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ORIGINAL ARTICLE
Year : 2020  |  Volume : 18  |  Issue : 3  |  Page : 228-231

Impact of educational intervention on oral health knowledge among AYUSH workers in Sriganganagar, Rajasthan – A quasi experimental study


1 Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
2 Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India

Date of Submission15-May-2018
Date of Decision03-Apr-2020
Date of Acceptance20-Sep-2020
Date of Web Publication24-Oct-2020

Correspondence Address:
Parul Sharma
Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_111_18

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  Abstract 


Background: Young children receive no dental care though they are frequently visiting AYUSH workers for routine medical check-ups. These checks-ups can be integrated with oral health to uplift the oral health status of children by taking advantage of an existing network of the workforce who has made roots into the existing society. Aims: The aim of this study was to assess the impact of educational intervention on oral health knowledge among AYUSH workers. Materials and Methods: Quasi-experimental study design was used among AYUSH workers registered under RBSK program in the Ganganagar district. A close-ended questionnaire was prepared. The intervention was carried out by a PowerPoint presentation regarding oral health after data collection. The same questionnaire was mailed again to the doctors after 1 month, with 1-week duration to respond back. Statistical analysis was performed using Chi-square and paired t-test using SPSS v22. Chi-square and paired t-test were used for analysis. P value was considered significant at <0.05. Results: Posttest analyses showed an overall increase in the knowledge level of AYUSH health care workers with a mean 13.22 ± 1.40, which was highly significant (P < 0.001), whereas the mean pretest score was 8.37 ± 2.8. Conclusion: The utilization of AYUSH health care workers at the grass root level can be used to provide basic oral health education to the general population in rural areas where the dentist-to-population ratio is low.

Keywords: Brushing, health care workers, knowledge, oral care, oral hygiene


How to cite this article:
Sharma P, Singh S, Mathur A, Batra M, Aggarwal VP, Gill MK. Impact of educational intervention on oral health knowledge among AYUSH workers in Sriganganagar, Rajasthan – A quasi experimental study. J Indian Assoc Public Health Dent 2020;18:228-31

How to cite this URL:
Sharma P, Singh S, Mathur A, Batra M, Aggarwal VP, Gill MK. Impact of educational intervention on oral health knowledge among AYUSH workers in Sriganganagar, Rajasthan – A quasi experimental study. J Indian Assoc Public Health Dent [serial online] 2020 [cited 2020 Nov 29];18:228-31. Available from: https://www.jiaphd.org/text.asp?2020/18/3/228/298994




  Introduction Top


Growth and development in any country's national health system, without an efficient evaluation system, lack the basic concepts and tools necessary for fulfilling the system's goals. The level of development in a country depends on the level of the health of its citizens.[1]

The most common chronic disease affecting children's health all over the world is dental caries, which continues to pose a serious problem, particularly among low-income population countries like India.[2] In India, under National Rural Health Mission, significant progress has been made in reducing mortality among children; one such program was “Rashtriya Bal Swasthya Karyakram” the services aim to cover children in rural areas and urban slums in addition to children enrolled in government and government aided schools. The health team primarily consists of two AYUSH doctors which is an acronym that is used to refer “The Indian medical system of Ayurveda, Yoga, Unani, Siddha, and also Homeopathy” and staff nurses and pharmacist.[3],[4]

The majority of young children receive no dental care until young age though they are frequently visiting AYUSH health care workers for routine medical check-ups. These routine check-ups can be integrated with oral health screening at primary health centers to uplift the oral health status of children [2] by taking advantage of an existing network of the workforce who has made roots into the existing society.

It might be a possibility that by integrating oral health services among AYUSH health care workers, universal screening can be done, which will further lead to early detection of dental conditions, timely intervention, ultimately leading to a reduction in mortality, morbidity, and lifelong disability.

