J Med Internet Res. 2026 Jun 15;28:e95562. doi: 10.2196/95562.
ABSTRACT
BACKGROUND: Refugees frequently face language and access barriers to preventive oral health information. Brief multilingual digital interventions may help reduce such barriers in shelter settings.
OBJECTIVE: This randomized controlled trial evaluated whether a multilingual digital microlearning video improved plaque control and selected self-reported oral health-related behaviors among adults living in refugee shelters.
METHODS: A 2-arm, parallel-group randomized controlled trial was conducted among 86 adults living in 2 municipal refugee shelters in Germany. Participants were randomized (1:1) to receive either a multilingual 4-minute oral hygiene microlearning video or delayed access (control group). Plaque index and gingival index were assessed clinically at baseline and at 2-month follow-up. Secondary outcomes included questionnaire-based measures of oral health literacy-related cognitions and self-reported oral health behaviors. Between-group differences in change scores were analyzed using 2-sided tests; exploratory multivariable regression analyses were conducted to assess potential effect modifiers.
RESULTS: Follow-up was completed by 83 (97%) of 86 participants. Plaque index decreased more in the intervention group than in the control group (mean change -0.21, SD 0.27 vs mean change -0.04, SD 0.17; P=.002). Gingival index decreased in both groups, but the between-group difference was not significant. Among questionnaire-based outcomes, toothbrushing frequency increased substantially, whereas the remaining oral health literacy-related items showed small numerical changes that did not reach statistical significance or remained stable. Approximately three-quarters of participants in the intervention group (32/42, 76%) reported reviewing the video at least once.
CONCLUSIONS: Brief multilingual digital microlearning improved plaque control and self-reported toothbrushing frequency in refugee shelters. Effects on broader oral health literacy-related outcomes were limited and should be interpreted cautiously. Larger, prospectively powered trials with longer follow-up periods and blinded outcome assessment are warranted.
PMID:42296536 | DOI:10.2196/95562
