{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T07:53:23Z","timestamp":1785657203805,"version":"3.56.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran","award":["1400-3-238-56966"],"award-info":[{"award-number":["1400-3-238-56966"]}]},{"name":"Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran","award":["1400-3-238-56966"],"award-info":[{"award-number":["1400-3-238-56966"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the total participants, 151 (37.75%) were men. The mean\u2009\u00b1\u2009standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89\u2009\u00b1\u200913.72 and 39.45\u2009\u00b1\u200913.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR\u2009=\u200928.63), intention (\u03b2\u2009=\u20091.47), attitude (\u03b2\u2009=\u20090.66), subjective norm (\u03b2\u2009=\u20092.82), and perceived behavioral control (\u03b2\u2009=\u20091.19) in both groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04\/03\/2022 (registration number: IRCT20220221054086N1).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-024-04315-5","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T15:02:00Z","timestamp":1715958120000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial"],"prefix":"10.1186","volume":"24","author":[{"given":"Anoosheh","family":"Ghasemian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katayoun","family":"Sargeran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Khami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Reza","family":"Shamshiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"4315_CR1","unstructured":"Oral health. Geneva: World Health Organization. 2023. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/oral-health."},{"key":"4315_CR2","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.99236","volume-title":"Oral cancer: current concepts and future perspectives","author":"A Khani Jeihooni","year":"2022","unstructured":"Khani Jeihooni A, Jafari F. Oral cancer: epidemiology, prevention, early detection, and treatment. In: Gokul, Sridharan, editors. Oral cancer: current concepts and future perspectives. London: IntechOpen; 2022. https:\/\/doi.org\/10.5772\/intechopen.99236."},{"key":"4315_CR3","unstructured":"Cancer Today. Global Cancer Observatory. International Agency for Research on Cancer, Lyon. GLOBOCAN 2020. https:\/\/gco.iarc.fr\/today\/online-analysis-table."},{"issue":"4","key":"4315_CR4","doi-asserted-by":"publisher","first-page":"160","DOI":"10.36348\/sjodr.2021.v06i04.005","volume":"6","author":"RM Vatchala Rani","year":"2021","unstructured":"Vatchala Rani RM, Manjunath BC, Bajpai M, Gupta P, Bhargava A, Kumar A. Is mouth self examination (MSE) a good tool for early detection of oral cancer? A review. Saudi J Oral Dent Res. 2021;6(4):160\u20135.","journal-title":"Saudi J Oral Dent Res"},{"issue":"1","key":"4315_CR5","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1056\/NEJMra1715715","volume":"382","author":"LQ Chow","year":"2020","unstructured":"Chow LQ. Head and neck cancer. N Engl J Med. 2020;382(1):60\u201372.","journal-title":"N Engl J Med"},{"key":"4315_CR6","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1093\/annonc\/mdz084","volume":"30","author":"D Hashim","year":"2019","unstructured":"Hashim D, Genden E, Posner M, Hashibe M, Boffetta P. Head and neck cancer prevention: from primary prevention to impact of clinicians on reducing burden. Ann Oncol. 2019;30:744\u201356.","journal-title":"Ann Oncol"},{"key":"4315_CR7","unstructured":"The Crete Declaration on Oral Cancer Prevention 2005: A commitment to action. 2005. https:\/\/screening.iarc.fr\/doc\/orh_crete_declaration_april05.pdf."},{"key":"4315_CR8","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/j.oraloncology.2008.05.023","volume":"45","author":"PE Petersen","year":"2009","unstructured":"Petersen PE. Oral cancer prevention and control: the approach of the World Health Organization. Oral Oncol. 