Hence, the present study was planned to investigate the existing knowledge regarding oral health among AYUSH health care workers and to evaluate the effectiveness of the educational intervention on the enhancement of oral health knowledge scores among the same.


  Materials and Methods Top


The present quasi-experimental study was conducted among AYUSH health care workers registered under Rashtriya Bal Swasthya Karyakram program in Ganganagar district, Rajasthan, India. A total of 47 AYUSH doctors were registered [Figure 1]. The study was conducted from February 2017 to April 2017 at Chief Medical and Health Officer's cabin, and the design of the study was quasi-experimental study.A purposive sampling using a total population sampling technique was adopted where the entire population is examined. The ethical clearance SDCRI/IEC/2016/003 was obtained from the respective institute. The study design was approved by the Institutional Ethical Review Board.
Figure 1: Data collection flow chart

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Questionnaire

A structured questionnaire was prepared by the researchers and was concurrently validated by public health dentist by getting it approved regarding ease of applicability and were asked about their comments regarding the language. The considerations given by the expert were readily introduced to the questionnaire. As the study population were doctors, they were well educated and had fluency toward the English language. The pilot study was conducted on a convenience sample of 10 AYUSH workers who were not included in the main study and questions with difficulty in understanding were altered and simplified.

The questionnaire consisted of sociodemographic data and oral health knowledge related questions. It was a close-ended questionnaire that focuses on the association of general and oral health, teeth present in deciduous dentition, eruption time of first permanent teeth, sign of caries detection, importance of fluoride and fluorosis, malocclusion, technique for brushing, treatment of avulsed teeth, and medium used for its storage and material used for interdental cleaning.

The intervention consisted of an oral hygiene education through the medium of PowerPoint presentation on oral health-related diseases, prevention, and treatment faced by the general population as of today.

Block medical officer arranged a meeting with all the AYUSH health care workers on world oral health day in central hospital. Therefore, the prepared presentation was decided to be projected on the same day, as it was the most favorable chance for the researcher to get exposed to all the participants under one roof and at the same time. Forty-seven AYUSH reported on the day of the seminar. The aim of the oral health education program was being mentioned to all the present AYUSH and was asked about their willingness to participate in the study. A total of 45 AYUSH showed a positive response and gave written consent to participate in the study. Questionnaires were distributed and collected before the presentation was delivered. The session continued for 40 min, and all the queries were answered. The researcher focused on cognitive-behavioral interventions for oral health practices. Therefore, aimed to re conceptualize the beliefs of subjects, replace maladaptive thinking patterns with adaptive patterns, and replace maladaptive behavior patterns with functional alternatives for better oral hygiene practices.

Due to nonavailability and regional differences, all the AYUSH workers could not be entitled together. Mail id of all the study population was collected from block medical officer. After 1 month, the same questionnaire was again mailed to the doctors, with 1-week duration to respond back. Forty-one AYUSH workers responded back. The filled questionnaire was then analyzed [Figure 1].

The data so collected were analyzed using the Statistical Package for the Social Sciences IBM Corp. Released 2013.IBM SPSS Solutions for Windows, Version 22.0. (Armonk, NY: IBM Corp.). Chi-square and paired t-test were being used for the statistical analysis with P value set at <0.05.


  Results Top


The response rate of the present study was 87.23%. The total attrition from phase one to phase two was six, and only 41 doctors participated in the second phase.

The gender distribution in AYUSH workers was shown, with a total of 41 AYUSH health care workers took part in the study having 46.34% and 53.65% males and females, respectively. The majority of AYUSH workers were of the age group 26–30 years (70.73%), with the majority of them reported with a working experience of <5 years (53.6%) [Table 1].
Table 1: Demographic characteristic of the study population

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The existing knowledge of AYUSH workers on oral diseases was reported as marks. Each correct answer carried one mark while incorrect answers received zero marks. The following rubric was used for assessing AYUSH workers knowledge: 0–4 was categorized as poor knowledge, 5–11 was categorized as average knowledge, and 12–14 was categorized was good knowledge. Before the intervention, only 14.6% of AYUSH workers had good knowledge scores, whereas a majority of the AYUSH workers had the average knowledge category (73.17%). After the intervention, the majority of AYUSH workers were having good knowledge scores [Table 2].
Table 2: Frequency and percentage distribution of pre-and posttest knowledge score

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Changes in the demographic variable at pre- and post-test were shown, with more improvement in knowledge score in AYUSH workers of age group 24–30 years, who were practicing for <5 years [Graph 1]a and [Graph 1]b.



