Iprc2014 presentation nathawut 12 aug 2014

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A Causal Relationship Model of Oral Hygiene Care Behavior and the Oral Hygiene Status of Early Adolescents

Nathawut Kaewsutha ,Ungsinun Intarakamhang , Patcharee Duangchan

11th International Postgraduate Research Colloquium

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OUTLINE OF PRESENTATION Introduction Objective Method Results Discussion Conclusion Implications

BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY

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INTRODUCTION AND BACKGROUND

Oral diseases, especially dental caries and gingivitis is one of the important public health problems

Cause suffering to patients because of the chronic painfulness

Adverse effects on mental health, personality, vocalization and life performance

Malfunction of teeth in childhood has direct impact on eating ability of children and can result in children’s malnutrition

The children may have learning problems because of absenteeism

Treatment of oral health problem is time- consuming and require a huge amount of budget and number of dental health professional Economic and social impact.


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INTRODUCTION AND BACKGROUND

Year 1989 1994 2001 2007

Prevalent 49.2 53.9 57.3 56.9

DMFT 1.50 1.55 1.64 1.64

Dental public health division, Ministry of public health, Thailand, 2007)

THAILAND SITUATION

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children of 12 years old , which are secondary school grade 7th

No surveillance program among secondary school students.

Number of secondary school students with oral disease is still untowardly increasing risky group- Frequency of carbohydrate consumption and

inappropriate dental hygiene Significant epidemiological aspect fully

permanent teeth Prevalence rate of dental caries and gingivitis

among this group is good predictor of dental problem among future adults

(Thailand National Dental Health Survey, 2012)

EARLY ADOLESCENTS


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ORAL HYGIENE CARE BEHAVIOR

A proper oral hygiene care during the early stage can prevent dental caries, gingivitis and the loss of permanent teeth in adult

The data from Thailand National Dental Health Survey, 2012- 7.62 % of children aged 12 brushed their teeth more than twice a day - 9.06% brushed their teeth after having snack

Lack of behavioral science study about causal relationship model of oral hygiene care behavior in early adolescent group


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RESEARCH OBJECTIVES

The purposes of this study were

to examine consistency of a hypothetical causal relationship model of oral hygiene care behavior with empirical data

to examine the influence of causal relationship factors related oral hygiene care behavior in early adolescent group


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THEORY AND CONCEPT RELATED TO HEALTH BEHAVIOR


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THEORY AND CONCEPT

Health belief model Social Learning (Cognitive)Theory Action competence : K-A-P


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The Health Belief Model

Rosenstock, Irwin (1974). "Historical Origins of the Health Belief Model". Health Education Behavior 2 (4): 328–335.


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Rosenstock, Irwin M.; Strecher, Victor J.; Becker, Marshall H. (1988). "Social learning theory and the health

belief model". Health Education & Behavior 15 (2): 175–183.


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Social Cognitive Theory

Bandura, A. (1977) Toward A Unifying Theory Of Behavioral Change. Psychol Rev. 1977 Mar; 84(2):191-215.Bandura, A., (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, p. 122-147.Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman

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•Social Learning Theory (Bandura ,1986)

•Model Of Reciprocal Determinism

•Self-Belief , Cognition , Self-Efficacy, Self-regulatory (controls), Self-reflective process, Self Management

•“coach approach” taken by professional life coaches and professional wellness coaches

Social Cognitive Theory

Bandura, A. (1977) Toward A Unifying Theory Of Behavioral Change. Psychol Rev. 1977 Mar; 84(2):191-215.Bandura, A., (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, p. 122-147.Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman

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Action competence : KAP Model


Saugstad-Gabrielsen T, Mach-Zagal R. Sundhedspædagogik for praktikere [Educating for health among practitioners]. 2nd edn. Copenhagen, Munksgaard Danmark, 2003.

Action competence includes:• knowledge about the problem• an attitude towards the problem• the ability to act to solve the

problem

Knowledge

Attitude

Practice

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CONCEPTUAL FRAMEWORK

Knowledge in oral hygiene and oral

diseases

: Knowledge and understand: Apply knowledge

Attitude toward oral health care

: Cognitive: Affective: Behavior

Perceived threatened diseases

: Percieved susceptibility: Percieved severity

Behavioral modification

: Self efficacy: Self control

Cues to actions

:Oral health information and media:Family support: Friend support

Oral hygiene care behavior

: Eating behavior: Tooth brushing behavior

Oral hygiene status

: Debris indexes


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MATERIALS AND METHODS Collect data from 391 students, Nakhon-Nayok Province,

selected through the stratified random sampling method.

Seven latent variables of the study were measured from 15 observed variables.

