Content Analysis of School Textbooks for Oral Health Promotion Information, among Six States/Union Territories of North India: A Mixed-method Study
Abstract
Background: Textbooks are key tool for promoting oral health education, yet their inclusion in Indian school textbooks remains underexplored. Despite schools being key platforms for healthy behaviors, few studies have evaluated oral health information in textbooks. This study aimed to evaluate adequacy, accuracy, and acceptability of oral health information in school textbooks from six northern Indian states and union territories, identifying gaps for improvement. Methods: A mixed-method study was conducted including textbooks from Punjab, Haryana, Himachal Pradesh, Jammu and Kashmir, Ladakh, and Chandigarh. Textbooks were assessed using oral health education curriculum analysis tool (O-HECAT), developed and validated through expert consultation for this study. Evaluation was performed by public health professionals, oral health experts, teachers, and parents. The tool’s content validity was confirmed through both qualitative and quantitative expert consultations and assessments across three levels: (i) Oral health module analysis, (ii) Textbook accuracy and acceptability, and (iii) Curriculum comparison. Results: A total of 123 textbooks were reviewed, ICSE board had the most comprehensive oral health content, while state boards like Haryana and Jammu and Kashmir had minimal coverage. Accuracy analysis revealed minor errors included terms like “teeth cancer” and unrealistic statements (e.g., sparkling white teeth). The content validation of O-HECAT tool revealed scale-level content validity index (CVI) universal agreement = 0.70 and scale-level CVI average = 0.89. Multiple curriculum analysis showed ICSE board score of 8 and Punjab board score of 7. Conclusion: Significant gaps exist in textbook oral health content, particularly in state boards, and even the ICSE board, although performing best, contained inaccuracies. Standardized, evidence-based curriculum updates and teacher training are needed to strengthen oral health education nationwide.
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BibTeX
@article{atodaria2026content,
title = {{Content Analysis of School Textbooks for Oral Health Promotion Information, among Six States/Union Territories of North India: A Mixed-method Study}},
author = {Dimple Atodaria and Arpit Gupta and Diptajit Das and Neha Patyal and Ashima Goyal},
journal = {Contemporary Clinical Dentistry},
year = {2026},
month = jul,
doi = {10.4103/ccd.ccd_100_26},
url = {https://doi.org/10.4103/ccd.ccd_100_26},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Content Analysis of School Textbooks for Oral Health Promotion Information, among Six States/Union Territories of North India: A Mixed-method Study
AU - Dimple Atodaria
AU - Arpit Gupta
AU - Diptajit Das
AU - Neha Patyal
AU - Ashima Goyal
PY - 2026
DA - 2026/07/01
JO - Contemporary Clinical Dentistry
DO - 10.4103/ccd.ccd_100_26
UR - https://doi.org/10.4103/ccd.ccd_100_26
AB - Background: Textbooks are key tool for promoting oral health education, yet their inclusion in Indian school textbooks remains underexplored. Despite schools being key platforms for healthy behaviors, few studies have evaluated oral health information in textbooks. This study aimed to evaluate adequacy, accuracy, and acceptability of oral health information in school textbooks from six northern Indian states and union territories, identifying gaps for improvement. Methods: A mixed-method study was conducted including textbooks from Punjab, Haryana, Himachal Pradesh, Jammu and Kashmir, Ladakh, and Chandigarh. Textbooks were assessed using oral health education curriculum analysis tool (O-HECAT), developed and validated through expert consultation for this study. Evaluation was performed by public health professionals, oral health experts, teachers, and parents. The tool’s content validity was confirmed through both qualitative and quantitative expert consultations and assessments across three levels: (i) Oral health module analysis, (ii) Textbook accuracy and acceptability, and (iii) Curriculum comparison. Results: A total of 123 textbooks were reviewed, ICSE board had the most comprehensive oral health content, while state boards like Haryana and Jammu and Kashmir had minimal coverage. Accuracy analysis revealed minor errors included terms like “teeth cancer” and unrealistic statements (e.g., sparkling white teeth). The content validation of O-HECAT tool revealed scale-level content validity index (CVI) universal agreement = 0.70 and scale-level CVI average = 0.89. Multiple curriculum analysis showed ICSE board score of 8 and Punjab board score of 7. Conclusion: Significant gaps exist in textbook oral health content, particularly in state boards, and even the ICSE board, although performing best, contained inaccuracies. Standardized, evidence-based curriculum updates and teacher training are needed to strengthen oral health education nationwide.
SN - 0976-237X
SN - 0976-2361
ER -