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      Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo - Arusha school health project (LASH): A cross-sectional study

      , 1 , 2 , 3 , 3 , 1 , 2

      BMC Pediatrics

      BioMed Central

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          Abstract

          Background

          Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.

          Methods

          Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).

          Results

          44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.

          Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.

          Conclusion

          Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.

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          Most cited references 34

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          The moderator-mediator variable distinction in social the moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations.

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            Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale.

            Socioeconomic inequalities in adolescent health have been little studied until recently, partly due to the lack of appropriate and agreed upon measures for this age group. The difficulties of measuring adolescent socioeconomic status (SES) are both conceptual and methodological. Conceptually, it is unclear whether parental SES should be used as a proxy, and if so, which aspect of SES is most relevant. Methodologically, parental SES information is difficult to obtain from adolescents resulting in high levels of missing data. These issues led to the development of a new measure, the Family Affluence Scale (FAS), in the context of an international study on adolescent health, the Health Behaviour in School-Aged Children (HBSC) Study. The paper reviews the evolution of the measure over the past 10 years and its utility in examining and explaining health related inequalities at national and cross-national levels in over 30 countries in Europe and North America. We present an overview of HBSC papers published to date that examine FAS-related socioeconomic inequalities in health and health behaviour, using data from the HBSC study. Findings suggest consistent inequalities in self-reported health, psychosomatic symptoms, physical activity and aspects of eating habits at both the individual and country level. FAS has recently been adopted, and in some cases adapted, by other research and policy related studies and this work is also reviewed. Finally, ongoing FAS validation work is described together with ideas for future development of the measure.
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              Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors.

              A major assumption underlying youth health promotion has been that physiological risk factors track from childhood into adulthood. However, few studies have systematically examined how behaviors change during adolescence. This paper describes longitudinal tracking of adolescent health behaviors in two Minnesota Heart Health Program communities. Beginning in sixth grade (1983), seven annual waves of behavioral measurements were taken from both communities (baseline n = 2376). Self-reported data included smoking behavior, physical activity, and food preferences. A progressive increase in the change to weekly smoking status was observed across the smoking status categories. As students began to experiment with smoking, they were more likely to either begin to be or remain regular smokers. Tracking of physical activity and food choice variables was also apparent. In nearly all the follow-up periods, the students identified at baseline as measuring high remained high, and those measuring low remained low. These results indicate that there is evidence of early consolidation and tracking of physical activity, food preference, and smoking behavior. The early consolidation of health behaviors implies that interventions should begin prior to sixth grade, before behavioral patterns are resistant to change. The smoking results suggest that students are experiencing difficulty quitting smoking; thus, youth smoking cessation interventions are warranted.
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                Author and article information

                Affiliations
                [1 ]Department of Clinical Dentistry, Community Dentistry, University of Bergen, Bergen, Norway
                [2 ]Centre for International Health, University of Bergen, Bergen, Norway
                [3 ]Department of Preventive and Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
                Contributors
                Journal
                BMC Pediatr
                BMC Pediatrics
                BioMed Central
                1471-2431
                2010
                30 November 2010
                : 10
                : 87
                3001697
                1471-2431-10-87
                21118499
                10.1186/1471-2431-10-87
                Copyright ©2010 Mbawalla et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research Article

                Pediatrics

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