2009;45:454\u201360.","journal-title":"Oral Oncol"},{"key":"4315_CR9","first-page":"85","volume-title":"Cancer: disease control priority","author":"R Sankaranarayanan","year":"2015","unstructured":"Sankaranarayanan R, Ramadas K, Amarasinghe H, Subramanian S, Johnson N. Oral cancer: prevention, early detection, and treatment. In: Gelband H, Jha P, Sankaranarayanan R, Horton S, editors. Cancer: disease control priority. Washington, DC: The World Bank; 2015. pp. 85\u201399."},{"issue":"225","key":"4315_CR10","doi-asserted-by":"publisher","first-page":"360","DOI":"10.31729\/jnma.4910","volume":"58","author":"G Shrestha","year":"2020","unstructured":"Shrestha G, Maharjan L. Mouth self-examination for prevention and control of oral cavity cancer. J Nepal Med Assoc. 2020;58(225):360\u20132.","journal-title":"J Nepal Med Assoc"},{"issue":"36","key":"4315_CR11","doi-asserted-by":"publisher","first-page":"4550","DOI":"10.1200\/JCO.2013.50.3870","volume":"31","author":"AK Chaturvedi","year":"2013","unstructured":"Chaturvedi AK, Anderson WF, Lortet-Tieulent J, Curado MP, Ferlay J, Franceschi S, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol. 2013;31(36):4550\u20139.","journal-title":"J Clin Oncol"},{"key":"4315_CR12","doi-asserted-by":"publisher","first-page":"417","DOI":"10.2174\/1874210601610010417","volume":"10","author":"S Bhargava","year":"2016","unstructured":"Bhargava S. Need of oral pre cancer awareness initiatives in India. Open Dent J. 2016;10:417\u20139.","journal-title":"Open Dent J"},{"key":"4315_CR13","first-page":"95","volume-title":"Health behavior: theory, research, and practice","author":"DE Monta\u00f1o","year":"2015","unstructured":"Monta\u00f1o DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior: theory, research, and practice. San Francisco: Jossey-Bass\/Wiley; 2015. pp. 95\u2013124."},{"issue":"2","key":"4315_CR14","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","volume":"50","author":"I Ajzen","year":"1991","unstructured":"Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179\u2013211.","journal-title":"Organ Behav Hum Decis Process"},{"key":"4315_CR15","doi-asserted-by":"publisher","first-page":"106327","DOI":"10.1016\/j.ypmed.2020.106327","volume":"143","author":"O Lareyre","year":"2021","unstructured":"Lareyre O, Gourlan M, Stoebner-Delbarre A, Cousson-G\u00e9lie F. Characteristics and impact of theory of planned behaviour interventions on smoking behaviour: a systematic review of the literature. Prev Med. 2021;143:106327.","journal-title":"Prev Med"},{"issue":"2","key":"4315_CR16","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/17437199.2010.521684","volume":"5","author":"M McEachan RRCh, Conner","year":"2011","unstructured":"McEachan RRCh, Conner M, Taylor NJ, Lawton RJ. Prospective prediction of health-related behaviours with the theory of planned behaviour: a meta-analysis. Health Psychol Rev. 2011;5(2):97\u2013144.","journal-title":"Health Psychol Rev"},{"issue":"2","key":"4315_CR17","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1080\/08870440290013644a","volume":"17","author":"W Hardeman","year":"2002","unstructured":"Hardeman W, Johnston M, Johnston D, Bonetti D, Wareham N, Kinmonth AL. Application of the theory of planned behavior in behavior change interventions: a systematic review. Psychol Health. 2002;17(2):123\u201358.","journal-title":"Psychol Health"},{"issue":"7","key":"4315_CR18","doi-asserted-by":"publisher","first-page":"563","DOI":"10.3109\/09638288.2014.935874","volume":"37","author":"P Kersten","year":"2015","unstructured":"Kersten P, McCambridge A, Kayes NM, Theadom A, McPherson KM. Bridging the gap between goal intentions and actions: a systematic review in patient populations. Disabil Rehabil. 2015;37(7):563\u201370.","journal-title":"Disabil Rehabil"},{"key":"4315_CR19","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1002\/ejsp.258","volume":"35","author":"FF Sniehotta","year":"2005","unstructured":"Sniehotta FF, Schwarzer R, Scholz U, Sch\u00fcz B. Action planning and coping planning for long-term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35:565\u201376.","journal-title":"Eur J Soc Psychol"},{"key":"4315_CR20","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1186\/s13063-015-1092-4","volume":"16","author":"D Cameron","year":"2015","unstructured":"Cameron D, Epton T, Norman P, Sheeran P, Harris PR, Webb TL, et al. A theory-based online health behaviour intervention for new university students (U@Uni:LifeGuide): results from a repeat randomized controlled trial. Trials. 