Friendship Network and Dental Brushing Behavior among Middle School Students: An Agent Based Modeling Approach

By using a standard questionnaire, the level of dental brushing frequency was assessed among 201 adolescent female middle school students in Tehran. The initial assessment was repeated after 5 months, in order to observe the dynamics in dental health behavior level. Logistic Regression model was used to evaluate the correlation among individuals' dental health behavior in their social network. A significant correlation on dental brushing habits was detected among groups of friends. This correlation was further spread over the network within the 5 months period. Moreover, it was identified that the average brushing level was improved within the 5 months period. Given that there was a significant correlation between social network's nodes' in-degree value, and brushing level, it was suggested that the observed improvement was partially due to more popularity of individuals with better tooth brushing habit. Agent Based Modeling (ABM) was used to demonstrate the dynamics of dental brushing frequency within a sample of friendship network. Two models with static and dynamic assumptions for the network structure were proposed. The model with dynamic network structure successfully described the dynamics of dental health behavior. Based on this model, on average, every 43 weeks a student changes her brushing habit due to learning from her friends. Finally, three training scenarios were tested by these models in order to evaluate their effectiveness. When training more popular students, considerable improvement in total students' brushing frequency was demonstrated by simulation results.