Abstract: The primary aim of the dissertation was to develop and evaluate a smartphone app, the WhiteTeeth app, designed to promote good oral health behaviour and oral hygiene among adolescent orthodontic patients between the ages of 12 and 16. The app's development and evaluation was guided methodically by intervention mapping (IM). Development thus starts with an analysis of the health problem and the identification of the psychosocial factors and health behaviour related to it. To identify the psychosocial factors underlying oral health behaviour in our target group, a systematic literature review with meta-analysis was conducted,a cross-sectional clinical study and semi-structured interviews. Then, to target these psychosocial factors and facilitate continuous behavioural support, various behaviour-changing techniques were incorporated into the app. The app provides feedback on users' oral health behaviour and allows users to evaluate and monitor their behaviour. Finally, a randomised controlled trial was conducted. This showed that the app had improved oral hygiene in adolescent orthodontic patients after 12 weeks.
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Worldwide, schools implement social-emotional learning programs to enhance students' social-emotional skills. Although parents play an essential role in teaching these skills, knowledge about their perspectives on social-emotional learning is limited. In providing insight into the perspectives of parents from adolescent students this paper adds to this knowledge. An explorative qualitative study was conducted to gain insight into parents' perspectives on adolescent social-emotional learning. A broadly used professional framework for social emotional learning was used as a frame of reference in interviews with parents from diverse backgrounds. Within and across case analyses were applied to analyze the interviews. A conceptual model of four social-emotional skills constructs considered crucial learning by parents emerged from the data: respectful behavior, cooperation, self-knowledge and self-reliance. Parents' language, interpretations and orderings of skills indicate that the model underlying these constructs differs from skills embedded in the professional framework.
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The worldwide obesity epidemic is a major and complex problem, resulting from the interaction of individual metabolic, genetic, and psychological factors with meso- and macro environmental factors. Adolescents, with their rapid changes in body composition, together with their shift in orientation from the direct family to the peer-related environment, are particularly vulnerable to unhealthy changes in life style. Habits with respect to food and physical activity tend to change substantially in this period as compared to earlier childhood, and peers seem to play an important role in shaping the behavior of adolescents. Adolescents tend to mimic their peers' behavior related to both healthy and unhealthy food choices as well as to physical activity and sports participation. This influence of peers depends on environmental circumstances such as availability of snacks, and is affected by individual psychological and demographic factors, and by macro-environmental factors such as cultural and social norms, legislation, food distribution, and media and advertising. A rapidly expanding source of influence on health behavior are media such as television, the internet (e.g., Facebook, twitter), and smartphones. These media may enhance overweight and reduce physical strength by reinforcing a sedentary life. However, potentially these media could be used to monitor and influence snacking behavior and physical activity for the better. An example of the use of new technology to enhance health behavior is the 'Wii' home video game. Using insights from social psychology, thoughtful choice architecture can be established to nudge adolescents to choose what is best for them without restricting freedom of choice and to help them with really implementing healthy intentions. A challenge for the coming decade is to develop 'Apps' aimed to decrease adolescent obesity while making use of social networks.
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