Effectiveness of edutainment use in video-based learning on oral health education for school-age children: a randomized clinical trial

Abstract

Background: Entertainment platforms have become more popular among children since the COVID-19 outbreak. The entertainment designed for education; “edutainment” could be a promising learning tool on oral health education (OHE). This study aimed to evaluate the effectiveness of edutainment use for OHE in school-age children. Methods: A total of 210 students (age range 9.2–10.8 years) were included. The three-arm parallel randomized controlled trial was conducted in three schools, receiving the same contents of OHE with different learning methods; classroom learning (CL), edutainment in video-based learning with and without repetition at a three-month follow-up (EVBL and EVBL-R). The knowledge, behavior, behavioral intention score, and oral health (OH) status; visble plaue (VPI) and gingival index (GI) were evaluated at baseline, immediate post-intervention, 3, and 6 months. Differences within and between groups for knowledge scores and OH status were analyzed by repeated measures and one-way ANOVA, respectively, and for both behavior and behavioral intention scores, Friedman’s two-way analysis of variance and Kruskal-Wallis test were analyzed, respectively, at a significant level of 0.05. Results: The knowledge score was significantly higher in CL for two out of three content domains (p = 0.01, p < 0.001) yet immediately improved within all groups (p < 0.001) with the range of 26.58–53.35% vs. 4.12–29.77% of both EVBLs. No significant difference was found in the behavior and behavioral intention scores among groups. EVBL and EVBL-R had significantly improved behavior scores throughout their follow-ups (p = 0.017, p = 0.006) with the range of 1.19–28.13% vs. 1.90-15.16% of CL and had a significant improvement for VPI (p < 0.001) or 32.5-57.08% vs. 36.45–38.79% of CL. There was no significant difference in GI, but it significantly improved only within the EVBL-R group after the repetition. Conclusion: EVBL was comparable to the CL in encouraging positive behaviors, while the CL was preferable for providing core knowledge. EVBL was more applicable to how-to content, and the repetition at least every three months might be able to promote a better OH status. Trial registration: The trial was registered in the Thai Clinical Trials Registry under the number TCTR20240816001 on 16/08/2024 (retrospective registration).