The exogenous latent variables included 1. knowledge in oral hygiene and oral diseases2. perceived threatened diseases3. cues to actions

The endogenous latent variables included 4. attitude toward oral health care5. behavioral modification6. oral hygiene care behavior 7. oral hygiene status


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The instrument used for collecting data was 6-point rating scale questionnaires : 13 variables Oral examination sheet: 2 variables

MATERIALS AND METHODS


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6-point rating scale questionnaires


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Oral examination sheet

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Questionnaires

The plaque debris check-up

evaluated tooth brushing practice

The step of the collect data

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Data were analyzed by descriptive statistics and examined for consistency of hypothetical a causal model with empirical data using LISREL.

MATERIALS AND METHODS


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THE RESULTS the hypothetical a causal model was consistent with

empirical data χ2 = 132.87, df = 75, p-value = 0.001, χ2/ df = 1.77; RMSEA = 0.044;

RMR = 0.053; CFI = 0.94; AGFI = 0.93; GFI = 0.96

The variables that directly effected oral hygiene care was behavioral modification; their standardized path coefficient was .54 respectively.

The variables that indirectly effected to oral hygiene care behavior were knowledge in oral hygiene and oral diseases, attitude toward oral health care, perceived threatened diseases and cues to actions; their standardized path coefficients were .13 .45, -.32 and .10 respectively.


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RESULTSBEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY

χ2 = 132.87, df = 75, p-value = 0.001, χ2/ df = 1.77; RMSEA = 0.044; RMR = 0.053; CFI = 0.94; AGFI = 0.93; GFI = 0.96

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RESULTSBEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY

χ2 = 132.87, df = 75, p-value = 0.001, χ2/ df = 1.77; RMSEA = 0.044; RMR = 0.053; CFI = 0.94; AGFI = 0.93; GFI = 0.96

Behavior modification

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THE RESULTS

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DISCUSSION


The causal relationship model of oral hygiene care behaviors by hypothetical is matched with the empirical data after adjust model

Fit index Criteria Before adjust model

After adjust model

χ2 , p p > .05 308.13, 0.00 132.87, 0.00

χ2/df < 5.00 3.76 1.77GFI > .90 0.9 0.96CFI > .90 0.76 0.94

AGFI > .90 0.86 0.93RMR < .08 0.13 0.053

RMSEA < .08 0.086 0.044

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DISCUSSION


Recommendation for Future study, Qualitative research techniques such as the in-depth interviews and

participatory observation in the students group to find answers about the meaning and terms of the factors that related oral

hygiene care behaviors

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DISCUSSION


This study focus on group of students in Nakhon Nayok province that represent the urban area in Thailand

The result of this study may be used to describe the phenomenon is limited

Further research should examine the invariance of the model in a group of students in urban and rural area in Thailand.

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CONCLUSION


The hypothetical a causal model was consistent with empirical data

The knowledge in oral hygiene and oral diseases factor, attitude toward oral health care factor, perceived threatened diseases, cues to actions and behavioral modification factor can explained the variance of oral hygiene care behavior

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IMPLICATIONS


In the future Experiment study about effect of behavior

modification program that using self-efficacy and self-control as part of a behavior modification program for change the oral hygiene care behavior in early adolescent.

useful in generating new knowledge for prevent and control tooth decay and gum disease in secondary school children in Thailand

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REFERRENCES


Bandura, A. (1977). Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall.Bandura. A. (2000). Self efficacy: The Exercise of Control. 4th ed. New York: W.H. Freeman & Co.Becker,MH. & Maiman, L. (1975,January). Sociobehavioral Determinants of Compliance with Health

Medical Care Recommendation. Medical Care,13(1),12.Backman, Desiree R.; et al. (2002). Psychosocial Predictors of Healthful Dietary Behavior on

Adolescents. J Nutr Educ Behav, 34, 184-93. Bogers, R.P. et al. (2004) Explaining Fruit and Vegetable Consumption: the Theory of Planned

Behaviour and Misconception of Personal Intake Levels. Appetite, 42, 157-66.Borzekowski Dina LG & Robinson TN. (2001). The 30-second effect: an experiment revealing the

impact of television commercials on food preferences of preschools. J Am Diet Assoc, 101, 42-46.Conner,M., Norman,P., Bell,R. (2002). The Theory of Planned Behavior and Healthy Eating. Health

Psychology, 21(2), 194-201.Joreskog, K. G. & Sorbom, D. (1996). LISREL 8:User's reference guide. Chicago, IL: Scientific Software

International. Kassem, Nada O. et al. (2003). Understanding Softdrink Consumption among Female Adolescents

Using the Theory of Planned Behavior. Health Education Research,18(3), 278-91.Kelloway, E. K. (1998). Using LISREL for structural equation modeling : a researcher's guide.

Thousand Oaks, Carifornia: Sage.Masalu, J.R.& Astrom, A.N. (2001). Predicting Intended and Self-perceived Sugar Restriction

among Tanzanian Students Using the Theory of Planned Behavior. Journal of Health Psychology, 6(4), 435-45.

THANK YOU &

Q&A


Iprc2014 presentation nathawut 12 aug 2014

Health & Medicine

Transcript of Iprc2014 presentation nathawut 12 aug 2014