Effectiveness of educational intervention based on transtheoretical model in promoting oral health self-care behaviors among elementary students

Studies have demonstrated the effectiveness of psychological stage-based educational interventions to promote healthy behaviors. This study examined the effectiveness of an educational intervention based on the stages-of-change model in improving oral self-care behaviors among students in Qazvin، Iran. In this randomized controlled study، 160 elementary schoolchildren who were in inactive stages were selected from 8 primary schools using multi-stage sampling approach and were assigned to either the control or the intervention group. Data، including demographic variables، transtheoretical model constructs and the modified plaque index، was collected using a questionnaire before and six months after the intervention. The educational intervention consisted of four 45‒60-minute sessions with a focus on attitude change، self-efficacy promotion and decisional balance change، using images، educational clips and special pamphlets in the intervention group. Data were analyzed with chi-squared test، paired t-test، independent t-test and ANOVA، followed by post hoc Scheffé’s test، Wilcoxon’s test and Mann-Whitney test (α = 0. 05). Before the intervention، none of the subjects were in the action and maintenance stage، while after the educational intervention، 26% of the intervention group subjects moved to active stages and the number of pre-contemplation stage subjects was halved (p value = 0. 0003). Significant improvements were observed in self-efficacy (p value = 0. 0006)، process of change (p value = 0. 002) and decisional balance (p value = 0. 005) in the intervention group. Training based on the stages model was able to significantly decrease the plaque index (p value = 0. 0001) and increase self-reported oral care behavior (p value = 0. 021). Educational intervention based on stages-of-change model can improve oral health-related behaviors، and clinical oral and plaque indexes among students.