Gamification to improve oral health knowledge, attitudes and behaviours among older adults : a community-based intervention study

Abstract

Background: Hong Kong is a major aging society, and older people have the worst oral health in the Hong Kong community. Health promotion is key to improving their oral health, but to date has had limited success. Gamification is a novel oral health promotion approach with promising evidence of effectiveness in general health promotion. Objectives: Our community health project aimed to determine the effectiveness of gamification oral health promotion compared to conventional oral health promotion in terms of oral health knowledge, attitude and behaviour among older community dwelling individuals in Hong Kong. Methods: A case control community based oral health promotion (OHP) intervention was conducted at six elderly centres across Hong Kong. The case (test) centres received a gamification OHP intervention and the control centres received a conventional OHP intervention. Intra- and inter-group oral health knowledge, attitude and behaviour were determined. Intra-group differences were assessed using paired t-test. Inter-group differences were assessed using independent t-test. Effect size was also calculated and compared. Results: The response rate was 81.3% (91/112) and the response rate was similar between test and control centres (P > 0.05). There were significant intra-group differences in oral health knowledge score for both test and control groups (both P<0.05). There were no significant inter-group differences in oral health knowledge (P>0.05), however, effect size change was larger in the test group than the control group (ES 0.7 vs 0.5). There were no significant intra- and inter-group differences in oral health attitude score (P>0.05). There were no significant intra- and inter-group differences in oral health behaviour score (P>0.05). Conclusions: Both conventional oral health promotion and gamification promotion were effective in terms of changing oral health knowledge. The effect size changes were somewhat larger for gamification approach compared to conventional oral health promotion approach, suggesting that this is preferable. Further testing of gamification oral health promotion initiative is warranted, and in particular to explore its effectiveness in changing oral health attitudes and behaviours.