2015;16:555.","journal-title":"Trials"},{"issue":"3","key":"4315_CR21","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1080\/10826084.2018.1508298","volume":"54","author":"X Zhao","year":"2019","unstructured":"Zhao X, White K, Young R. A TPB-based smoking intervention among Chinese high school students. Subst Use Misuse. 2019;54(3):459\u201372.","journal-title":"Subst Use Misuse"},{"key":"4315_CR22","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1186\/s12905-023-02411-2","volume":"23","author":"S Najafi","year":"2023","unstructured":"Najafi S, Mohammadkhah F, Afzali Harsini P, Sohrabpour M, Khani Jeihooni A. Effect of educational intervention based on theory of planned behaviour on promoting preventive behaviours of oral cancer in rural women. BMC Womens Health. 2023;23:249.","journal-title":"BMC Womens Health"},{"issue":"1","key":"4315_CR23","doi-asserted-by":"publisher","first-page":"13","DOI":"10.29252\/jech.7.1.13","volume":"7","author":"A Khani Jeihooni","year":"2020","unstructured":"Khani Jeihooni A, Razavi M, Kashfi SM, Ansari M, Gholami T. Effect of educational intervention based on the theory of planned behavior on preventing water pipe smoking in secondary school students. J Educ Community Health. 2020;7(1):13\u201321. [In Persian].","journal-title":"J Educ Community Health"},{"issue":"2","key":"4315_CR24","doi-asserted-by":"publisher","first-page":"54","DOI":"10.21859\/jech-03028","volume":"3","author":"Y Fathi","year":"2016","unstructured":"Fathi Y, Moeini B, Bazvand A, Barati M, Roshanaei G. The effectiveness of educational program based on theory of planned behaviour on preventing and decreasing tobacco smoking among post-secondary students. J Educ Community Health. 2016;3(2):54\u201361. [In Persian].","journal-title":"J Educ Community Health"},{"issue":"4","key":"4315_CR25","first-page":"504","volume":"3","author":"I Mohammadi Zeidi","year":"2013","unstructured":"Mohammadi Zeidi I, Pakpour Haji Agha A. Effectiveness of an educational intervention based on theory of planned behavior to reduce intentions to smoke among secondary school students. J Res Health. 2013;3(4):504\u201313.","journal-title":"J Res Health"},{"key":"4315_CR26","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1186\/s12903-023-03239-w","volume":"23","author":"F Mohammadkhah","year":"2023","unstructured":"Mohammadkhah F, Mardani Amirhajelu R, Bakhtiar M, Alempour Salemi S, Kevenjan M, Khani Jeihooni A. The effect of training intervention based on the theory of planned behavior on oral and dental health behaviors in pregnant women. BMC Oral Health. 2023;23:521.","journal-title":"BMC Oral Health"},{"key":"4315_CR27","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1186\/s12887-020-02381-6","volume":"20","author":"M Karimy","year":"2020","unstructured":"Karimy M, Higgs P, Solayman Abadi Sh, Armoon B, Araban M, Rouhani MR, et al. Oral health behavior among school children aged 11\u201313 years in Saveh, Iran: an evaluation of a theory-driven intervention. BMC Pediatr. 2020;20:476.","journal-title":"BMC Pediatr"},{"issue":"4","key":"4315_CR28","first-page":"292","volume":"21","author":"S Soltani","year":"2020","unstructured":"Soltani S, Sharifirad Gh, Mahaki B, Ali Eslami A. The effect of oral health educational intervention program among mothers of children aged 1\u20136, based on the theory of planned behavior. J Dent Shiraz Univ Med Sci. 2020;21(4):292\u20139.","journal-title":"J Dent Shiraz Univ Med Sci"},{"key":"4315_CR29","doi-asserted-by":"publisher","first-page":"3838","DOI":"10.3390\/ijerph16203838","volume":"16","author":"JH Lin","year":"2019","unstructured":"Lin JH, Huang YK, Lin KD, Hsu YJ, Huang WF, Huang HL. Randomized controlled trial on effects of a brief clinical-based intervention involving planning strategy on self-care behaviors in periodontal patients in dental practice. Int J Environ Res Public Health. 