Evaluation of oral health education by different oral health workforce in Bulacan, Philippines

Abstract

Aim:

The purpose of the study was to determine if there was an improvement in the students oral health knowledge after conducting the oral health promotion based on oral health knowledge test results, as well as the results from the students knowledge, attitudes, skills and aspirations (KASA) survey with several socioeconomic factors of students considered.

Methodology:

Three health workers were randomly selected to participate in a descriptive cross-sectional study on the oral health knowledge, and KASA assessment of the students. The study consisted of 324 (34.90% males, 65.10% females) 12- to 21- year old secondary school (Grades 7 – 12) students living in San Jose Del Monte, Bulacan. Students were selected according to class availability and were assigned to each health worker and dentist at random. Community Health Worker 1 (CHW1) was a university graduate while members of the Community Health Worker 2 (CHW2) group did not have a university degree. A socioeconomic status (SES) questionnaire and a pretest were first distributed to the students. Classes were each randomly assigned to one of the three oral health educators namely: Dentist, CHW1 and CHW2. Lecture and proper tooth brushing demonstration were performed. Posttest and KASA questionnaires were handed out afterwards. Chi-square test for categorical variables and one-way Analysis of Variance (ANOVA) for continuous variables were used to compare the socio-demographic factors among the oral health educators students. One-way ANOVA, and one-way Analysis of Covariance (ANCOVA) adjusting for covariates: pretest, and socioeconomic factors (age, gender, age of father, age of mother, educational attainment of father, educational attainment of mother, household size and number of minors in the household) were used for comparison among the three groups., Post hoc tests (Scheffé, Dunnett T3 and Sidak) were also applied to compare the pretest and posttest results while ANOVA, ANCOVA, and post hoc tests (Scheffé and Sidak) were used for the KASA survey results.

Results:

Results showed that there was a significant difference between the pretest and posttest scores among the groups by paired samples t-test (p< 0.001). Through ANCOVA, it was observed that, after adjusting for the covariates, a statistically significant difference (p< 0.001) was found among the students posttest scores in all three groups of educators (Dentist, CHW1, and CHW2). Furthermore, Sidak post hoc test for ANCOVA specifically indicated a significant difference between the Dentist and CHW2 groups (p< 0.001), as well as in between the CHW1 and CHW2 groups (p< 0.001). For KASA, after adjusting for the covariates by ANCOVA, all comparisons showed no significant difference among the three groups except for the Knowledge part (p< 0.001). Moreover, Sidak post hoc test for ANCOVA revealed that the Dentist group, in particular, demonstrated a significant difference with the CHW1 group (p< 0.001).

Conclusion:

An improvement in the students oral health knowledge after conducting the oral health promotion has been observed. CHW1 was found to be as effective as the dentist in enhancing the students oral health knowledge. The educational background of CHWs played a vital role in terms of effectiveness which was reflected in the posttest results. KASA survey overall results demonstrated similar outcome in the three groups. However, the influence of socioeconomic factors was not significantly evident.