Validity assessment of oral health promotion activities targeting the older population for community care in South Korea: A Delphi study.

OBJECTIVE: The purpose of this study was to establish an oral health activity assessment tool for older people and evaluate its validity. BACKGROUND: To provide reasonable and efficient oral health promotion services with limited medical resources, a tool including categories and items of oral health promotion activities for older people should be prepared. MATERIALS AND METHODS: The tool initially consisted of 76 items on oral health promotion activities for older people classified into assessment-performance-evaluation stages. Topics for each stage included general and oral health, daily health, oral health status, behaviour, and awareness. In addition, two Delphi surveys were conducted on 10 experts who met the selection criteria, and the final items were derived based on the review opinions. RESULTS: As a result of the first and second Delphi surveys, the content validity for all items was ≥0.60 and the content validity index was ≥0.80. In the first survey, the degree of convergence in some items was 0-0.88. After modifying the contents according to expert opinions, the degree of convergence was improved from 0 to 0.50 in the second survey. The degree of agreement ranged from 0.75 to 1.00, indicating that experts agreed. Finally, a total of 65 items were derived. CONCLUSION: A 65-item tool was derived through two Delphi surveys for the assessment of oral health activities for older people. The use of the tool developed in this study would likely contribute to better prevention of oral diseases and the promotion of oral health among older people.

Factors predicting different times for brushing teeth during the day: multilevel analyses.

BACKGROUND: The most effective and simple intervention for preventing oral disease is toothbrushing. However, there is substantial variation in the timing of brushing teeth during the day. We aimed to identify a comprehensive set of predictors of toothbrushing after lunch and after dinner and estimated contextual (i.e., geographic) variation in brushing behavior at different times of the day. METHODS: We constructed a conceptual framework for toothbrushing by reviewing health behavior models. The main data source was the 2017 Community Health Survey. We performed a four-level random intercept logistic regression to predict toothbrushing behavior. (individual, household, Gi/Gun/Gu, and Si/Do). RESULTS: Individuals under 30 years of age had higher likelihood of brushing after lunch, while brushing after dinner was higher among those aged 40-79 years. People engaged in service/sales, agriculture/fishing/labor/mechanics, as well as student/housewife/unemployed were 0.60, 0.41, and 0.49 times less likely to brush their teeth after lunch, respectively, compared to those working in the office, but the gap narrowed to 0.97, 0.96, 0.94 for brushing after dinner. We also found significant area-level variations in the timing of brushing. CONCLUSIONS: Different patterns in association with various factors at individual-, household- and Si/Gun/Gu-levels with toothbrushing after lunch versus toothbrushing after dinner suggests a need for tailored interventions to improve toothbrushing behavior depending on the time of day.

Definition and Classification of Dental Hygiene Interventions Based on the Dental Hygiene Process of Care: A Delphi Study.

This study aimed to conceptualize the dental hygiene intervention performed by dental hygienists based on the dental hygiene process of care. The dental hygiene intervention classification was conducted on the qualitative content analysis method. The contents of the primary dental hygiene intervention classification were refined after review by three internal experts. The final classification of dental hygiene interventions was derived through an expert Delphi survey conducted twice with 15 professors in charge of clinical dental hygiene. In the Delphi survey, the content validity and clarity were evaluated. As a result of the first and second expert Delphi surveys, the content validity ratio for all dental hygiene interventions and definitions was ≥0.60, and the content validity index was ≥0.80. The degree of agreement was a minimum of 0.80 and a maximum of 1.00. Thirty-eight dental hygiene interventions were conceptualized, and the essence of the dental hygienist was confirmed. Dental hygienists are oral health experts who help in preventing oral diseases and promoting oral health by providing evidence-based comprehensive preventive management through interaction with their clients, and they are a primary care worker who could contribute to health promotion. In the future, dental hygienists are expected to be actively involved in the primary care system and dental clinical sites and contribute to health promotion through practical discussions for this purpose.

Effects of Problem-Based Learning on the Problem-Solving Ability and Self-Efficacy of Students Majoring in Dental Hygiene.

This study developed a problem-based learning (PBL) module to improve integrated thinking and problem-solving ability in students of dental hygiene. After applying PBL, the study tested the improvement in the problem-solving ability and self-efficacy of students. The subjects were 31 fourth-year students of the Department of Dental Hygiene at G University. The PBL process was applied to three topics for 15 weeks, and the tools for evaluating problem-solving ability and self-efficacy were reconstructed and used before and after the application to examine the effects of the module. The result indicates that the mean of problem-solving ability (32 detailed items) increased from 3.37 to 3.65 (an increase of 0.28) after classes (p < 0.001). Alternatively, the average for self-efficacy (22 detailed questions) increased from 0.21 to 2.89 (p < 0.05; an increase of 2.67). The study also confirmed the correlation between problem-solving ability and the total posttest score for self-efficacy (p < 0.001). Thus, the problem-solving ability and self-efficacy of learners were improved in the class to which PBL was applied. These improvements exerted a significant effect on the improvement of problem-solving ability. This finding confirmed the effect of the PBL method on dental hygiene education.

