Introduction
Methods
Search strategy
Eligibility criteria
Criteria | Justification | |
---|---|---|
Inclusion | Primary and secondary schoolchildren (aged > 6–19) | Focuses on school-aged children |
Interventions that are delivered by students (peers) | This review investigates the potential of peer (student-led) interventions | |
Studies that compare peer-led interventions to another mode of delivery | to identify interventions that bring about a change in outcomes | |
School-based interventions in both public & private schools | This review seeks to capture experiences in all school environments | |
Studies in which oral health is their focus or part of their focus | To ensure an understanding of the impact of peer (student) led interventions on oral health | |
Exclusion | Pre-schoolchildren (< age 6) and children with disabilities | The review aims to explore interventions with implications for school-based populations. Targeted interventions for different conditions and younger age groups may require different strategies |
Interventions not delivered by students (peers) | This review investigates the potential of peer (student-led) interventions | |
Any study where a comparator is not identified | To facilitate comparison between different modes of delivery | |
Study conducted in a setting other than schools (e.g., community-based, healthcare setting) | This review seeks to capture experiences in school environments | |
Studies which do not have oral health as their focus or part of their focus | To ensure an understanding of the impact of peer (student) led interventions on oral health |
Study selection
Data extraction
Study ID (country) | Sample size | Intervention | Comparator | Selection of peers | Follow up | Theoretical model |
---|---|---|---|---|---|---|
Laiho et al. (1993) (Finland) [19] | 357 | 45 min Education & free toothbrushes delivery & xylitol chewing gum | Dentist-led & Self-teaching | Selected by school | 2 weeks & 2 months | No |
Haleem et al. (2012) (Pakistan) [20] | 1517 | 1 h education and daily toothbrushing | Dentist-led, Teacher-led & Self learning | Nominated by teacher in charge | 6,12,18 &24 months | Social cognitive theory |
Haleem et al. (2015) (Pakistan) [21] | 935 | 1 h education with daily toothbrushing vs reinforcement on monthly basis | Teacher-led & dentist-led | Nominated by teacher | 6 months after 1 session. 6, 12 months post-reinforcement | Social learning theory |
Debby et al. (2016) (Indonesia) [22] | 70 | 10 educational sessions across 4 weeks | Dentist-led | Selected by teacher | 4 weeks | No |
Vangipuram (2016) (India) [23] | 450 | 20 min educational session | Dentist-led | Not mentioned | 3 & 6 month | No |
Villanueuva-Vilchis (2019) (Mexico) [24] | 385 | Instructions about diet and oral self-care and daily toothbrushing for 1 month | Conventional dental instruction (CDI)- led by paediatric dentist | Nominated by teachers (based on their academic achievement& socialising) | 3 months | Lay Advisors Model |
Karimy et al. (2020) (Iran) [25] | 365 | Four (1 h) educational sessions weekly plus planning toothbrushing | Dental research staff-led | Nominated by peers (then interviewed to evaluate interest & suitability) | 2 months | Planned Behaviour theory |
Karami et al. 2019 (Iran) [26] | 120 | Oral Health Education (OHE), 10 min animations & practical training | Teacher-led | Selected by school | One month | |
Xiang et al. 2022 (Hong Kong) [27] | 1184 | Six sessions: OHE Booklets & toothbrushes | Self-learning | Selected by teacher in charge | 6&12 months | SCT & Health Belief Model |
Aleksejeniene & Pang, 2022 (Canada) [28] | 372 | 1 month: Lecture-based presentation followed by 4 peer-led OHE & practical sessions | Dental hygienist-led | Random selection | 8 &12 months | Lay Advisors Model |
Quality assessment
Data synthesis
Results
Study characteristics
Selection of peer-leaders
Training of peer-leaders
Comparing oral health outcomes
Knowledge, attitude, and behaviour
Oral health status
Quality of oral self care
Oral Health Related Quality of Life (OHRQoL)
Clinical Measures | Knowledge | Attitudes & behaviours | Skills | OHRQoL | |||
---|---|---|---|---|---|---|---|
Main Outcomes: | DMFT | Oral Hygiene (PI, BOP, Cal) | OH Knowledge | OH Behaviour/ Practice | OH Attitude/ Intention | Quality of Oral Self Care/ Skills | |
Haleem et al., 2012 [20] | N | Y | Y | Y | N | N | N |
Vangipuram et al., 2016 [23] | N | Y | Y | Y | Y | N | N |
Villaneuva-Vilchis, 2019 [24] | N | N | N | N | N | Y (p < 0.001) | N |
Haleem et al., 2015 [21] | Y | Y | Y | Y | Y | N | N |
Karimy et al., 2020 [26] | N | N | N | Y | Y | N | N |
Debby et al., 2016 [22] | N | N | Y | N | Y | N | N |
Laiho et al., 1993 [19] | N | N | Y | N | Na | N | N |
Xiang et al., 2022 [27] | Y (p < 0.001) | Y | N | Y | N | N | Y |
Aleksejuniene & Pang, 2022 [28] | N | N | Y | Y | N | Y | N |
Karami et al., 2019 [25] | N | N | Y | Y | Y | N | N |