Improving Oral Health Knowledge and Habits in People With Diabetes Through a Theory Guided WhatsApp Education Program

NCT ID: NCT07323771

Last Updated: 2026-01-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

98 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-15

Study Completion Date

2025-11-30

Brief Summary

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The goal of this Educational interventional study is to test the usefulness of an educational program delivered through WhatsApp videos in increasing oral health knowledge and habits in people with Diabetes between the age of 18 and 65 years. The main question it aims to answer is:

Does a WhatsApp-based educational Program improve oral health knowledge and behaviors in people with diabetes, and is it more effective than education delivered through brochures? Participants in one group will receive educational videos through WhatsApp, while the other group receive a brochure containing oral health information. Researchers will then compare the groups to see if the intervention made a difference.

Participants will:

* Fill a baseline questionnaire to assess their current knowledge and behaviors.
* They then either participate in a one-month educational program delivered through WhatsApp, or receive an educational brochure.
* Wait for 1 month after the program to allow for application of knowledge.
* Fill a post intervention questionnaire to assess changes in knowledge and behavior.

Detailed Description

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The purpose of this study is to determine whether an educational intervention based on the Health Belief Model (HBM) and delivered through WhatsApp may improve diabetes patients' oral health behaviors and knowledge. This study is a randomized controlled trial (RCT) with two groups: an intervention group (WhatsApp-based education) and a control group (brochure-based education). Adults (18-65 years) with Type 2 Diabetes Mellitus from a diabetes clinic in Karachi were recruited. 98 participants (49 in each group) were selected through random allocation. The randomization process ensured that participants are evenly distributed between the groups based on key factors, specifically gender, educational level and duration of diabetes to reduce potential bias from these characteristics. This study was a single blinded study in which participants were not informed about the existence of two distinct groups. The WhatsApp based intervention consisted of 12 short educational videos, each approximately 3 to 5 minutes in duration, these videos were sent individually to each participant every alternate day from Monday to Friday, resulting in three videos per week over a period of one month, Reminders were sent the following day after each video to encourage engagement and sustain behavior change. Each week was focused on specific HBM constructs delivered through short, professionally scripted educational videos in Urdu. Each week was focused on specific HBM constructs. The control group received only an educational brochure.

A structured questionnaire was used to evaluate participants' knowledge and oral hygiene practices at two points: baseline (before intervention) and one-month post-intervention. The questionnaire was designed to measure HBM constructs (e.g. perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy), awareness of oral care and oral hygiene related behaviors. Data were analyzed using SPSS Version 27.

Conditions

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Oral Health Knowledge Oral Health Behavior Change Diabetes Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants were randomly assigned to either the intervention group or the control group, following a 1:1 allocation ratio. The randomization process was stratified based on three key characteristics including gender, educational level, and duration of diabetes, to ensure balanced distribution and to minimize potential bias.

Randomization was conducted using random number generator where each participant was assigned a random number, then participants were allocated equally into either Intervention Group which received HBM based education via WhatsApp or control Group which received an educational brochure.
Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants
This study was single blinded in which participants were not informed about the presence of two distinct groups; they were only aware about receiving education related to oral health.

Study Groups

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Educational Brochure Group

Participants in this group receive oral health education through an educational brochure

Group Type OTHER

Educational Brochure Group

Intervention Type BEHAVIORAL

The Educational brochure provides information on the relationship between Type 2 Diabetes Mellitus and oral health and recommended oral hygiene practices. No WhatsApp based videos are provided during the study period

Health Belief Model Based WhatsApp Oral Health Education Program

Participants receive a Health Belief Model (HBM) based oral health education program through WhatsApp videos for four weeks.

Group Type OTHER

Health Belief Model (HBM) Based WhatsApp Oral Health Education Program

Intervention Type BEHAVIORAL

The program includes short educational videos, weekly thematic content, reminders, and behavior-reinforcement messages aimed at enhancing oral health knowledge, HBM constructs, and oral hygiene behaviors among individuals with Type 2 Diabetes Mellitus.

Interventions

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Health Belief Model (HBM) Based WhatsApp Oral Health Education Program

The program includes short educational videos, weekly thematic content, reminders, and behavior-reinforcement messages aimed at enhancing oral health knowledge, HBM constructs, and oral hygiene behaviors among individuals with Type 2 Diabetes Mellitus.

