Use of Mobile Phone Text Messaging Versus Leaflets in Oral Health Education for Mothers of Preschool Children in an Urban Setting in Tanzania

Abstract

Introduction

Introduction: Oral health information forms the foundation of health promotion and disease prevention. Advances in information technology have created opportunities to enhance the delivery of health information beyond traditional educational approaches.

Purpose

This study aimed to examine and compare the effectiveness of providing oral health information through mobile phone text messages and printed leaflets on mothers’ knowledge, oral health practices, and the oral hygiene status of preschool children.

Methods

This cluster-randomized controlled field trial was conducted among mother–child pairs of preschool children in Dar es Salaam, Tanzania. Participants received oral health information on preschool oral care over a two-week period through either printed leaflets or mobile phone short message service (SMS) messages, while the control group received routine care. The primary outcomes were mothers’ oral health knowledge, oral health practices, and children’s oral hygiene status. Data were analysed using SPSS version 25.0. Generalized estimating equations were used to compare the effects of the two interventions.

Results

A total of 132 mother–child pairs were randomized into three groups: control (38.6%, n = 51), leaflet intervention (32.6%, n = 43), and mobile phone SMS intervention (28.8%, n = 38). At baseline, the proportions of mothers with acceptable oral health knowledge and oral health practices, and children with good oral hygiene status, were 22.7%, 30.3%, and 33.3%, respectively. The model assessing children’s oral hygiene status and mothers’ oral health knowledge and practices demonstrated significant intervention-by-time interactions at follow-up for both the leaflet and SMS groups. The SMS intervention showed comparatively higher odds of improvement (OR = 10.7, 95% CI [4.5, 25.4]) than the leaflet intervention (OR = 7.3, 95% CI [3.2, 16.6]) and the control group (p = .001).

Conclusion

Provision of oral health information to mothers improved their oral health knowledge, oral health practices, and their children’s oral hygiene status. Mobile phone SMS messaging demonstrated relatively greater improvements than leaflets and routine care, although the findings should be interpreted with caution. SMS-based oral health education may be a feasible approach for enhancing parental oral health literacy and promoting better oral health outcomes among preschool children.