2019;16:3838.","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"4315_CR30","doi-asserted-by":"publisher","first-page":"e87","DOI":"10.2196\/jmir.7024","volume":"19","author":"SM Malik NAb, Yatim","year":"2017","unstructured":"Malik NAb, Yatim SM, Lam OLT, Jin L, McGrath CPJ. Effectiveness of a web-based health education program to promote oral hygiene care among stroke survivors: randomized controlled trial. J Med Internet Res. 2017;19(3):e87.","journal-title":"J Med Internet Res"},{"issue":"2","key":"4315_CR31","first-page":"88","volume":"15","author":"Z Makvandi","year":"2015","unstructured":"Makvandi Z, Karimi-Shahanjarini A, Faradmal J, Bashirian S. Evaluation of an oral health intervention among mothers of young children: a clustered randomized trial. J Res Health Sci. 2015;15(2):88\u201393.","journal-title":"J Res Health Sci"},{"issue":"2","key":"4315_CR32","doi-asserted-by":"publisher","first-page":"665","DOI":"10.3390\/ijerph17020665","volume":"17","author":"LC Hung","year":"2020","unstructured":"Hung LC, Kung PT, Lung CH, Tsai MH, Liu SA, Chiu LT, et al. Assessment of the risk of oral cancer incidence in a high-risk population and establishment of a predictive model for oral cancer incidence using a population-based cohort in Taiwan. Int J Environ Res Public Health. 2020;17(2):665.","journal-title":"Int J Environ Res Public Health"},{"key":"4315_CR33","unstructured":"Self-examination. Mouth Cancer Foundation: Awareness and Support. https:\/\/www.mouthcancerfoundation.org\/self-examination\/."},{"issue":"4","key":"4315_CR34","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1590\/1413-81232015204.00542014","volume":"20","author":"AME de B Martins","year":"2015","unstructured":"Martins AME, de Souza B, Haikal JGS, Paula DS, de Ferreira AMB, Pordeus EF. Prevalence of oral cancer self-examination among elderly people treated under Brazil\u2019s Unified Health System: household health survey. Cien Saude Colet. 2015;20(4):1085\u201398.","journal-title":"Cien Saude Colet"},{"issue":"1","key":"4315_CR35","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/adj.12274","volume":"60","author":"P Lopez Jornet","year":"2015","unstructured":"Lopez Jornet P, Gomez Garcia FJ, Lucero Berdugo M, Parra Perez F, Pons-Fuster Lopez A. Mouth self-examination in a population at risk of oral cancer. Aust Dent J. 2015;60(1):59\u201364.","journal-title":"Aust Dent J"},{"key":"4315_CR36","doi-asserted-by":"publisher","first-page":"2263","DOI":"10.1016\/j.pec.2019.07.001","volume":"102","author":"H Lee","year":"2019","unstructured":"Lee H, Ho PSh W, WCh H, Lee CY, Huang CH. Effectiveness of a health belief model intervention using a lay health advisor strategy on mouth self-examination and cancer screening in remote aboriginal communities: a randomized controlled trial. Patient Educ Couns. 2019;102:2263\u20139.","journal-title":"Patient Educ Couns"},{"key":"4315_CR37","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1186\/s12889-023-16298-z","volume":"23","author":"M Dhanapriyanka","year":"2023","unstructured":"Dhanapriyanka M, RDFC K, Jayasekara P. Effectiveness of health promotion intervention on the knowledge and selected practices related with oral cancer among a group of vulnerable youth in Sri Lanka. BMC Public Health. 2023;23:1355.","journal-title":"BMC Public Health"},{"key":"4315_CR38","doi-asserted-by":"publisher","first-page":"27","DOI":"10.4103\/jehp.jehp_82_15","volume":"6","author":"K Singh","year":"2017","unstructured":"Singh K, Sharma D, Kaur M, Gauba K, Thakur JS, Kumar R. Effect of health education on awareness about oral cancer and oral self-examination. J Edu Health Promot. 2017;6:27.","journal-title":"J Edu Health Promot"},{"key":"4315_CR39","volume-title":"Theoretical foundations of health education and health promotion","author":"M Sharma","year":"2008","unstructured":"Sharma M, Romas JA. Theoretical foundations of health education and health promotion. Massachusetts: Jones and Bartlett; 2008."