title: Effect of social media in improving knowledge among patients having fixed appliance orthodontic treatment: A single-center randomized controlled trial.
abstract: BACKGROUND
  Research has shown that orthodontic patients are more likely to retain information presented in an audiovisual format. However, there has been little research on the effectiveness of audiovisual information provided through different routes such as the Internet. This parallel-group randomized controlled trial assessed whether provision of audiovisual information on the YouTube (Google, San Bruno, Calif) Web site to orthodontic patients undergoing fixed appliance treatment results in improved patient knowledge when compared with conventional methods of information provision. The effects of sex and ethnicity were also investigated.
  
  
  METHODS
  Participants were recruited from the Department of Orthodontics of the Eastman Dental Hospital, University College London Hospitals NHS Foundation Trust, United Kingdom. The patients were 13 years of age and over, with no history of orthodontic treatment, and patient and parental (where appropriate) consent were obtained. The participants were randomized into control (n = 34) and intervention (n = 33) groups using a random number table; there was stratification based on age group, with permuted blocks of 10 patients. Both groups were given routine verbal and written patient information related to fixed appliances, and the participants in the intervention group were sent 3 e-mails over 6 weeks requesting that they view a 6-minute YouTube video containing similar information but in audiovisual format. Patient knowledge was measured using identical questionnaires answered on the day of recruitment (baseline) and again 6 to 8 weeks later. The researchers were unaware of group allocations when enrolling patients and scoring questionnaires.
  
  
  RESULTS
  Sixty participants (89.55%) completed the study. Those who completed the trial in the intervention group (n = 30) demonstrated significantly greater improvements in knowledge than did those in the control group (n = 30), scoring, on average, almost 1 point more (95% CI for the difference, 0.305-1.602; P = 0.005) on the final questionnaire. Ethnicity had a statistically significant effect on improvement in knowledge, but sex did not. No harm to any patient was noted during the trial.
  
  
  CONCLUSIONS
  Presenting audiovisual information through the YouTube Web site to orthodontic patients resulted in a significant improvement in patient knowledge. Supplementation of verbal and written patient information with audiovisual information via the Internet is therefore worthy of consideration.
  
  
  BACKGROUND
  National Research and Ethics Service (REC number 12/LO/0863), United Kingdom.
  
  
  METHODS
  The protocol was not published before trial commencement.
  
  
  BACKGROUND
  No funding or conflict of interest to be declared.
authors.affiliation: Honorary specialist registrar, Department of Orthodontics, University College London Eastman Dental Institute, London, United Kingdom. Electronic address: fsilwadi@gmail.com.
authors.forename: Fadi M
authors.initials: FM
authors.lastname: Al-Silwadi
authors.affiliation: Consultant orthodontist, Department of Orthodontics, Eastman Dental Hospital, University College London Hospitals NHS Foundation Trust, London, United Kingdom; consultant orthodontist, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
authors.forename: Daljit S
authors.initials: DS
authors.lastname: Gill
authors.affiliation: Unit head, Department of Biostatistics, University College London Eastman Dental Institute, London, United Kingdom.
authors.forename: Aviva
authors.initials: A
authors.lastname: Petrie
authors.affiliation: Professor, Department of Orthodontics, University College London Eastman Dental Institute, London, United Kingdom.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D003142:Communication; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D009967:Orthodontic Appliances; D010353:Patient Education as Topic / Q000379:methods; D011446:Prospective Studies; D012737:Sex Factors; D061108:Social Media; D011795:Surveys and Questionnaires; D014741:Video Recording