Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial

Abstract Background In recent years, more attention has been paid to virtual education methods in the field of oral health. Oral health literacy (OHL) plays a major role in reducing oral health inequalities. Individuals with inadequate health literacy are more susceptible to oral disorders. This stu...

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Main Authors: Negar Ebrahimi, Katayoun Sargeran, Reza Yazdani, Ahmad Reza Shamshiri
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Oral Health
Subjects:
Online Access:https://doi.org/10.1186/s12903-025-05560-y
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author Negar Ebrahimi
Katayoun Sargeran
Reza Yazdani
Ahmad Reza Shamshiri
author_facet Negar Ebrahimi
Katayoun Sargeran
Reza Yazdani
Ahmad Reza Shamshiri
author_sort Negar Ebrahimi
collection DOAJ
description Abstract Background In recent years, more attention has been paid to virtual education methods in the field of oral health. Oral health literacy (OHL) plays a major role in reducing oral health inequalities. Individuals with inadequate health literacy are more susceptible to oral disorders. This study was a parallel randomized controlled trial with a non-inferiority design that aimed to compare a virtual educational intervention with traditional in-person education to improve OHL. Methods This study was conducted in adults visiting a university dental school, from February 2022 to May 2023. After the inclusion and exclusion criteria were checked and informed consent was obtained, the participants were randomly allocated into two groups by balanced block randomization. One group received in-person education in the waiting room, and the other received an educational video through an online messenger. The Oral Health Literacy Adult Questionnaire (OHL-AQ) assessed participants’ OHL levels before, immediately after, and three months after the intervention. The researchers who analysed the data were blinded. Generalized estimating equation (GEE) analysis was used to compare the groups (P < 0.05). The non-inferiority margin was determined using the fixed-margin method. Results In total, 149 individuals participated. Seventy-five patients were randomly allocated to the in-person group, and 74 were allocated to the virtual group; their data were analysed. GEE analysis revealed no significant difference in the change of OHL scores immediately after the intervention between the two groups (P = 0.07). However, at the three-month follow-up, the in-person group exhibited a significantly greater improvement in OHL scores compared to the virtual group (P = 0.03). After three months, virtual education was inferior to in-person education, unlike in the immediate post-test. Conclusion After three months, an online video sent in a messenger environment was less effective than traditional in-person education in improving OHL. Trial registration The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 08–02-2022, (IRCT20220106053643N1|| http://www.irct.ir/ ).
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spelling doaj-art-72b30d0263be421cbc4fe7de34f76d042025-02-09T12:57:13ZengBMCBMC Oral Health1472-68312025-02-0125111110.1186/s12903-025-05560-yDoes the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trialNegar Ebrahimi0Katayoun Sargeran1Reza Yazdani2Ahmad Reza Shamshiri3Dental Implant Research Centre, Dentistry Research Institute, Tehran University of Medical SciencesResearch Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical SciencesResearch Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical SciencesDepartment of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, North Karegar StAbstract Background In recent years, more attention has been paid to virtual education methods in the field of oral health. Oral health literacy (OHL) plays a major role in reducing oral health inequalities. Individuals with inadequate health literacy are more susceptible to oral disorders. This study was a parallel randomized controlled trial with a non-inferiority design that aimed to compare a virtual educational intervention with traditional in-person education to improve OHL. Methods This study was conducted in adults visiting a university dental school, from February 2022 to May 2023. After the inclusion and exclusion criteria were checked and informed consent was obtained, the participants were randomly allocated into two groups by balanced block randomization. One group received in-person education in the waiting room, and the other received an educational video through an online messenger. The Oral Health Literacy Adult Questionnaire (OHL-AQ) assessed participants’ OHL levels before, immediately after, and three months after the intervention. The researchers who analysed the data were blinded. Generalized estimating equation (GEE) analysis was used to compare the groups (P < 0.05). The non-inferiority margin was determined using the fixed-margin method. Results In total, 149 individuals participated. Seventy-five patients were randomly allocated to the in-person group, and 74 were allocated to the virtual group; their data were analysed. GEE analysis revealed no significant difference in the change of OHL scores immediately after the intervention between the two groups (P = 0.07). However, at the three-month follow-up, the in-person group exhibited a significantly greater improvement in OHL scores compared to the virtual group (P = 0.03). After three months, virtual education was inferior to in-person education, unlike in the immediate post-test. Conclusion After three months, an online video sent in a messenger environment was less effective than traditional in-person education in improving OHL. Trial registration The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 08–02-2022, (IRCT20220106053643N1|| http://www.irct.ir/ ).https://doi.org/10.1186/s12903-025-05560-yOral healthHealth literacyDental health educationDistance education
spellingShingle Negar Ebrahimi
Katayoun Sargeran
Reza Yazdani
Ahmad Reza Shamshiri
Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial
BMC Oral Health
Oral health
Health literacy
Dental health education
Distance education
title Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial
title_full Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial
title_fullStr Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial
title_full_unstemmed Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial
title_short Does the transition from face-to-face to face-to-screen improve oral health literacy? A non-inferiority randomized controlled trial
title_sort does the transition from face to face to face to screen improve oral health literacy a non inferiority randomized controlled trial
topic Oral health
Health literacy
Dental health education
Distance education
url https://doi.org/10.1186/s12903-025-05560-y
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