{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:40:13Z","timestamp":1787730013583,"version":"build-2784847793"},"reference-count":64,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swiss Government Excellence Scholarship","award":["#2021.0876\/Iran\/OP"],"award-info":[{"award-number":["#2021.0876\/Iran\/OP"]}]},{"name":"Department of Community Oral Health, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran","award":["#2021.0876\/Iran\/OP"],"award-info":[{"award-number":["#2021.0876\/Iran\/OP"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Nudge theory proposes using subtle interventions to encourage individuals to make better decisions. The aim of this study was to evaluate the effectiveness of the Nudge theory in plaque control and assess caries experience among third-grade primary schoolchildren with refugee and immigrant backgrounds in Mashhad, Iran. Moreover, Afghan and Iranian schoolchildren were compared to assess differences in oral health outcomes. A quasi-experimental field trial was conducted in three public primary schools, comprising 309 participants approximately 9 years old. Interventions were randomly assigned to three schools: School I Messages based on Social Norms (MSN), School II Messages based on Fear of Negative Outcome (MFNO), and School III control group (C). MSN and MFNO received customized motivational video clips at baseline, while C only received Oral hygiene instruction (OHI). All participants received OHI, a brush, and toothpaste. Baseline plaque index (PI) and caries experience in primary and permanent dentition (dmft\/DMFT) were recorded. PI was reassessed at two weeks, two months, and six months post-intervention. All data were subjected to statistical analysis. The mean PI decreased significantly in all three groups at the two-week follow-up (p &lt; 0.01). The PI improvements declined over a six-month follow-up period in all groups, and the mean PI difference after six months compared to the pre-intervention was significant only in MSN and MFNO (p &lt; 0.01), while C reverted almost to the pre-study level. Schoolchildren with at least one filled tooth or Iranian nationality showed a greater PI reduction (p &lt; 0.01, p = 0.05). The overall mean \u00b1 SD dmft and DMFT were 4.24 \u00b1 2.11 and 1.70 \u00b1 1.24, respectively. Among all the examined participants, 32 (10.40%) individuals were caries-free. The mean dmft was statistically significantly higher in Afghan children than in Iranians (p = 0.01). MSN was more effective on PI reduction in the short term, while MFNO was more long-lasting. Using the Nudge theory via visual aids was more effective in motivating children to perform better oral self-care than solely traditional OHI.<\/jats:p>","DOI":"10.3390\/dj12070228","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T15:15:19Z","timestamp":1721402119000},"page":"228","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating the Effectiveness of the Nudge Theory in Improving the Oral Self-Care of Schoolchildren with Refugee and Immigrant Backgrounds in Mashhad, Iran"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0385-0727","authenticated-orcid":false,"given":"Seyed Ahmad","family":"Banihashem Rad","sequence":"first","affiliation":[{"name":"Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland"},{"name":"Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Esteves-Oliveira","sequence":"additional","affiliation":[{"name":"Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland"},{"name":"Department of Restorative Dentistry and Endodontology, Justus-Liebig-University Giessen, 35390 Giessen, Germany"},{"name":"Department of Conservative Dentistry, Periodontology and Endodontology, University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery (UZMK), University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9531-0102","authenticated-orcid":false,"given":"Ali","family":"Kazemian","sequence":"additional","affiliation":[{"name":"Department of Community Oral Health, School of Dentistry, Mashhad University of Medical Sciences, Mashhad 9177948959, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5651-3634","authenticated-orcid":false,"given":"Negar","family":"Azami","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Mashhad University of Medical Sciences, Mashhad 9177948959, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4835-8872","authenticated-orcid":false,"given":"Mehrzad","family":"Khorshid","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Mashhad University of Medical Sciences, Mashhad 9177948959, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylin","family":"Sohrabi","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Mashhad University of Medical Sciences, Mashhad 9177948959, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Attaran Khorasani","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Mashhad University of Medical Sciences, Mashhad 9177948959, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8573-485X","authenticated-orcid":false,"given":"Guglielmo","family":"Campus","sequence":"additional","affiliation":[{"name":"Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland"},{"name":"Department of Cariology, Saveetha Dental College and Hospitals, SIMATS DEEMED University, Chennai 600077, India"},{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1017\/S0020818321000369","article-title":"Forced displacement and asylum policy in the developing world","volume":"76","author":"Blair","year":"2022","journal-title":"Int. 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