Abstract
ObjectiveExploring the feasibility to understand changes in oral hygiene behaviour using the Health Action Process Approach (HAPA) model applied to qualitative research interviews in patients with diabetes and periodontitis undergoing standard periodontitis treatment.MethodsPatients with type 1/2 diabetes and chronic periodontitis (n = 8) received standard non‐surgical periodontal treatment accompanied with personalized oral hygiene instructions by a dental hygienist. Clinical indices (% bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), % of sites with PD ≥ 5 mm, periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA) were recorded pre‐ and post‐treatment. At 3 months post‐treatment, patients were interviewed using a topic guide relating to oral health. A behaviour change framework was constructed from elements of the HAPA model and used directly to map interview data to evaluate oral hygiene behaviour in these patients.ResultsData from this feasibility study suggest a clinical improvement in periodontal status, albeit only monitored for 3 months. Application of the HAPA model highlighted the behavioural change pathway that diabetes patients undertake before, during and after periodontal treatment. The data suggest that patients move through all elements of the motivation phase and all elements of the volition phase except for the recovery self‐efficacy element.ConclusionThe novel approach of applying the HAPA model to qualitative research data allowed for the collection of richer data compared to quantitative analysis only. Findings suggest that, in general, patients with periodontitis and diabetes successfully manage to incorporate new oral hygiene behaviours into their daily routine.
Highlights
Periodontitis is a chronic inflammatory disease affecting the tooth‐supporting structures, which requires lifelong management involving self‐care by the affected individuals, and professionally delivered care from dental professionals.[1]
The Health Action Process Approach (HAPA) model[21] is one of the latest behavioural change theories applied to oral hygiene behaviour.[18,20,22]
It is well recognized that adherence to behaviours that optimize oral hygiene are an essential for achieving successful outcomes for peri‐ odontal disease treatment.[2,3]
Summary
Periodontitis is a chronic inflammatory disease affecting the tooth‐supporting structures, which requires lifelong management involving self‐care by the affected individuals, and professionally delivered care from dental professionals.[1]. Psychological constructs such as locus of control, self‐efficacy, action‐planning or intention are correlated with tooth brushing, plaque index, flossing or ques‐ tionnaire data in complex pathway analysis regression models.[18,19,20] the Health Action Process Approach (HAPA) model[21] is one of the latest behavioural change theories applied to oral hygiene behaviour.[18,20,22]. The aim of this study was to investigate whether it is feasible to understand a behavioural change in oral hygiene using the HAPA model through qualitative interview analysis in patients with diabetes and periodontal disease who have received standard care only and not a specialized psychological intervention
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