{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T15:38:46Z","timestamp":1776785926263,"version":"3.51.2"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,10]],"date-time":"2018-10-10T00:00:00Z","timestamp":1539129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Transitional Research Fellowship","award":["TRF-2014-07-003"],"award-info":[{"award-number":["TRF-2014-07-003"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dental Hygiene"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Exploring the feasibility to understand changes in oral hygiene behaviour using the Health Action Process Approach (HAPA) model applied to qualitative research interviews in patients with diabetes and periodontitis undergoing standard periodontitis treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with type 1\/2 diabetes and chronic periodontitis (n\u00a0=\u00a08) received standard non\u2010surgical periodontal treatment accompanied with personalized oral hygiene instructions by a dental hygienist. Clinical indices (% bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), % of sites with PD\u00a0\u2265\u00a05\u00a0mm, periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA) were recorded pre\u2010 and post\u2010treatment. At 3\u00a0months post\u2010treatment, patients were interviewed using a topic guide relating to oral health. A behaviour change framework was constructed from elements of the HAPA model and used directly to map interview data to evaluate oral hygiene behaviour in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from this feasibility study suggest a clinical improvement in periodontal status, albeit only monitored for 3\u00a0months. Application of the HAPA model highlighted the behavioural change pathway that diabetes patients undertake before, during and after periodontal treatment. The data suggest that patients move through all elements of the motivation phase and all elements of the volition phase except for the recovery self\u2010efficacy element.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The novel approach of applying the HAPA model to qualitative research data allowed for the collection of richer data compared to quantitative analysis only. Findings suggest that, in general, patients with periodontitis and diabetes successfully manage to incorporate new oral hygiene behaviours into their daily routine.<\/jats:p><\/jats:sec>","DOI":"10.1111\/idh.12365","type":"journal-article","created":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T15:13:55Z","timestamp":1536160435000},"page":"55-63","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Exploring changes in oral hygiene behaviour in patients with diabetes and periodontal disease: A feasibility study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7389-5816","authenticated-orcid":false,"given":"Katrin M.","family":"Jaedicke","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Wellbeing University of Sunderland Sunderland UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M.","family":"Bissett","sequence":"additional","affiliation":[{"name":"Centre for Oral Health Research, School of Dental Sciences and Institute of Cellular Medicine Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Finch","sequence":"additional","affiliation":[{"name":"Department of Nursing, Midwifery &amp; Health Northumbria University, Coach Lane Campus West Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared","family":"Thornton","sequence":"additional","affiliation":[{"name":"Newcastle Clinical Trials Unit Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M.","family":"Preshaw","sequence":"additional","affiliation":[{"name":"Centre for Oral Health Research, School of Dental Sciences and Institute of Cellular Medicine Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.4.727-752.2001"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12012"},{"key":"e_1_2_6_4_1","volume-title":"A clinical guide to periodontology","author":"Palmer R","year":"2003"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2011.868"},{"key":"e_1_2_6_6_1","volume-title":"Delivering better oral health: an evidence\u2010based toolkit for prevention","author":"Public Health England","year":"2017"},{"key":"e_1_2_6_7_1","first-page":"CD005097","article-title":"Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases","volume":"4014","author":"Renz A","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12356"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2009.00314.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000351829"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-016-0436-0"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/idh.12012"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2009.01453.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2012.01926.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-5037.2006.00175.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0765.1997.tb00540.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.2011.00274.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1996.tb02090.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-016-0164-5"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12224"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12091"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-0597.2008.00361.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ipd.12287"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0024509"},{"key":"e_1_2_6_25_1","first-page":"134","article-title":"Periodontal disease and diabetes","volume":"19","author":"Bissett SM","year":"2015","journal-title":"J Diabetes Nurs"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2006.00193.x"},{"key":"e_1_2_6_27_1","volume-title":"Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus","author":"World Health Organization","year":"2011"},{"key":"e_1_2_6_28_1","volume-title":"Oral health promotion: general dental practice. 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