TITLE: Evaluation of knowledge and awareness of pediatric oral health among school teachers of Hazaribag before and after oral health education: Study Protocol for Interventional study
AUTHORS: drvipinahuja, dr annapurna ahuja, dr nilima thosar

[DESCRIPTION]


Background: The aim of this study will be assess the knowledge of school teachers about
pediatric oral health and the assessment of the impact of a webinar training
intervention in improving their knowledge. 


Methods:
A total of 156 teachers will participated in the research. A self‑administered,
30‑item questionnaire is designed in the English language and consists of
two sections: the first section included demographic details; the second
section included 30 questions on pediatric oral health with three divided
subsections as follows: Subsection A (7 questions): Questionnaire on general
pediatric oral health, Subsection B (9 questions): Questionnaire on preventive
pediatric oral health, Subsection C (14 questions): Questionnaire on clinical
pediatric oral health. After receiving Google forms, all the participants will
attend an oral health education webinar program using a web-based online
education training protocol on the Zoom platform. After this webinar
training session, post-training assessment of the oral health knowledge will be
done using the same online semi‑structured self‑administered
questionnaire. 


Statistical analysis 


The collected data will be entered into Microsoft Excel 2007 and subjected to
statistical analysis using SPSS version 22.0 (IBM Statistics Inc., Chicago,
Illinois, USA). The statistical test used will be Chi-Square test to assess the
categorical difference in scores before and after oral health education.
P ≤ 0.05 will be considered for statistical significance.




[STEPS]
SECTION: Introduction
1. 



Children’s growth and development is directly linked to their oral health. As they spend a
lot of time in schools, oral education can bring an inevitable change in dental
attitude and behaviour of these children, if taught with other subjects in
schools. There is a paucity of studies reported in the past which prove that
the school teachers had poor knowledge of oral health in varied aspects especially dentistry for children. Pediatric dentistry is an invincible segment of dentistry covering all aspects of dentistry in children from birth to adolescence. Hence, adequate knowledge should be given right from infancy to parents, school teachers and children.1-6
Studies conducted on knowledge, attitude and practices in school teachers in relation to oral health had clearly demonstrated the inaccurate and lack of information to the people of this profession.


 





SECTION: Aims and Objectives of the study
2. 

1.
To assess and evaluate the knowledge and awareness of school teachers in
Hazaribag town of Jharkhand regarding pediatric oral health


2.
To determine if an online webinar series of lectures could ameliorate the
knowledge and awareness level in school teachers


3.
To compare these parameters at pre- and post-webinar levels.



9. 
2.1. 
SECTION: Methodology
3. 

Study design


An interventional study will be conducted among primary, elementary and high school
teachers of private schools in the Hazaribag town of Jharkhand State in East
India to evaluate the knowledge of participants on pediatric oral health. A
total of 156 school teachers will be selected using a random sampling method. 


Inclusion Criteria

1. Primary, Elementary and
High school teachers of private schools in the Hazaribag town of Jharkhand


     
2. School teachers who are ready to receive web based online education training. 


     
3. School teachers who acquire basic computer knowledge


     
4. School teachers who gave their consent for the study 


Exclusion Criteria


     
1. Primary, Elementary and High school teachers of government schools in the Hazaribag town of Jharkhand


     
2. School teachers who were not interested in web based online dental education training. 


All the nominated teachers will take part in the training as an indispensable
segment of a one-week teachers training program to be organized by the
Department of Pediatric and Preventive Dentistry, Hazaribag College of Dental
Sciences and Hospital, Hazaribagh. 


 
Study questionnaire


A self‑administered, 30‑item questionnaire is formulated as Google forms in English
language; the design and inclusiveness of the questionnaire is finalized with
the support of a team of experts from the Department of Pediatric and
Preventive Dentistry, Periodontics and Public Health Dentistry before the
study. The questionnaire includes two sections: the first section is about
demographic details such as gender, marital status, school location; the second
section is about 30 questions on pediatric oral health with three divided
subsections: Subsection A (including 7 questions): Questionnaire on general
pediatric oral health, B (including 9 questions): Questionnaire on preventive
pediatric oral health and C (including 14 questions): Questionnaire on clinical
pediatric oral health will evaluate the knowledge of teachers toward oral
health in children. All the questions were in a digital format, uploaded on
Google Forms. A pilot study will be done prior to our study among primary and
elementary school teachers and the participants will not be counted in the
training program. Any problems and technical hitches, if incur during the
filling of the pilot form will be corrected. Pre and Post training
questionnaire will be compared and statistically analysed.


