THE IMPACT OF ORAL HEALTH RELATED ADVERTISEMENTS ON THE ORAL HEALTH BEHAVIOUR AMONG CHILDREN IN TWO PRIMARY SCHOOLS IN NAIROBI.

Transcription

1 - \ THE IMPACT OF ORAL HEALTH RELATED ADVERTISEMENTS ON THE ORAL HEALTH BEHAVIOUR AMONG CHILDREN IN TWO PRIMARY SCHOOLS IN NAIROBI. DOUGLAS D. ORAMIS. V28/2039/07 BDS III ItENYATTA NATIONAL APPRO'lED 7 SEP 2010 HOSPITAL I FHllS &. RESEARCH COMMITTEB '" A Community Dentistry research proposal submitted in partial fulfillment of the requirements for the degree of Bachelor of Dental Surgery (BDS) of the University of Nairobi. 2010

2 SUBMISSION FOR ETHICS APPROVAL I, Douglas D. Oramis wish to submit this proposal to the Kenyatta National Hospital/University Of Nairobi Research Ethics and Standards Committee for approval. ii

3 SUPERVISORS APPROVAL This proposal has been submitted for Research Standards and Ethics review with our approval as University Supervisors. DR. F G MACIGO 8DS (Nbi), MPH (Nbi), PGD-STI(Nbi) Senior Lecturer-Dept. of Periodontology, Community and Preventive dentistry School of Dental Sciences University of Nairobi. ~~. Signature: Date: O:L/o1/ :l.-o /0 DR. A M KEMOLI 8DS (Nbi), MSc (Amsterdam) of England) DGDP, diploma (Royal College of Surgeons Lecturer-Dept. of Paediatric Dentistry and Orthodontics School of Dental Sciences, Date: 10 iii

4 CONTENTS Submission for ethical approval ii Supervisors approval iii Table of contents iv List of abbreviated words vi Definition of terms vii ABSTRACT 1 CHAPTER 1 INTRODUCTION PROBLEM STATEMENT JUSTIFICATION OF STUDy OBJECTIVES Specific Objectives 9 General Objectives HyPOTHESiS 9 CHAPTER 2 LITERATURE REViEW CHAPTER 3 MATERIALS AND METHODS 3.1 Study area Study population Study design Sample size Sampling method 17 iv

5 3.6 Data collection Data analysis Logistics Ethical issues Benefits of the study 21 REFERENCES 22 SCHEDULE OF ACTIVITIES 26 BUDGET 27 APPENDICES: Appendix 1 28 Appendix 2 35 v

6 LIST OF ABBREVIATED TERMS ADA: American Dental Association BOA: British Dental Association BOS: Bachelor of Dental Surgery CBO: Central Business District KNH: Kenyatta National Hospital SPSS: Statistical Package for Social Sciences TV: Television UON: University Of Nairobi WHO: World Health Organization vi

7 DEFINITION OF TERMS Advertisement:-is a communication intended to persuade an audience (viewers, readers or listeners) to purchase or take some action upon certain products, ideals, or services. Impact:-The effect that something has on somebody or something.used interchangeably with "influence" Mass media:-refers to all forms of media that are open to and accessible by the public. This includes newspapers, television, internet, magazines, radio etc Oral health behaviour:-aii activities that an individual engages and which are conducive for the prevention or limitation of oro-dental diseases and the preservation oral health. of Oral health promotion:-the creation of awareness through dissemination of knowledge on how to achieve good oral health including a healthy diet oral hygiene skills and regular dental examinations with the aim of prevention of diseases. Sugar free gum:-a type of chewing gum that does not contain carbohydrates sucrose or glucose in the ingredients but substitutes in place of sugar,mostly fructose,sorbitol and xylitol. in form of vii

