Chapman & Hall/CRC; 2013.
31. Gharibi F, Kassaeian SS, Kahouei M, Vailnezhadi A. Effectiveness of health communicators program in promoting of community knowledge, attitude and practice in Iran through educational interventions: A systematic review. Koomesh 2020 Jan;22(4):563-73.
32. Haerian-Ardakani A, Mohmedi M, Mazloomi Mahmodabad S, Akbari S, Zare D. Comparison of the effect of oral health education delivered by a dental student and health volunteers on the knowledge, attitude and performance of housewives. Tolooebehdasht. 2013 Dec;12(3):184-93.
33. Mazloomy Mahmoudabad S, Khani H, Kaseb F, Fallahzadeh H. The effect of nutrition and health heart instruction of health volunteers on knowledge, attitude and performance of mothers. Tolooebehdasht. 2013 Mar;11(4):81-90.
34. Salehi M, Kelishadi M, Zandye M, Keshavarz J, Bagheri A. The effect of female health volunteers education on knowledge and attitude of urban population about mental health in Isfahan province. Iran J Med Educ. 2005 Dec;5(2):111-9.
35. Villalta J, Askaryar H, Verzemnieks I, Kinsler J, Kropenske V, Ramos-Gomez F. Developing an Effective Community Oral Health Workers-"Promotoras" Model for Early Head Start. Front Public Health. 2019 Jul 3;7:175.
2. Farid M, Tizvir A, Fashi Z. Health care status of residents of the slum areas of Karaj 2015. Alborz Univ Med J. 2017 Nov;6(4):276-82.
3. World Health Organization. Good practices in delivery of primary health care in urban settings. 2012.
4. Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, Sartori J, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet. 2017 Feb 4;389(10068):547-558.
5. Bakhtiari A, Takian A, Sayari AA, Bairami F, Tabrizi JS, Mohammadi A, et al. Design and deployment of health complexes in line with universal health coverage by focusing on the marginalized population in Tabriz, Iran. J. Med. Spirit. Cultiv. 2017;25(4):213-32.
6. Khayat S, Dolatian M, Fanaei H, Navidian A, Mahmoodi Z, Kasaeian A. Study of lifestyle, the most important challenge and its related factors in suburban women. J Health. 2021 Jan;11(5):652-63.
7. Sahab DA, Bamashmous MS, Ranauta A, Muirhead V. Socioeconomic inequalities in the utilization of dental services among adults in Saudi Arabia. BMC Oral Health. 2022 Apr 21;22(1):135.
8. Watt RG, Venturelli R, Daly B. Understanding and tackling oral health inequalities in vulnerable adult populations: from the margins to the mainstream. Br Dent J. 2019 Jul;227(1):49-54.
9. Tomar SP, Kasar PK, Tiwari R. Study of oral hygienic practices and oral health status among school children in Jabalpur, Madhya Pradesh: a cross-sectional study. Int J Community Med Public Health. 2016 Feb;3(2):403-7.
10. Ali R, Ahmad R, Ul Haq HS, Khan RS, Hassan R, Siddiqui AA. Knowledge and attitudes regarding oral hygiene among urban slum dwellers in Pakistan. Int J Contemp Med Res. 2018;5(8):3-7.
11. Patel AB, Shah RR, Ramanuj VB. Comparative study of oral hygienic practices and oral health status among people residing in urban and urban slum of Ahmedabad municipal corporation. Int J Community Med Public Health. 2017 Jun;4(6):2181-5.
12. Mukanga B, Sakala K, Nyirenda TH, Daka V, Mulenga D. Oral health knowledge, attitude and practices among adolescents in Choma District of Zambia. Med J Zambia. 2022 Nov;49(2):118-27.
13. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005 Sep;83(9):661-9. Epub 2005 Sep 30.
14. Horowitz AM, Kleinman DV. Oral health literacy: the new imperative to better oral health. Dent Clin North Am. 2008 Apr;52(2):333-44, vi.
15. Adams RJ, Stocks NP, Wilson DH, Hill CL, Gravier S, Kickbusch I, et al. Health literacy--a new concept for general practice? Aust Fam Physician. 2009 Mar;38(3):144-7.