To assess the effectiveness of oral health education, the mean of correct responses was calculated at pre- and posttest, in which an increase in knowledge among health care workers was observed. Posttest analyses showed an overall increase in the knowledge level of AYUSH health care workers with a mean 13.22 ± 1.40, whereas the mean pretest score was 8.37 ± 2.8.(P < 0.001)


  Discussion Top


The present quasi-experimental study was done as there has been scarce data available regarding oral health and diseased state knowledge among AYUSH health workers. The program was not only designed to raise knowledge toward prevention but also to make them aware toward early identification of these diseases.

In the present study, the majority of AYUSH workers were female and participants were mainly from the age group 24–30 years; similar results were reported in the study conducted by Kaur et al.[5] and Sandhya et al.[6]

While assessing the frequency and percentage distribution of pre- and posttest knowledge of AYUSH health care worker, it was found that the maximum number of AYUSH health care worker was having an average knowledge score (5–11) before the intervention. This could be due to the fact that they had average awareness regarding the importance of oral health because during their professional course, less emphasis is laid on oral health as dental diseases are believed to be associated with morbidity rather than mortality.

After the intervention, an increase in knowledge score of the AYUSH health workers (85.3%) was evident which may be due to knowledge gaps that were identified at pretest assessment, and these gaps were filled to a satisfactory extent through the educational intervention, which was provided to these AYUSH health care workers. The misconceptions regarding the causes of oral diseases were commonly found worldwide regardless of geographical location and professional status was also observed even in these AYUSH health care workers.

When comparison of pre- and postintervention was assessed, it was evidently seen that AYUSH health workers of younger age group, that is, 24–30 years showed more improvement in knowledge score, the same trend was evident in AYUSH health workers practicing for <5 year showing the same which may be due to the fact that younger people are more keen to learn new things as compared to older people who are more stagnant with their thoughts.

Limitation

Survey with structured questionnaire may also have some typical shortcomings, such as over and under-reporting due to social acceptance and a phenomenon that the anonymous character of this study may have minimized but could not eliminate.


  Conclusion Top


The current study illustrates that the health education through intervention is feasible and can be effective in improving the scenario which will, in turn, improve the oral health status of the population. There is a further need for a follow-up research dedicated to assess the effectiveness of utilizing the AYUSH health care workers in providing oral health education through intervention.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Raeisi AR, Yarmohammadian MH, Bakhsh RM, Gangi H. Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model. J Educ Health Promot 2012;1:1.  Back to cited text no. 1
    
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Rabiei S, Mohebbi SZ, Yazdani R, Virtanen JI. Primary care nurses' awareness of and willingness to perform children's oral healthcare. BMC Oral Health 2014;14:26.  Back to cited text no. 3
    
4.
Samal J. Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission. Ayu 2015;36:5-8.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Kaur S, Kaur B, Ahluwalia SS. Oral health knowledge, attitude and practices amongst health professionals in Ludhiana, India. Dentistry 2015;5:1.  Back to cited text no. 5
    
6.
Sandhya MP, Shanthi M, Fareed N, Sudhir KM, Kumar RK. Effectiveness of oral health education among primary health care workers at the primary health center in Nellore district, Andhra Pradesh. J Indian Assoc Public Health Dent 2014;12:74.  Back to cited text no. 6
  [Full text]  


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