Using Intervention Mapping to Develop ISAC, a Comprehensive Intervention for Early Detection and Prevention of Oral Cancer in Saudi Arabia

Oral cancer forms a major public health issue. In Saudi Arabia, Jazan region has the highest rate of oral cancer; > 35% of total cases. Furthermore, dentists' engagement in oral cancer screening and patient education in Jazan region is limited. This paper aimed to describe the process used to develop a comprehensive oral cancer (OC) practice intervention to be implemented in dental clinics. The intervention was informed by the six steps of intervention mapping (IM). Steps 1-3 included mixed methods approach of reviewing relevant existing literature, focus group discussions, observations, one-on-one interviews, and questionnaires utilizing the community participatory approach. Step 4 used information form steps 1-3 to develop the intervention components and its associated tools to facilitate its delivery. Steps 5 and 6 specified the prospective plans for implementation and evaluation. ISAC is the developed intervention that comprises the following: Informing dental patients about performing routine OC screenings, Screenings for OC, Advising patients, and Connecting patients to the required services. ISAC practical applications were clustered into two components: (a) didactical session covering aspects related to OC practices and introducing ISAC and (b) practical session that included a step-by-step modeling of the intervention. Using IM facilitated the systematic planning of the ISAC intervention that covers the main issues revealed by the need's assessments. Working towards developing the ISAC required extensive work in assessing dental public health issues in a specific context with limited data - and this constituted a great challenge. The development of the ISAC was a lesson that casts light on the advantages of engaging multidisciplinary expertise to tackle serious public health issue like OC.