16. Sahbaei F NN, Keshavarz N, Tohidi M. Practice of the health volunteers in Iran. J. Med. Counc. Islam. Repub. Iran. 2016;34(2):157–162.
17. Hoodfar H. Activism under the radar. Volunteer women health workers in Iran. Middle East Rep. 2009 Mar;250:56-8.
18. Alami A, Nedjat S, Majdzadeh R, Rahimi Foroushani A, Hoseini SJ, Malekafzali H. Factors influencing women's willingness to volunteer in the healthcare system: evidence from the Islamic Republic of Iran. East Mediterr Health J. 2013 Apr;19(4):348-55.
19. Allen WC. Overview and evolution of the ADDIE training system. Adv Dev Hum Resour. 2006 Nov;8(4):430-41.
20. Smith PL, Ragan TJ. Instructional design. 3rd ed. Hoboken (NJ): John Wiley & Sons; 2005.
21. Watson SI, Sartori J, Ndugwa R, Caiaffa W, Haregu T, Capon A, et al. Improving the health and welfare of people who live in slums. Lancet. 2017 Feb 4;389(10068):559-570..
22. Fathi M. Oral health book. 1st ed. Tehran: Ministry of Health and Medical Education of Iran; 2001.
23. Chow SC, Shao J, Wang H, Lokhnygina Y. Sample size calculations in clinical research. 2nd ed. Boca Raton (FL): Chapman & Hall/CRC; 2008.
24. Kaveh S, Najafi A, PourAlimohammadi N, Tabatabae S. Effect of a menopausal health training led by health volunteers on community women's knowledge an interventional study. Tolooebehdasht. 2013 Mar;11(4):135-49.
25. Patel SR, Margolies PJ, Covell NH, Lipscomb C, Dixon LB. Using Instructional Design, Analyze, Design, Develop, Implement, and Evaluate, to Develop e-Learning Modules to Disseminate Supported Employment for Community Behavioral Health Treatment Programs in New York State. Front Public Health. 2018 May 7;6:113.
26. Naghibi Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Determinants of oral health: does oral health literacy matter? ISRN Dent. 2013;2013:249591. .
27. Silness J, loe H. Periodontal disease in pregnancy. Ii. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964 Feb;22:121-35.
28. Sistani MM, Yazdani R, Virtanen J, Pakdaman A, Murtomaa H. Oral health literacy and information sources among adults in Tehran, Iran. Community Dent Health. 2013 Sep;30(3):178-82.
29. Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health. 2011 Feb 7;10:9.
30. Hardin JW, Hilbe JM. Generalized estimating equations. 2nd ed. Boca Raton (FL): Chapman & Hall/CRC; 2013.
31. Gharibi F, Kassaeian SS, Kahouei M, Vailnezhadi A. Effectiveness of health communicators program in promoting of community knowledge, attitude and practice in Iran through educational interventions: A systematic review. Koomesh 2020 Jan;22(4):563-73.
32. Haerian-Ardakani A, Mohmedi M, Mazloomi Mahmodabad S, Akbari S, Zare D. Comparison of the effect of oral health education delivered by a dental student and health volunteers on the knowledge, attitude and performance of housewives. Tolooebehdasht. 2013 Dec;12(3):184-93.
33. Mazloomy Mahmoudabad S, Khani H, Kaseb F, Fallahzadeh H. The effect of nutrition and health heart instruction of health volunteers on knowledge, attitude and performance of mothers. Tolooebehdasht. 2013 Mar;11(4):81-90.
34. Salehi M, Kelishadi M, Zandye M, Keshavarz J, Bagheri A. The effect of female health volunteers education on knowledge and attitude of urban population about mental health in Isfahan province. Iran J Med Educ. 2005 Dec;5(2):111-9.
35. Villalta J, Askaryar H, Verzemnieks I, Kinsler J, Kropenske V, Ramos-Gomez F. Developing an Effective Community Oral Health Workers-"Promotoras" Model for Early Head Start. Front Public Health. 2019 Jul 3;7:175.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v22i36.19699 | |
| Keywords | ||
| Oral Health Health Literacy Poverty Areas Women Community Health Services | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Dahmardeh A, Yazdani R, Pakdaman A, Shamshiri AR. Effectiveness of an Intervention for Oral Health Promotion of Disadvantaged Women. Front Dent. 2025;22.
