|Year : 2021 | Volume
| Issue : 5 | Page : 167-170
Effectiveness of a structured instructional module regarding the prevention of oral cancer among adolescents in urban colleges
Vimal Vibhakar1, Ankur Jethlia2, Nidhi Thakur3, Milind Wasnik4, Ram Prasad Sah5, Subhash Bandgar6
1 Depatment of General Surgery, Naval Hospital Navjivani, Kannur, Kerala, India
2 Depatment of Maxillofacial Surgery and Diagnostic Sciences Diagnostic Division, College of Dentistry, Jazan University, Saudi Arabia
3 Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India
4 Department of Public Health Dentistry, Government Dental College and Hospital, Raipur, Chhattisgarh, India
5 Department of Dentistry, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India
6 Department of Prosthodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
|Date of Submission||02-Oct-2020|
|Date of Decision||03-Oct-2020|
|Date of Acceptance||05-Oct-2020|
|Date of Web Publication||05-Jun-2021|
Ram Prasad Sah
Department of Dentistry, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Oral cancer is a preventable disease that can be controlled by tobacco cessation and health education. For development of a healthy nation, a healthy society is desirable that is dependent on physically and mentally strong adolescents and adults. Objectives: The present study was conducted to assess the effectiveness and utilization of a structured instructional module on knowledge, attitude, and practice regarding the prevention of oral cancer among adolescents. Materials and Methods: The study was conducted on 500 preuniversity urban college students, divided into two groups: experimental and control groups (n = 250 each). A structured instructional module was developed and knowledge, attitude, and practice of students were analyzed. Pre and post values for all parameters were taken and subjected to statistical analysis using SPSS software version 20.0. Results: The data were collected and compared for sociodemographic variables and knowledge, attitude, and practice of students for prevention of oral cancers. A statistically significant correlation was observed between all the parameters for both the groups. In the experimental group, a significant correlation (P ≤ 0.05) was observed between pre- and posttest values for knowledge, attitude, and practices for prevention of oral cancers. Conclusion: It has been observed that there are several implications of the structured instructional module in the field of education, practice, administration, and research.
Keywords: Attitude, knowledge, oral cancer; practice, structured instructional module
|How to cite this article:|
Vibhakar V, Jethlia A, Thakur N, Wasnik M, Sah RP, Bandgar S. Effectiveness of a structured instructional module regarding the prevention of oral cancer among adolescents in urban colleges. J Pharm Bioall Sci 2021;13, Suppl S1:167-70
|How to cite this URL:|
Vibhakar V, Jethlia A, Thakur N, Wasnik M, Sah RP, Bandgar S. Effectiveness of a structured instructional module regarding the prevention of oral cancer among adolescents in urban colleges. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Dec 1];13, Suppl S1:167-70. Available from: https://www.jpbsonline.org/text.asp?2021/13/5/167/317595
| Introduction|| |
Around 21% of the world population consists of adolescents (aged 10–19 years) and young adults (20–24 years). During the psychological development of adolescents and young adults, various kinds of behavioral patterns are established. UNICEF database (2019) revealed that around 1.2 billion people under 20 years of age are at a high risk of developing habits like smoking and tobacco chewing that can lead to various problems like oral cancers in their early and late years of life. Thus, it is necessary to educate them regarding the risk of harmful habits and their consequences like the development of oral cancers.
Cancer is a noncommunicable, second most common global disease that can affect any individual, irrespective of his gender, race, culture, or socioeconomic status. It is considered to be one of the most fearful diseases, with a high incidence of pain, disfigurement, and death of the patient. It can involve any cell, or tissue of the human body, and occurs with wide morphological and clinical variations throughout the world. The common sites of occurrence of oral carcinomas are labial or buccal mucosa, alveolar bone, tongue, gingivolabial sulcus, etc. Around 90% of oral cancers are of squamous cell origin.
According to the data obtained by International Agency for Research on Cancer in 2007, India is at high risk for oral cancer due to the high prevalence of tobacco chewing, bidi smoking, and alcohol consumption. The primary cause was found to be tobacco chewing in 90% of cases. It accounts for one-third of all cancers and 50% of cancers affecting males.
The present study was conducted to assess the effectiveness and utilization of structured instructional module on knowledge, attitude, and practice regarding prevention and control of morbidity and mortality rate of oral cancer among adolescents. The study also aimed at using the module to teach the staff nurses and peripheral health workers, which in turn can educate general public regarding causes and prevention of oral cancer by community personnel.
| Materials and Methods|| |
The study design adopted was quasi-experimental design. The study was conducted on 500 preuniversity urban college students using a stratified random sampling technique. The study subjects were divided into two groups: experimental and control groups (n = 250 each) after obtaining informed consent. Both male and female English medium students aged 15–19 years (adolescents), who were available and willing to participate in the study, were included in the study.
A self-administered structured questionnaire was used to evaluate the effectiveness of structured instructional module on prevention of oral cancer among adolescents. The structured knowledge questionnaire (30 items), 5-point Likert's Attitude Scale (14 items with 7 positive and 7 negative statements), and self-reported practice checklist (15 items) were developed based on prevention of cancer.
For knowledge assessment, each correct answer carries 1 mark, with a total of 30 marks. The scores were distributed as follows: inadequate knowledge: ≤50, moderately adequate knowledge: 51%–75%, and adequate knowledge: >75%. Similarly, attitude items were scored as unfavorable: ≤50%, moderate favorable: 51%–75%, and favorable attitude: >75% score. Practice items were interpreted as low practice ≤50%, moderate 51%–75%, and high practice level >75% score.