Evaluation of an Oral Health Management Project in Connection to a Non-Communicable Disease Prevention and Management Project: A Case Study in South Korea.

This study aimed to develop, pilot, and evaluate a three-year integrated preventive management project focused on chronic diseases and oral health prevalence. A total of 1148 users of the health care office of the G Public Health Center with dental risk factors were selected for this study and connected to the dental counseling department. Respondents were classified into a group that would receive counseling-type self-education on oral care and a second group that needed dental care. To evaluate the dental care utilization and satisfaction, a telephone survey was conducted with the 263 people. Oral health behavioral changes were analyzed in 97 comparable subjects who responded to both the oral health basic survey and telephone survey. More than 90% of the subjects who visited the dental clinics were positively satisfied with the system for requesting care and with being referred to dental clinics at the public health center or community dental clinics. Measures of oral health perception and of behavior need showed positive changes. This study was effective in inducing positive changes in the oral health management behavior of chronically ill patients and in promoting the use of preventive management-centered dental care.

Factors Affecting Preventive Dental Treatment of Adolescents in Korea.

We conducted a multilevel analysis to identify factors affecting adolescents' preventive dental treatment experience in South Korea. We sampled 72,435 students who participated in the 9th Korea Youth Risk Behavior Web-based Survey. The individual-level variables were divided into demographic factors, socioeconomic factors, oral health behavioral factors, and oral symptom experience factors. The regional-level variables included oral health resources, rate of students receiving oral health education at school by region, social deprivation index, and the number of private educational institutions. A higher rate of receiving oral health education in school by region was associated with increased fluoride application (1.04 times, p = 0.003). However, the number of private educational institutes per 1000 people was negatively associated with fluoride application experienced by students (0.64 times, p = 0.039). Students underwent more scaling when there were more dentists per 10,000 individuals (1.14 times, p = 0.008) and less scaling in areas with a higher social deprivation index (0.88 times, p = 0.024). To increase the access to preventive care for oral diseases among adolescents, a preventive system should be established in schools, and a primary dental care system should be established through the cooperation of the government, private dental clinics, and schools.

The effect of project-based learning modules on a community dental hygiene practicum in South Korea.

PURPOSE: The goal of this study is to develop and apply learning modules to help community dental hygienists acquire the necessary competencies and verify the effectiveness of the modules. METHODS: On the basis of 12 domestic and international reference papers, the concept of a community dental hygiene process of care was defined, and 393 learning goals were found to perform the primary and secondary categorization processes. The final 52 learning goals were assigned as a 15-week module series to develop project-based learning modules. The modules were used in 2018 during the first semester of the community dental hygiene practicum at G University (bachelor's degree) and H University (associate's degree). Surveys were performed before and after the application of the modules to evaluate the method's effectiveness. RESULTS: Confidence in problem-solving abilities, project value, teamwork competency, and community dental hygiene competency were compared before and after the application of the modules. Students at both G and H universities showed statistically significant improvements across all 4 indices. Project authenticity and learning outcomes were analyzed in students at G and H universities after applying the modules; the results demonstrated that project authenticity and learning outcomes were positive. CONCLUSION: The learning modules can be presented as systematic educational modules, which have inherent academic significance for dental hygiene, and in turn can strengthen students' competency in community practice areas.

Types of Perception of Home Visiting Oral Health Care Services for Korean Older Persons: A Q Methodology Study.

This study was conducted using the Q methodology to categorize Korean older persons' subjective perceptions of home visiting oral health care services. Various opinions regarding home visiting oral health care services were collected based on related literature, and by conducting in-depth interviews with 12 people. Thirty-two statements were finally selected, and Q classification was applied. Based on data analysis with the PC-QUANL program, six factors (seven types) were derived, which accounted for 49.6% of the total variance. By comprehensive analysis of the types of subjective perceptions of home visiting oral health care services, the following two characteristics were identified. Korean older persons were expected to promote their own oral health activities, or improved access to expert health care services, through the home visiting oral health care services. Additionally, they had a need for social, economic, emotional, and informational support. Therefore, home visiting dental personnel should be able to provide customized visiting oral health care services based on evaluation of the need and type of perception of older persons. Thus, it is essential for visiting dental personnel to be trained in the knowledge of social welfare, and to develop diverse competencies.