Mosque-based Oral Health Intervention Using Solomon Design

NCT07584512 | Completed DMC

• 1 other identifier: NIPSOM/IRB/2017/09
• Study Type: interventional
• Target: 142
• Locations: 1 country
• Sites: 2

Brief Summary

This quasi-experimental study evaluates a mosque-based oral health education intervention ("Smile With Prophet", SWP) among adult male mosque attendees in Dhaka, Bangladesh, using a Solomon four-group design. A total of 142 participants were enrolled across two mosques (intervention and control). The analytical sample comprises 80 adult male attendees (≥18 years) allocated to four groups: intervention and control, each with pretest-posttest and posttest-only arms (n=20 per group). The SWP intervention consists of oral health education delivered through Friday sermons (khutbas), supported by educational leaflets and provision of miswak. Outcomes are measured at baseline and 3-week follow-up and include oral health knowledge (14-item questionnaire), self-reported tooth brushing practices (15-item questionnaire), and clinical plaque scores (Greene-Vermillion Simplified Oral Hygiene Index, reversed). The primary objective is to evaluate the effect of the intervention on knowledge and plaque scores. The secondary objective is to assess self-reported practice changes.

Conditions

Dental Plaque Accumulation; Oral Hygiene Education

Keywords

Faith-Based Health Promotion; Pretest sensitization; Sunnah; Community Health; Bangladesh;; Solomon Four-Group Design; Quasi-Experimental; Health Belief Model; Miswak; Tooth Brushing; Oral Health Education; Mosque-Based Intervention; Khutba; seremon

Outcome Measures

Primary Outcomes (2)

• Clinical Plaque Score (Reversed)

  Objective clinical measure of oral hygiene. Assessed using the Greene-Vermillion Simplified Oral Hygiene Index (reversed). Dental examiner evaluates plaque thickness along the gingival margin on four surfaces (distal, facial, mesial, lingual) of each tooth. Reversed score range 0-3. Higher reversed score indicates less plaque and better oral hygiene. This is the primary evidence of behavior change

  Baseline (Week 1, pretested groups only) and 3-week follow-up (Week 3, all groups)

• Oral Health Knowledge Score

  Measured using a 14-item self-administered questionnaire assessing understanding of oral hygiene, tooth brushing frequency, miswak use, dietary effects on teeth, and gum health. Each correct answer scores 1 point. Total score range 0-14. Higher score indicates better knowledge.

  Baseline (Week 1, pretested groups only) and 3-week follow-up (Week 3, all groups)

Secondary Outcomes (1)

• Self-Reported Tooth Brushing Practice Score

  Baseline (Week 1, pretested groups only) and 3-week follow-up (Week 3, all groups)

Study Arms (4)

Arm 1 (E1): Intervention + Pretest

EXPERIMENTAL

Participants receive the SWP (Smile With Prophet) oral health education intervention plus a pretest assessment. The intervention includes: (1) oral health education delivered via Friday sermon (khutba) integrating Islamic teachings on hygiene; (2) distribution of educational leaflet; (3) provision of miswak; (4) dental health campaign with clinical examination. Pretest (baseline) includes questionnaire (knowledge, practice) and clinical plaque assessment. Posttest is conducted at 3-week follow-up.

Behavioral: Smile With Prophet (SWP)

Arm 2 (E2): Intervention Only (No Pretest)

EXPERIMENTAL

Participants receive the SWP (Smile With Prophet) oral health education intervention but do not undergo pretest assessment. The intervention includes: (1) oral health education delivered via Friday sermon (khutba) integrating Islamic teachings on hygiene; (2) distribution of educational leaflet; (3) provision of miswak; (4) dental health campaign with clinical examination. Posttest only is conducted at 3-week follow-up.

Behavioral: Smile With Prophet (SWP)

Arm 3 (C1): Control with Pretest

NO INTERVENTION

Participants receive no oral health education intervention. They undergo pretest assessment (baseline questionnaire and clinical plaque examination) and posttest assessment at 3-week follow-up. This arm controls for pretest sensitisation effects. After study completion, participants received the SWP intervention.

Arm 4 (C2): Control Only (No Pretest)

NO INTERVENTION

Participants receive no oral health education intervention and do not undergo pretest assessment. They undergo posttest only at 3-week follow-up. This arm controls for both pretest sensitisation and temporal trends. After study completion, participants received the SWP intervention.

Interventions

Smile With Prophet (SWP) BEHAVIORAL

"Smile With the Prophet (pbuh)" (SWP) intervention is an intervention specially designed for this intervention study. Composed of the following: Khutba: 15-minute Friday sermon (khutba) delivered by the Imam, integrating evidence-based oral health messages with Islamic teachings on hygiene (Sunnah); each supported by several Qur'an verses (ayah), or Islamic faith-based decrees. The messages were developed through consultation involving Advisory Committee board consisting of Islamic scholars and public health professionals. Booklet: A 4-page illustrated educational leaflet on proper tooth brushing technique and use of miswak, available in Bengali; Miswak \& Toothbrush :Provision of a miswak (traditional tooth cleaning stick) and a soft-bristled toothbrush

Arm 1 (E1): Intervention + Pretest; Arm 2 (E2): Intervention Only (No Pretest)

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Respondent is willing to participate and gives consent.
• Respondent is aged 18 years or older.
• Respondent attends weekly congregation prayers at the selected mosque.

You may not qualify if:

• Respondent is mentally unstable or unable to understand the intervention (e.g., too old or cognitively impaired).

Sponsors & Collaborators

• Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh: lead

Study Sites (2)

Masjid As Siddique (RA)

Dhaka, 1217, Bangladesh

Location

Angarzora Ahli Hadeeth Jame Masjid

Dhaka, 1219, Bangladesh

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: 3.12.1 Hiring Doctors: None of the doctors were used for second time for data collection campaigns to avoid examiners bias. A total of 10 doctors are hired for four dental check-up (pre and post test in intervention \& control mosques). But they were not informed about the objectives of the study and whether the mosque was an intervention or control mosque, or whether the campaign was baseline data collection or for follow up data 3.2.1 Mosque Agreement: Written informed consent was obtained from heads of the mosque Committees or from imams or khatibs for their and their mosques' participation after describing required data collection procedures (without disclosing the desired objectives hypothesis of the study thus masking the intention) • Privacy and confidentiality were maintained strictly, as each of the participants was assessed separately and the dentist examined the participants with in a screened compartment of the mosque.
• Purpose: PREVENTION
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: In this Solomon four-group design, participants were allocated to four groups: intervention and control, each with pretest-posttest and posttest-only arms. Two similar mosques were selected conveniently. Within each site, participants were randomly assigned (pseudo-randomisation). Pretesting was conducted in one intervention and one control group. Baseline data were collected during the first Friday congregation, prior to a 15-minute sermon. A miswak was provided after clinical assessment. A reinforcement session (second 15-minute khutba) and distribution of educational leaflets were conducted during the second Friday. A soft-bristled toothbrush was given at this time as an intervention and attendance tracker. Final follow-up assessments (questionnaire and clinical examination) were conducted during the third Friday. The intervention mosque phase ran from 23 September to 7 October 2022. The control mosque phase ran from 14 October to 28 October 2022. Each phase lasted 3 weeks. Attend

Study Record Dates

• First Submitted: May 6, 2026
• First Posted: May 13, 2026
• Study Start: September 23, 2022
• Primary Completion: October 28, 2022
• Study Completion: October 28, 2022
• Last Updated: May 14, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

BA (2)