Effect of a tele-orthodontics platform on knowledge, attitudes, and practices among orthodontic professionals in Yemen: a single-arm pretest–posttest intervention study
TL;DR
The tele-orthodontics platform provided a small increase in knowledge, although the high baseline scores and the limitation of the 3-point scale’s ceiling effect might have restricted this result.
Abstract
To evaluate the effect of a tele-orthodontics platform on orthodontists’ and orthodontic residents’ knowledge, attitudes, and practices (KAP) in Yemen, as well as to assess the platform’s acknowledged benefits, obstacles, and consultants’ responsiveness. This single-arm pretest, posttest quasi-experimental study initially identified 210 orthodontic professionals academically registered in Yemen; after exclusions and a pilot phase, 80 participants were recruited from January 2023 to March 2025. Participants completed a KAP questionnaire at baseline, after which they were given access to a custom-designed tele-orthodontics platform for one year, where they could receive asynchronous consultant feedback. Subsequently, they completed the post-intervention questionnaire. Normality of data was confirmed (Shapiro, Wilk, p > 0.05), and construct validity was supported by principal component analysis (KMO = 0.917, Bartlett’s p < 0.001), which identified three factors explaining 58.04% of variance. Paired-samples t-tests were used for primary analysis, while subgroups were compared using t-tests/ANOVA and chi-square tests. Effect sizes (Cohen’s d, η², Cramér’s V) were presented. The 80 participants (mean age 33.8 ± 4.5 years; females 61.25%; orthodontic residents 81.25%) demonstrated high baseline knowledge (2.70 ± 0.34), positive attitudes (3.71 ± 0.71), and moderate practice (3.35 ± 0.61). After the intervention, knowledge was significantly higher ( p = 0.007) with a small effect size (d = 0.43), however, attitudes and practices did not change ( p > 0.05). Within-group exploratory analyses showed modest knowledge gains, with females showing the largest improvement ( p < 0.001, d = 0.74, medium effect). Between-groups analyses only found a difference in knowledge improvement between genders in favor of females ( p = 0.025, d = 0.49, small-to-medium). Major barriers included technical problems (80%) and concerns about privacy (30%). Moreover, half rated the benefits of using the platform as good, and 45% rated the responsiveness of the consultant as good. The tele-orthodontics platform provided a small increase in knowledge, although the high baseline scores and the limitation of the 3-point scale’s ceiling effect might have restricted this result. Attitudes and practices did not change, which points to a continuing disconnect between acquiring knowledge and clinical adaptation. Similar knowledge gains regardless of level of engagement indicate that even indirect exposure can help to strengthen knowledge.