Are educating and promoting interventions effective in oral health?: A systematic review.

OBJECTIVE: It is estimated that about 20%-25% of the world's population are suffering from periodontal diseases or severe gum diseases. This requires appropriate interventions. For the development of effective and evidence-based programmes tailored to the target group, the aim of this review was to survey to the effectiveness of oral health education and promotion interventions in the relevant groups of people. METHODS: The electronic databases including PubMed, EMBASE, Web of science and Cochrane Library were searched for English language studies between 2010 and (January-December) 2016. To assess the quality of articles, the checklist was used that includes 19 items. Studies were selected based on PICOs criteria, and finally, 16 studies were entered in our study. RESULTS: A total of 16 articles were selected, classified into two groups (A and B groups), so that group A with short-term effects includes improving knowledge, attitudes, self-efficacy, oral health behaviour (toothbrushing and flossing), theoretical constructs (perceived susceptibility, perceived severity and perceived behavioural control) which consists of 15 articles and group B with long-term effects includes improving decayed teeth, plaque, calculus and bleeding which consists of six articles. CONCLUSION: Approximately, this study supports effectiveness of all oral health education and promotion interventions, especially in short-term outcomes. Regarding the importance of long-term and short-term outcomes for oral health education and promotion programmes, These interventions could be performed in the future with several target groups including family and teachers.

Oral Health Education and Promotion Programmes: Meta-Analysis of 17-Year Intervention.

OBJECTIVES: Oral Health Education and Promotion Interventions (OHEPIs) focus on improving knowledge, to adopt favourable oral health behaviours that can enhance oral health and clinical oral health. However, no meta-analyses exist that evaluate the effectiveness of OHEPI programmes. The aim of this meta-analysis was to determine the effectiveness of oral health education and promotion programmes. METHODS: The PubMed, EMBASE, Cochrane and ScienceDirect databases from years 2000 to 2016 were searched. Eleven studies based on Participant, Intervention, Comparison, Outcome Study (PICOs) and quality assessment criteria were selected for the systematic review and meta-analysis. Meta-analysis of the data was carried out using the Comprehensive Meta-Analysis V2.0 software. As the heterogeneity of subgroups was higher than 50%, an effect random model was used for the computation of average odds ratio. RESULTS: The heterogeneity of the studies was higher than 50% (I2  = 92%, P < .001); therefore, the random effect model was used to calculate the average odds ratio. 3 subgroups, (A) programme outcomes (long- and short-term outcomes), (B) age groups and (C) the follow-up periods after the intervention, were extracted for the intervention review. Overall, programme outcome and the 3-month subgroup follow-up were both significantly increased (OR = 2. 41, CI: 1.3, 4.7; P = .005) (OR = 1.14, CI: 1.01, 1.30; P = .03) in terms of odds effectiveness of the interventions. But the age subgroups showed no significance (OR = 0.93, CI: 0.74, 1.17; P = .52) in odds effectiveness of the interventions. CONCLUSIONS: This study found that past OHEPIs are effective and positive impacts on dental visits, attitudes, as well as brushing and flossing behaviours during 3 months post-intervention among children.

The challenges of female adolescents' health needs.

Due to adolescents' future crucial roles, their health needs should be included in the national health system policy. In this cross-sectional study 2010 female adolescents were recruited from randomly selected schools in Iran. To obtain their health needs, the participants completed a self-administrated questionnaire. It was revealed that emotional needs were the most important health needs of adolescents. Furthermore, there was a meaningful relationship between health needs' score with the adolescents' age and their mothers' education level. Finally, the mean score of health needs was significantly higher in urban adolescents. Therefore, it is suggested that adolescents' emotional health needs to be paid attention; otherwise irrecoverable serious problems may occur in the next generation's health.

An inventory for assessment of female workers' health promotion behaviour based on the integrated model of planned behaviour and self-efficacy.