Pretest was conducted for an average 50 min time to complete the tool and followed by administration of the structured instructional module for the experimental group. Posttest was conducted with the same tool after a period of 1 week. The same procedure was followed for the control group without administering the structured instructional module. The data collected was analyzed using descriptive and inferential statistics using statistical software SPSS 21.0 Armonk (2012).
| Results|| |
Various demographic characteristics (11 items) were recorded. The overall mean knowledge scores of respondents on prevention of oral cancer on pre- and posttest in experimental and control group are depicted in [Table 1]. A comparison between pre- and post-test practice scores of the experimental and control group on prevention of oral concern is shown in [Table 2]. The results of the present study were analyzed using Pearson's correlation statistical analysis to find the correlations between knowledge, attitude, and practice in both experimental and control groups. For posttest attitude, all demographic variables except source of information, place of residence, father's occupation, mother's occupation, and family monthly income showed a positive association in the experimental group [Table 3].
|Table 1: Overall mean knowledge scores of respondents on the prevention of oral cancer on pre- and posttest in experimental and control groups|
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|Table 2: Comparison between pre- and posttest practice scores of experimental and control group on prevention of oral concern=500|
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|Table 3: Association between demographic variables and post-est attitude level on prevention of oral cancer - experimental group. (n1=250)|
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| Discussion|| |
It was observed that the majority of subjects were in the age group of 15–16 years in both the groups. Similar findings have been observed in the study conducted by Makwana et al. In our study, male subjects were more than females. In demographic data, we also asked for a number of siblings and type of family, as in a study by Peter and Sequeriea, it was observed that among adolescent students, the use of tobacco is significantly associated with a brother/sister smoke. The present study emphasized on relationship of various sociodemographic characteristics on different aspects of oral cancers which was similar to the study conducted by Ganesh et al.
In relation to the source of health information, majority of the subjects got information from electronic media. It has been observed by various researchers that rapid social changes in the world are taking place due to the expansion of mass media. The knowledge, attitude, and practice of adolescents on the prevention of oral cancer were also significantly correlated with various sociodemographic parameters. Similar findings were also observed in studies conducted by Cruz et al. and Orlando et al.
It has been observed that there was a significant change in knowledge regarding the prevention of oral cancers, similar findings have been observed in studies conducted by Tomar and Logan and Torabi et al. A significant change was observed in attitude regarding the prevention of oral cancers after instructional module. The results of our study were in accordance with a study by Smyth et al. We observed a positive correlation between knowledge, attitude, and practice of adolescents on the prevention of oral cancer. Thus, the results of various studies supported the findings of the present study.,,,
Various teaching programs and journal presentations could be organized by administrators for community health nurses to enhance their knowledge and keep them aware of the causes for oral cancer and its prevention. Findings of the present study suggest that educators and administrators should encourage nurses to read, discuss, and conduct research studies to enable the nurse to make data-based decision rather than intuitive decisions.
| Conclusion|| |
The present study revealed that structured instructional module has enhanced the knowledge, attitude, and practice of adolescents, which is essential in preventing oral cancer in tfuture. It can be used to educate different sections of the population in different settings. The study can be replicated on larger samples in different settings. Thus, further studies should be conducted considering large population involving both rural and urban areas.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Smokeless Tobacco and Some Tobacco Specific N- Nitrosamines. Vol. 89. Lyon: International Agency for Research on Cancer; 2007.
Makwana NR, Shah VR, Yadav S. A study on prevalence of smoking and tobacco chewing among adolescents in rural areas of Jamnagar District, Gujarat State. Tob Control 2003;12:e4.
Peter S, Sequeriea S. Essentials of Preventive and Community Dentistry. 11th
ed. New Delhi: Arya Publishing House; 2003. p. 206-15.
Ganesh R, John J, Saravanan S. Socio demographic profile of oral cancer patients residing in Tamil Nadu A hospital based study. Indian J Cancer 2013;50:9-13.
] [Full text]
Motallebnejad MM, Khanian M, Alizadeh R, Dabbaghian I. Community survey of knowledge about oral cancer in Babol: Effect of an education intervention. East Mediterr Health J 2009;15:1489-95.
Cruz GD, Le Geros RZ, Ostroff JS, Hay JL, Kenigsberg H, Franklin DM. Oral cancer knowledge, risk factors and characteristics of subjects in a large oral cancer screening program. J Am Dent Assoc 2002;133:1064-71.
Orlando A, Salerno P, Tarsitani G. Opinions and attitudes on oral cancer in a sample of students attending a state secondary school in Rome. A pilot study. Minerva Stomatol 2001;50:139-43.
Tomar SL, Logan HL. Florida adults' oral cancer knowledge and examination experiences. J Public Health Dent 2005;65:221-30.
Torabi MR, Yang J, Li J. Comparison of tobacco use knowledge, attitude and practice among college students in China and the United States. Health Promot Int 2002;17:247-53.
Smyth E, Caamaño F, Fernández-Riveiro P. Oral health knowledge, attitudes and practice in 12-Year Old School children. Singapore Med J 2009;50:49-53.
Jayakrishnan R, Geetha S, Binukumar B, Sreekumar P, Lekshmi K. Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State. Indian J Dent Res 2011;22:195-9.
] [Full text]
Priyadarshini HR. Prevalence of smokeless tobacco habits among oral cancer patients attending Karnataka cancer treatment and research institute, Hubli, Karnataka, India A retrospective hospital based study. J Oral Health Res 2011;2:3-6.
Manoharan N, Tyagi BB, Raina V. Cancer incidences in rural Delhi-2004-05. Asian Pac J Cancer Prev 2010;11:73-7.
Ayo-Yusuf OA, Lalloo R, Johnson NW. Trends and ethnic disparities in oral and oro-pharyngeal cancers in South Africa, 1992-2001. SADJ 2013;68:168-73.
[Table 1], [Table 2], [Table 3]