iprc2014 presentation nathawut 12 aug 2014
TRANSCRIPT
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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.
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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THEORY AND CONCEPT RELATED TO HEALTH BEHAVIOR
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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THEORY AND CONCEPT
Health belief model Social Learning (Cognitive)Theory Action competence : K-A-P
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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.
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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.
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
•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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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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BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
Oral examination sheet
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BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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.
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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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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BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
THE RESULTS
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DISCUSSION
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
BEHAVIORAL SCIENCE RESEARCH INSTITUTE, SRINAKHARINWIROT UNIVERSITY
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
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