},{"key":"4315_CR40","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1038\/sj.ebd.6400623","volume":"10","author":"S Warnakulasuriya","year":"2009","unstructured":"Warnakulasuriya S. Significant oral cancer risk associated with low socioeconomic status. Evid Based Dent. 2009;10:4\u20135.","journal-title":"Evid Based Dent"},{"issue":"66","key":"4315_CR41","first-page":"149","volume":"17","author":"R Sadeghi","year":"2017","unstructured":"Sadeghi R, Zanjari N. The spatial inequality of development in the 22 districts of Tehran metropolis. Social Welf Q. 2017;17(66):149\u201384. [In Persian].","journal-title":"Social Welf Q"},{"key":"4315_CR42","unstructured":"Ajzen I. Constructing a TPB questionnaire: conceptual and methodological considerations. 2002. https:\/\/docplayer.net\/21387809-Constructing-a-tpb-questionnaire-conceptual-and-methodological-considerations.html."},{"issue":"4","key":"4315_CR43","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1111\/j.1744-6570.1975.tb01393.x","volume":"28","author":"CH Lawshe","year":"1975","unstructured":"Lawshe CH. A quantitative approach to content validity. Pers Psychol. 1975;28(4):563\u201375.","journal-title":"Pers Psychol"},{"key":"4315_CR44","volume-title":"Nursing research: design, statistics, and computer analysis","author":"CF Waltz","year":"1981","unstructured":"Waltz CF, Bausell RB. Nursing research: design, statistics, and computer analysis. Philadelphia: W.B. Saunders Company; 1981."},{"key":"4315_CR45","doi-asserted-by":"publisher","DOI":"10.1002\/9781119513469","volume-title":"Applied longitudinal analysis","author":"GM Fitzmaurice","year":"2011","unstructured":"Fitzmaurice GM, Laird NM, Ware JH. Applied longitudinal analysis. New Jersey: John Wiley & Sons, Inc; 2011."},{"key":"4315_CR46","volume-title":"Managing missing data in patient registries: Addendum to registries for evaluating patient outcomes: a user\u2019s guide","author":"C Mack","year":"2018","unstructured":"Mack C, Su Z, Westreich D. Managing missing data in patient registries: Addendum to registries for evaluating patient outcomes: a user\u2019s guide. USA: Agency for Healthcare Research and Quality; 2018."},{"key":"4315_CR47","doi-asserted-by":"publisher","first-page":"e2","DOI":"10.1016\/j.jcpo.2013.04.002","volume":"1","author":"PJ Ford","year":"2013","unstructured":"Ford PJ, Farah CS. Early detection and diagnosis of oral cancer: strategies for improvement. J Cancer Policy. 2013;1:e2\u20137.","journal-title":"J Cancer Policy"},{"issue":"1","key":"4315_CR48","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/j.1752-7325.2008.00095.x","volume":"69","author":"SE Scott","year":"2009","unstructured":"Scott SE, Grunfeld EA, Auyeung V, McGurk M. Barriers and triggers to seeking help for potentially malignant oral symptoms: implications for interventions. J Public Health Dent. 2009;69(1):34\u201340.","journal-title":"J Public Health Dent"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04315-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-024-04315-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04315-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T15:02:43Z","timestamp":1715958163000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-024-04315-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,17]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4315"],"URL":"https:\/\/doi.org\/10.1186\/s12903-024-04315-5","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,17]]},"assertion":[{"value":"10 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The protocol and all study procedures were approved by the Research Ethics Committee of Tehran University of Medical Sciences (ethical code: IR.TUMS.DENTISTRY.REC.1400.189). The research was conducted in accordance with the principles and guidelines of the Declaration of Helsinki. Written informed consent was obtained from all participants before their involvement in the study. For individuals aged 15 to 18 years, written informed consent was obtained from their parents and\/or legal guardians. Subjects were assured that they could withdraw from the study at any time and that their personal information would be kept confidential.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"577"}}