Effectiveness of Motivational Interviewing: Face-to-face Individual Counseling vs Online Group

Objectives: This randomized controlled trial aimed to compare the effectiveness of two modes of motivational interviewing (MI), i.e., face-to-face individual counseling and online groups, with prevailing health education (HE) in improving adolescents’ oral health.
Methods: Twelve (12) schools were randomly assigned into 3 groups, receiving HE (Group I), face-to-face individual MI (Group II) and online group MI (Group III) respectively. Overall, 489 adolescents (12-13 years old) with infrequent toothbrushing and/or frequent snacking were recruited, with 158, 169 and 162 adolescents in Group I-III. Information on socio-demographic factors, oral health self-efficacy and behaviors, oral hygiene and caries status was collected through questionnaires and dental examinations at baseline and after 12 months.
Results: There was no significant difference in key socio-demographic, behavioral and clinical variables among three groups at baseline. After 12 months, compared with Group I, significantly higher likelihood of increasing toothbrushing frequency was observed in Group II [OR(95%CI): 1.65(1.02,2.68);p=0.041], whilst no significant difference was detected between Group III and Group I (p>0.05). Significantly lower plaque score was found in Group II [β(95%CI):-0.49(-0.98,0.00); p=0.049] and Group III [β(95%CI):-0.54(-1.04,-0.05);p=0.034], as compared with Group I, whereas Group II did not differ from Group III (p>0.05). Taking Group I as reference, a significantly lower number of teeth with new early caries lesion △D_{ICDASII 1-2}T was found in Group II [β(95%CI): -2.26(-4.03,-0.49);p=0.018] and Group III [β(95%CI):-2.57(-4.35,-0.79);p=0.009], with no significant difference between Group II and Group III (p>0.05). However, there was no significant difference among three groups in terms of number of teeth with new cavitated lesions △D_ICDASII3-6MFT (p>0.05). No significant difference was detected in both intervention groups, compared with Group I, in terms of self-efficacy and snacking behavior.
Conclusions: Both face-to-face individual MI and online group MI outperformed HE in improving adolescents’ oral health behaviors, oral hygiene status and caries status.