This study aimed to develop and assess the psychometric properties of an Inventory for Iranian Female Workers' Health Promotion Assessment (IWAHPA). In the first phase of the study a content analysis approach was applied to explore the meaning of health promoting behaviours among female workers. A 120-item questionnaire was developed, based on the integrated model of planned behaviour and self-efficacy. In the second phase the instruments' psychometric properties were assessed. Scale level content validity index was 0.93. Confirmatory factor analysis showed confirmatory factor index 0.97, goodness of fit index 0.95 and root mean square error of approximation 0.05. Concurrent validity versus the Health-Promoting Lifestyle Profile II showed r = 0.60. Cronbach alpha ranged from 0.70 to 0.93 across the subscales. Test-retest reliability revealed no significant differences. The IWAHPA is a culturally sensitive instrument, with a satisfactory level of validity and reliability, that can be used for planning female workers' health services.

An inventory for assessment of the health needs of Iranian female adolescents.

Health needs assessment is a first step to planning adolescent health programmes but it needs to be socioculturally relevant to the target population. This study aimed to develop an instrument to assess the health needs of Iranian female adolescents and evaluate its psychometric properties. Content analysis was applied to explore the health needs of female adolescents through focus group discussions with adolescents and in-depth interviews with key informants. Five themes were identified: educational needs, and emotional, social, physical and spiritual health needs. A scale-level content validity index of 0.92 was obtained. The factor structure was identified by principal component analysis; 5 factors were extracted which accounted for 44.89% of the variance. Reliability of the instrument was demonstrated with a Cronbach alpha of 0.90 for the entire scale. Consistency was established with test-retest reliability with an interval of 2 weeks (intracluster correlation coefficient = 0.984, P < 0.001). There was a negative correlation with the Pediatric Quality of Life Inventory (r = -0.66, P < 0.001). The instrument is culturally sensitive with satisfactory validity and reliability and could be used for planning of adolescent health services.

Socially-deviant middle eastern women at a great risk of poor reproductive health.

BACKGROUND: It is important to examine scale and scope of the reproductive health among socially-vulnerable women. The study was aimed at testing the hypothesis that as compared to general population, reproductive health is poorer among socially-vulnerable women. METHODS: We enrolled 100 cases and 203 controls conducted from January 2010 to January 2011. Cases were socially-vulnerable women seeking care from Tehran's Center for Improving Social Health of Socially-Damaged Women (Specific Center for Socially-Vulnerable Women). Controls were women referring to health centers of Tehran. RESULTS: Mean age of cases and controls were 34.1 years and 33.8 years, respectively. Unwanted pregnancy was reported by 62.9% of cases and 33% of controls. Among socially-vulnerable women, 50.6% of abortions were reported to happen during the period in which they were using drugs. Among cases, 45.7% reported to give birth to low birth weight newborns and for controls was 11.7%. Among cases with low birth weight child, 64.9% used drug during pregnancy. Birth control was reported by 81.5% of cases and 92.8% controls. The most common method of contraception was condom among both cases (66%) and controls (31.2%). At least one screening test for cervical cancer was reported by 82.8% of controls and for 47% of cases. Mean age at first sexual intercourse was 15.7 years among cases and 20.9 years among controls. Mean Sexual Performance Scale score was lower among cases (22.3) than controls (25.9) and sexual dysfunction was more prevalent among cases (80.6%) than controls (59.1%). CONCLUSION: A high prevalence of reproductive health disorders was documented among socially-damaged women as compared to the women from general population.

An inventory for assessment of the health needs of Iranian female adolescents

Health needs assessment is a first step to planning adolescent health programmes but it needs to be socioculturally relevant to the target population. This study aimed to develop an instrument to assess the health needs of Iranian female adolescents and evaluate its psychometric properties. Content analysis was applied to explore the health needs of female adolescents through focus group discussions with adolescents and in-depth interviews with key informants. Five themes were identified: educational needs, and emotional, social, physical and spiritual health needs. A scale-level content validity index of 0.92 was obtained. The factor structure was identified by principal component analysis; 5 factors were extracted which accounted for 44.89% of the variance. Reliability of the instrument was demonstrated with a Cronbach alpha of 0.90 for the entire scale. Consistency was established with test-retest reliability with an interval of 2 weeks [intracluster correlation coefficient = 0.984, P< 0.001]. There was a negative correlation with the Pediatric Quality of Life Inventory [r = -0.66, P < 0.001]. The instrument is culturally sensitive with satisfactory validity and reliability and could be used for planning of adolescent health services