8 ABSTRACT Background: The exploration of both the beneficial and harmful effects of advertisements on the oral health behaviour of children is essential to identify how the advertising industry can be used to propagate oral health promotion strategies. It is through this assessment that we can enhance oral health promotion programs that are participatory and holistic. This is to positively influence the knowledge, attitude and behaviour of children towards sustainable good oral health,enabling them to take control over the determinants of oral health behaviour. Objective: To determine the impact of oral health related advertisements behaviour among primary school children. on the oral health Design: Descriptive, Cross Sectional study using school based study groups. Setting: Parkroad Primary School,in, Ngara location, Central Division and Nairobi Primary School in Westlands Division.Both being urban based learning institutions in Nairobi District Study population: All pupils studying at Parkroad Primary School and Nairobi Primary School. Methods: The sampling process will be done through stratified random sampling method. The data collection will be through a self administered questionnaire. Data obtained will be 1

9 analyzed via using the SPSS Version 17.0 Software and the results will be presented in form of tables, graphs,pie charts and text as appropriate. Study benefits: Provision of information that will be useful in determining the possible modes of promoting oral health through the mass media, initiation of school based oral health promotion strategies and also information on further research in the field on means of planning oral health promotion programs. 2

10 INTRODUCTION CHAPTER 1 Generally advertisements are a form of mass communication designed to promote the sale of a product or service or the propagation long term or short term. Types of advertisements of an idea. The objectives of this can be Advertisements can be divided into two broad categories-consumer advertisements and trade advertisements. Consumer advertisements are directed at the public. Trade advertisements are directed at wholesalers or distributors who resell to the public. Advertisements to the public-which are a sub-category of consumer advertisementsmay take the form of institutional advertisements, image advertisements, informational advertisements, or cooperative advertisements. [1] Institutional advertisements seek to create a favorable impression of a business or institution without trying to sell a specific product. This type of advertising is designed solely to build prestige and public respect. Many advertisers prefer a strategy known as image advertising. These advertisers seek to give a product a personality that is unique, appealing, and appropriate so that the consumer will want to choose it over similar products that might fulfill the same need. The personality is created partly by the product's design and packaging but, more importantly, by the words and pictures the advertisements associate with the product. This personality is known as a brand image. Advertisers believe brand image often leads consumers to select one brand over another or instead of a less expensive generic product. This is done through repetitive display of the product coupled with enticing claims about it.[1]infomercials -a portmanteau of the words "information" and "commercials" -is an example of such. These are long format television commercials which are typically 5 minutes or longer whose main objective is to create impulse purchase among the public. They are usually characterized by description, display and demonstration of the products coupled with 3

11 testimonials from consumers and industry professionals. [2) Informational advertisements seek to promote an idea or influence a behaviour. Sometimes known as public service advertising, it may try to discourage young people from using illicit drugs or tobacco, or it may encourage people to adopt safer, healthier hfestyles.!" Oral health related advertisements in this case are those that have content which promote oral health care products, oral hygiene practices, oral health education and also those promoting oral health care products which are known to be risk factors for certain diseases. Depending on the manner of in which they are presented, they can fall into institutional, image or informational advertisements. Oral health related advertisements and oral health behaviour Advertisements act as a social instrument of influencing memory for products and subsequent stimulation of consumer behaviour. [3) Oral health related advertisements can be presented in various forms- auditory, visual and audiovisual forms-all of which have the potential to influence the recipient either positively or negatively. Audiovisual combine audio and video or combine or sound and vision in their presentation. The media through which advertisements can be channeled are television, cinema or videos, newspapers and magazines, posters, banners and billboards, public shows and exhibitions and the World Wide Web. According to Hedman et al "good oral health behaviour is necessary from a young age to ensure positive long term dental health". [4] Therefore it is necessary to nurture it from a tender age so that it becomes natural in later years. The oral health behaviours interest to this study are oral hygiene habits, dietary habits and utilization of dental services. Oral hygiene habits will be limited to toothbrushing, use of mouthwashes will involve the consumption cakes, biscuits and cakes) of dental attendance of flossing, tongue cleaning, or dental rinses and use of sugar-free chewing gum. Dietary habits behaviour of cariogenic diet in form of sugary food (sweets, and soft drinks. In utilization of dental services the frequency shall be examined in terms of number of visits in a year. Advertisements influence these behaviours either directly or indirectly, positively or 4