Intervention Type BEHAVIORAL

Educational Brochure Group

The Educational brochure provides information on the relationship between Type 2 Diabetes Mellitus and oral health and recommended oral hygiene practices. No WhatsApp based videos are provided during the study period

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18-65 years with a confirmed diagnosis of T2DM
* Able to use WhatsApp for the study duration
* Able to read and write in Urdu

Exclusion Criteria

* Edentulous
* Individuals diagnosed with life-threatening diseases such as advanced cancer, end-stage renal disease, or severe cardiac failure
* Diminished cognitive ability
* Radiotherapy in head and neck region.
* Planning to migrate during the study period.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dow University of Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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ILMA KIRAN

MPH Trainee and Lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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ILMA KIRAN, BDS, MPH

Role: PRINCIPAL_INVESTIGATOR

Dow University of Health Sciences

Locations

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National Institute of Diabetes & Endocrinology

Karachi, Sindh, Pakistan

Site Status

Countries

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Pakistan

References

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Jacome-Hortua AM, Rincon-Rueda ZR, Sanchez-Ramirez DC, Angarita-Fonseca A. Effects of a WhatsApp-Assisted Health Educational Intervention for Cardiac Rehabilitation: A Randomized Controlled Clinical Trial Protocol. Methods Protoc. 2024 Apr 19;7(2):35. doi: 10.3390/mps7020035.

Reference Type BACKGROUND
PMID: 38668142 (View on PubMed)

Gao X, Wong ML, Kalhan AC, Xie JJ, Siti Hajar H, Yeo ABK, Allen PF. Theory-derived intervention to improve oral health of older adults: study protocol for a randomised controlled trial. BMJ Open. 2022 Dec 12;12(12):e064791. doi: 10.1136/bmjopen-2022-064791.

Reference Type BACKGROUND
PMID: 36523250 (View on PubMed)

Jeihooni AK, Jamshidi H, Kashfi SM, Avand A, Khiyali Z. The Effect of Health Education Program Based on Health Belief Model on Oral Health Behaviors in Pregnant Women of Fasa City, Fars Province, South of Iran. J Int Soc Prev Community Dent. 2017 Nov-Dec;7(6):336-343. doi: 10.4103/jispcd.JISPCD_339_17. Epub 2017 Dec 29.

Reference Type RESULT
PMID: 29387617 (View on PubMed)

Omar MA, Hasan S, Palaian S, Mahameed S. The impact of a self-management educational program coordinated through WhatsApp on diabetes control. Pharm Pract (Granada). 2020 Apr-Jun;18(2):1841. doi: 10.18549/PharmPract.2020.2.1841. Epub 2020 May 3.

Reference Type RESULT
PMID: 32477434 (View on PubMed)

Haghdoost A, Bakhshandeh S, Tohidi S, Ghorbani Z, Namdari M. Improvement of oral health knowledge and behavior of diabetic patients: an interventional study using the social media. BMC Oral Health. 2023 Jun 3;23(1):359. doi: 10.1186/s12903-023-03007-w.

Reference Type RESULT
PMID: 37270487 (View on PubMed)

Malekmahmoodi M, Shamsi M, Roozbahani N, Moradzadeh R. A randomized controlled trial of an educational intervention to promote oral and dental health of patients with type 2 diabetes mellitus. BMC Public Health. 2020 Mar 4;20(1):287. doi: 10.1186/s12889-020-8395-4.

Reference Type RESULT
PMID: 32131790 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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https://diabetes.org/health-wellness/keeping-your-mouth-healthy

Provides general information on the relationship between diabetes and oral health and guidance on maintaining good oral hygiene habits to prevent gum disease and oral complications.

https://idf.org/about-diabetes/diabetes-complications/diabetes-and-oral-health/

Provides concise information on how diabetes increases the risk of oral diseases such as gum infection and tooth decay, and emphasizes the importance of good oral hygiene and regular dental care as part of diabetes management.

Other Identifiers

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IRB4057/DUHS/Approval/2025/294

Identifier Type: -

Identifier Source: org_study_id

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