Trial reportBMC geriatrics2025
Application of health action process approach model to promote toothbrushing behavior among Iranian elderly population: a cluster randomized controlled trial.
Trial report in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Trial
- Effectiveness of HAPA-based oral hygiene instruction in patients over 65 years of age: a randomized controlled trial.BMC oral health · 2025Trial
- From Diagnosis to Behaviour Change: Applying the Health Action Process Approach to Smoking Cessation After Head and Neck Cancer.Behavioral sciences (Basel, Switzerland) · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundImproving the oral health of elderly individuals, involving various healthcare providers, should be a key objective for multidisciplinary teams responsible for their care. We aimed to compare the effectiveness of an oral health education program based on the health action process approach (HAPA) model when provided by a dentist versus a health officer among elderly people.
methodsThis cluster-randomized controlled trial included elderly residents aged more than 60 years from 24 municipal neighborhood houses (n = 190) in Tehran, Iran, in 2021. A questionnaire was administered through face-to-face interviews at baseline to collect sociodemographic characteristics and HAPA model constructs related to toothbrushing behavior. The Simplified Oral Hygiene Index (OHI-S) was also assessed. The neighborhood houses were assigned to two groups via simple randomization: Group A, which received oral and dental health education based on the HAPA model by a dentist and an educational pamphlet (N = 89); and Group B, which was educated by a health officer and an educational pamphlet (N = 101). Both groups received reinforcement every two weeks. Follow-up oral examinations were conducted after 1 and 3 months by a blinded, calibrated examiner. The marginal model of generalized estimating equations (GEEs) with Bonferroni post hoc correction was used for intragroup and intergroup comparisons.
resultsThe frequency of toothbrushing was not significantly different between the two groups (p = 0.09) after one or three months. However, the frequency of toothbrushing increased significantly in both groups (p < 0.001). Additionally, no difference was found in the OHI-S score between the two groups (p = 0.56); nevertheless, there was a statistically significant improvement in oral hygiene status in both intervention groups (p < 0.001).
conclusionNo difference was observed in the effectiveness of educational interventions using the HAPA model when delivered by a dentist versus a health officer working in a municipal center. Both interventions were effective at promoting the oral hygiene status of elderly individuals. These interventions could be integrated into existing public health programs.
trial registrationThe trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 7-12-2020 (registration number: IRCT20200928048868N1).
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