12 negatively. Directly through capturing the attention of the child and leading to a change in behaviour in tandem with the message passed. Indirectly through capturing the attention of the parent or guardian who then imparts the change upon the child. Advertisements can positively influence the oral health behaviours of children through; Encouraging children to purchase oral health related products such as fluoridated toothpastes, mouthwashes, toothbrushes, dental floss, etc Encouraging children to visit oral health care facilities regularly and participate in organized free Dental Camps available. Informing children on the dangers of consuming cariogenic diet such as sweets, biscuits, cakes, chocolate, soft drinks like sodas Informing children on oral health diseases and conditions like dental caries, gum diseases, malocclusion. Informing children on the importance oral hygiene practices such as tooth brushing, flossing, tongue cleaning. Discouraging children from partaking in activities detrimental to their oral health such as digit sucking, tongue thrusting,teeth grinding etc However, other advertisements through; can negatively influence the children, for example Promoting the consumption of cariogenic diet such as confectionaries like cakes, pastries, biscuits, chocolates and soft drinks like sodas. Promoting underage drinking and smoking both of which have adverse effects on the oral health. So far no studies have been carried out in Kenya regarding the impact of advertisements on the oral health behaviour of either children or adults. The results of this study will be used to examine the beneficial and harmful effects of oral health related advertisements on children's oral health behaviour and to identify how the 5

13 stakeholders in oral health can come up with programs that are advertisement oriented to enhance oral health promotion and education. Although knowledge alone is insufficient to prevent oral diseases it is usually necessary for individuals to make decisions upon which to act. It is the basis upon which oral behaviour is practiced. In order to do so, there must be an evaluation of the available resources. Public advertising is a powerful tool to do so via the mass media. The objectives of oral health promotion are to [51:_ o To improve oral health o To reduce or eliminate oral health inequalities o To increase access to oral health care o Emphasizing oral health promotion and disease prevention. 6

14 1.1 PROBLEM STATEMENT Studies have found out that advertisements do provide information on oral health[8,9]to a significant population and are integral in the formulation of oral health promotion strategies[36]. Studies have been done on advertisements in relation to various issues such as memory and recognition of advertised products[3], sources of information on oral health[8], eating behaviou,. 32].However, there have been no studies done to assess oral health related advertisements impact on oral health behaviour. This study will aim to achieve this by specifically examining the potential impact of oral health related advertisement on selected oral health behaviours. There have been no studies carried out in Kenya to assess this effect. The recent statistics from the Kenya Facts and Figures[40]there are 974 registered dentists in the country. Only a paltry of these are pedodontists. There are 5712 health institutions. Of which not all offer basic oral health care. Taking into account the total country population estimated at 38.3 million, it becomes evident that resources for curative aspects of oral health diseases are strained. Therefore the preventive aspects need to be taken into account to fill this void resulting from lack of population exposure to oral health care. Assessment of the impact of oral health related advertisements on this target population will provide crucial information that is relevant to the decision making process among oral health care providers to take the necessary steps in positively influencing oral health behaviour and initiation of oral health promotion strategies in Kenya that rely on advertisements and the mass media in general as channels of communication. 7

15 1.2 JUSTIFICATION OF STUDY The purpose of this study is to collect data on the impact of oral health related advertisements on the oral health behaviour of children in a primary school in Nairobi. There have been no studies carried out in Kenya to assess this impact. The results of this study will be used to examine the beneficial and harmful effects of Oral health related advertisements on pupils. This will provide information on possible modes of promoting oral health through the mass media and also information on further research in the field and on means of planning oral health promotion programs such as those that are school based to strengthen the WHO policies that seeks the promotion of oral health in schools, aimed at developing healthy lifestyles and self-care practices in children and young people. 8

16 1.3 OBJECTIVES General Objectives: To determine the impact of oral health related advertisements behaviour among children in two primary schools in Nairobi. on the oral health Specific Objectives: 1.To determine whether advertisements are a source of information on oral health behaviour. 2.To determine the form of oral health related advertisement impact on oral health behaviour. with the greatest 3.To determine the type of oral health behaviour most influenced related advertisements. by oral health 1.4.HYPOTHESIS Audio-visual advertisements primary school children. have the greatest impact on the oral health behaviour of 9