Effect of mHealth Intervention on Oral Health-Related Quality of Life Among Adult Patients With Chronic Systemic Diseases

King Faisal University206 enrolled

Overview

This study evaluated whether an mHealth oral health education intervention could improve oral health-related quality of life among adults with chronic systemic diseases registered in specialized disease centers in Al-Ahsa, Saudi Arabia. Adults with type 1 diabetes mellitus, cardiovascular disease, chronic kidney disease, or hereditary blood disorders were included. Participants were assigned to either an intervention group or a control group. Both groups continued to receive routine care. The control group received a standardized printed oral health education leaflet, while the intervention group received an mHealth oral health education program consisting of five educational videos covering toothbrush and fluoride toothpaste selection, toothbrushing technique, dental flossing, tongue cleaning, and water flosser use. The educational materials were delivered electronically through a secure web-based platform, with links sent through WhatsApp at regular intervals during the 3-month intervention period. Oral health-related quality of life was assessed using the validated Arabic version of the 14-item Oral Health Impact Profile (OHIP-14) at baseline, 1 month, and 3 months. The main hypothesis was that participants receiving the mHealth intervention would show greater improvement in oral health-related quality of life over the 3-month study period compared with participants receiving the control condition.

This pragmatic quasi-experimental study was conducted among adult patients registered in four specialized disease centers in Al-Ahsa, Saudi Arabia: the Endocrinology and Diabetes Center, Prince Sultan Center for Cardiac Diseases and Surgery, Al-Jaber Kidney Center, and Hereditary Blood Diseases Center. The study population included adults with type 1 diabetes mellitus, cardiovascular disease, chronic kidney disease, or hereditary blood disorders. Eligible participants provided electronic informed consent before participation. Following baseline assessment, participants were assigned to parallel intervention and control groups. The intervention lasted 3 months, with assessments conducted at baseline (T0), 1 month (T1), and 3 months (T2). Participants in both groups continued their routine health care. The control group received a standardized printed oral health education leaflet containing recommendations for daily home oral care. In addition to routine care, the intervention group received five Arabic educational videos addressing toothbrush and fluoride toothpaste selection, toothbrushing technique, dental flossing, tongue cleaning, and water flosser use. The intervention was delivered through a secure web-based platform, and access links were sent through WhatsApp. The educational package was re-sent every 2 weeks during the intervention period to reinforce exposure to the educational content. Oral health-related quality of life was measured using the validated Arabic version of the 14-item Oral Health Impact Profile (OHIP-14). Assessments were completed at baseline, 1 month, and 3 months. The principal comparison focused on differences between the intervention and control groups in change in total OHIP-14 score from baseline to the 3-month assessment. Additional analyses examined OHIP-14 over the study period and its relationship with selected participant characteristics.

Interventions

mHealth Oral Health Education InterventionBEHAVIORAL

A 3-month Arabic mHealth oral health education intervention consisting of five educational videos covering toothbrush and fluoride toothpaste selection, toothbrushing technique, dental flossing, tongue cleaning, and water flosser use. The videos were delivered through a secure web-based platform, with access links sent via WhatsApp. The complete educational package was provided at baseline and re-sent every 2 weeks through week 10. Participants continued to receive their usual care throughout the study.

Printed Oral Health Education LeafletBEHAVIORAL

A standardized printed oral health education leaflet providing recommendations for daily home oral care, provided as part of routine care.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 years or older. * Registered at one of the participating specialized disease centers in Al-Ahsa, Saudi Arabia. * Physician-confirmed diagnosis of type 1 diabetes mellitus, cardiovascular disease, chronic kidney disease, or a hereditary blood disorder. * Medically stable at the time of enrollment. * Has access to a smartphone and the internet. * Able to understand Arabic. * Provides electronic informed consent. * Willing and able to participate for the 3-month study period. Exclusion Criteria: * Unable to use a smartphone or access the digital intervention. * Cognitive or psychiatric impairment that could interfere with participation or completion of study assessments. * Severe disability that prevents participation in the study procedures. * Completely edentulous. * Pregnant at the time of enrollment. * Currently enrolled in another oral health intervention study. * Planning to relocate during the 3-month study period. * Medically unstable or considered unsuitable for participation based on clinical assessment.

Outcomes

Primary Outcomes

Change in Total Oral Health Impact Profile-14 (OHIP-14) Score From Baseline to 3 Months

Oral health-related quality of life was assessed using the validated Arabic version of the 14-item Oral Health Impact Profile (OHIP-14). Each item is scored from 0 to 4, yielding a total score ranging from 0 to 56. Higher scores indicate poorer oral health-related quality of life. The outcome is the change in total OHIP-14 score from baseline to 3 months, compared between the intervention and control groups.

Time frame: Baseline and 3 months

Secondary Outcomes

Change in Total Oral Health Impact Profile-14 (OHIP-14) Score From Baseline to 1 Month

Oral health-related quality of life was assessed using the validated Arabic version of the 14-item Oral Health Impact Profile (OHIP-14). Each item is scored from 0 to 4, yielding a total score ranging from 0 to 56. Higher scores indicate poorer oral health-related quality of life. This outcome assesses the change in total OHIP-14 score from baseline to 1 month and compares the change between the intervention and control groups.

Time frame: Baseline and 1 month

Total Oral Health Impact Profile-14 (OHIP-14) Score Trajectory Across the Study Period

Oral health-related quality of life was assessed using the validated Arabic version of the 14-item Oral Health Impact Profile (OHIP-14) at baseline, 1 month, and 3 months. Total scores range from 0 to 56, with higher scores indicating poorer oral health-related quality of life. This outcome evaluates changes in total OHIP-14 score across the three assessment time points.

Time frame: Baseline, 1 month, and 3 months

Seven Domain Scores of the Oral Health Impact Profile-14 (OHIP-14)

The seven domains of the Arabic OHIP-14 were assessed separately: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. Each domain consists of two items scored from 0 to 4, yielding a domain score ranging from 0 to 8. Higher domain scores indicate a greater negative impact on oral health-related quality of life. Domain scores were assessed separately at baseline, 1 month, and 3 months to evaluate changes over the study period.