An inventory for assessment of the health needs of Iranian female adolescents

Health needs assessment is a first step to planning adolescent health programmes but it needs to be socioculturally relevant to the target population. This study aimed to develop an instrument to assess the health needs of Iranian female adolescents and evaluate its psychometric properties. Content analysis was applied to explore the health needs of female adolescents through focus group discussions with adolescents and in-depth interviews with key informants. Five themes were identified: educational needs, and emotional, social, physical and spiritual health needs. A scale-level content validity index of 0.92 was obtained. The factor structure was identified by principal component analysis; 5 factors were extracted which accounted for 44.89% of the variance. Reliability of the instrument was demonstrated with a Cronbach alpha of 0.90 for the entire scale. Consistency was established with test-retest reliability with an interval of 2 weeks [intracluster correlation coefficient = 0.984, P < 0.001]. There was a negative correlation with the Pediatric Quality of Life Inventory [r = -0.66, P < 0.001]. The instrument is culturally sensitive with satisfactory validity and reliability and could be used for planning of adolescent health services

Effect of nutritional intervention on the prevalence of metabolic syndrome and heart disease risk factors in urban Tehran (Tehran lipid and glucose study).

In a case-control study a nutritional intervention consisting of an educational program based on the Therapeutic Lifestyle Change diet (TLC) guidelines was implemented in one area of Tehran. Data were collected from subjects in the intervention area (n =133) and controls from another area (n = 183), before and 3.8 years after the intervention. Mean energy and macronutrient intakes and prevalence of risk factors including metabolic syndrome were compared between and within cases and controls. Baseline and follow-up evaluations showed improvement in hypercholesterolemia and high LDL cholesterol levels in cases versus controls. Central obesity and low HDL cholesterol levels increased significantly in controls but not in cases. As there were no significant differences between the 2 groups in energy and macronutrient intakes, it is difficult to claim that nutritional interventions played an important role.

Effect of nutrition intervention on non-communicable disease risk factors among Tehranian adults: Tehran Lipid and Glucose Study.

BACKGROUND/AIM: Several epidemiologic studies have shown that many nutritional and non-nutritional risk factors for non-communicable diseases are modifiable. This study was conducted to determine the effectiveness of nutrition intervention on non-communicable disease risk factors among Tehranian urban adults. METHODS: In the Tehran Lipid and Glucose Study (TLGS), 1,474 subjects, aged 3 years and over, were selected for dietary assessment; nutrition intervention was implemented for one third through pamphlets, posters, nutritional consultations, educational courses, and demonstration of films in the community health medical centers, schools, and other public places. After a 3.8-year follow-up period, data were collected for 578 subjects, aged 18-74 years, who participated in the second phase of the study; there were 356 subjects in the control group and 222 in the intervention group. Mean body mass index, energy intake, macronutrients, fibre, micronutrients, serum lipids, fasting blood sugar, and systolic and diastolic blood pressures were determined in both groups. RESULTS: The mean fasting blood sugar concentrations increased significantly in the control group and decreased significantly in the intervention group. Mean diastolic blood pressure and total cholesterol and low-density lipoprotein cholesterol levels decreased in both groups. However, the body mass index showed a significant increase in both groups. Adjusted for age, sex, and baseline variables, the cholesterol intake (214 vs. 232 mg/day, p < 0.05) was significantly lower in the intervention as compared with the control group. CONCLUSIONS: The present study shows decreases in fasting blood sugar, total serum cholesterol, and daily cholesterol intake after nutrition interventions. Specific intervention measures, keeping in mind cultural and socio-economic factors, could modify dietary patterns and are effective in the primary pre- vention of non-communicable diseases.