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Comparison of three forms of teaching - a prospective randomized pilot trial for the enhancement of adherence
C H Reinhardt1, M J Noack, G Wassmer
1Department of Biology Teaching, State Teacher Training Center, Köln, Germany. drcreinhar@aol.com
Objective:
Adherence of young adults to preventive programmes is low. The following study compares three different educational concepts to increase toothbrushing adherence in young adults.
Methods:
Nine vocational school classes (157 young adults) were randomly assigned to three different 60-min approaches: (I) Education by a dentist, (II) Peer-teaching and (III) 'Adherence triangle concept' uniting dentists, teachers and participants as equal partners in intervention planning combined with peer teaching. Follow-up was 1 week for approaches I and II, and 1 week, 3 and 9 months for approach III. Adherence was defined as reported change from the childhood toothbrushing technique to adult technique. Adherence was evaluated using anonymous questionnaires and by diary analysis.
Results:
After instruction, 90% of participants (approaches I-III) showed the desired behaviour in practice and theory. Reported adherence after 1 week with approach I was 28.5%, with approach II 39% and with approach III 95%. Prolonged follow-up of approach III yielded 76% after 3 months and 68% after 9 months. Adherence using approach III was significantly higher (P ≤ 0.001) than using approach I and II after 1 week. Adherence rates with approach III after 9 months were still higher than those of approaches I and II after 1 week.
Conclusions:
The 'adherence triangle' concept enhanced reported adherence significantly in comparison with previous studies and the one-dimensional concepts of approaches I and II. The tools of the adherence triangle concept seem worthwhile to be considered when planning new preventive action.
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