Study procedure


Four stages of training program: 


Stage 1: Pre-training module of knowledge and awareness assessment: A 30-Item questionnaire
will be send to all the participating school teachers with a title of pre-test
questionnaire. The questionnaire will be in the form of an online self‑administered
questionnaire (English) and will be formatted as google forms.  


Stage 2: Webinar-based oral health education module: This module comprises of oral
health education program to be attended by all participants using a web-based
online education training protocol on the Zoom platform. The training is
specially designed for school teachers and is segregated into four sessions:


Ist session: Introduction to
pediatric dentistry and morphology of tooth- this session
includes lecture of 30 minutes and where school teachers are introduced with
children dentistry and importance of primary teeth with their clinical
applications. The morphological differences between primary and permanent teeth
will be highlighted with reference to dental caries and its prevention.


IInd session: Oral health care and
brushing techniques in children- this session includes
lecture of 45 minutes and where school teachers will be educated in oral care
and hygiene maintenance of children oral cavity. The knowledge will be shared
on plaque and gingiva, gingival problems in growing children and also tooth
brushing techniques in children are taught with special mention to Fones
techniques; after that demonstration of brushing techniques will be given to
comprehend the brushing skills practically. 


IIIrd session: Early Childhood
Caries- this session includes lecture of 45 minutes and
the pandemic incurrence of early childhood caries in children, etiological
factors like bottle feeding, sugary syrups, prevention and treatment aspects
including restorations and pulp therapies will be shared with school teachers. 


IVth session: Clinical myths and
facts of children dentistry - this session includes lecture of
45 minutes and it is a tailored made discussion on clinical myths and facts of
children dentistry in Indian population with special mention to pulp therapy,
dental caries, malocclusion, oral cancer, dental trauma, and dental fluorosis,
home and professional dental practices, prevention of oral diseases. A plethora
of myths and their corresponding facts will be discussed and the section of
training will be concluded. 


Stage 3: A panel discussion followed by a dental quiz: After completing each session,
a panel discussion will be done for 30-45 minutes with the aim of clarifying
individual teacher queries and discussing frequently asked questions regarding
pediatric oral health with panellists comprising of professors from varied departments
of Pediatric and Preventive Dentistry, Periodontics and Implantology, Public
Health Dentistry and Oral Pathology in Hazaribag College of Dental Sciences and
Hospital, Hazaribag. After that, a dental quiz will be organized to assess the
dental knowledge gained through the webinar session.


Stage 4: Post-training module of knowledge and awareness assessment: A 30-Item questionnaire
which will be same as pre-test questionnaire will send to all the participating
school teachers with a title of post-test questionnaire and the scores will be
recorded and compared to Pre-test scores. The feedback will also be recorded
form the participants regarding the program. 


Ethical considerations 


Ethical
approval is obtained from the Institutional Review Board of Hazaribag College
of Dental Sciences and Hospital, Hazaribag, Jharkhand, India (with no.
HCDSH/ADM/BNF/2020/214 and dated 25.01.2020). The written informed consent will
be obtained from all the participants before the start of the study. 


Scoring 


The
data collection, scoring and data analysis will be done by single trained
investigator (Dr Annapurna Ahuja) to avoid inter-examiner variability by
analysing the pre-questionnaire before online education and post-questionnaire
after online education. The scoring will be done as ‘1’ for Option A, ‘2’ for option B, ‘3’ for option C.  The test-retest reliability of the Questionnaire will be estimated by providing the same questionnaire to same participants of pilot study at different times and after a satisfactory correlation coefficient is established, study will be proceed further. 



SECTION: Statistical analysis
4. 

The collected data will be entered into Microsoft Excel 2007 and subjected to statistical analysis using SPSS version 22.0 (IBM Statistics Inc., Chicago, Illinois, USA). The statistical test used will be Chi-Square test to assess the categorical difference in scores before and after oral
health education. P ≤ 0.05 will be considered for statistical significance. 



5.