Riley Joseph L, Gilbert Gregg H, Heft Marc W
Division of Public Health Services and Research, College of Dentistry University of Florida, Gainesville, FL, USA.
Community Dent Oral Epidemiol. 2006 Aug;34(4):289-98. doi: 10.1111/j.1600-0528.2006.00280.x.
Behavioral science postulates that underlying characteristics of populations, rather than sociodemographic groupings, are more proximal causes of oral health disparities through differing oral health behaviors. To our knowledge this is the first report in the literature that examines longitudinal correlates of oral health and dental care using groups of persons holding similar attitudes and beliefs.
The subjects were 873 participants in the Florida Dental Care Study, a longitudinal study of oral health among dentate adults. Hierarchical cluster analysis identified four groups with similar dental attitudes that were labeled 'favorable attitudes about dental care', 'frustrated believers in dental care', 'negative attitudes and cost concerns', 'pessimistic about personal and professional oral care'.
The attitudinal groups cut across race, sex, and age with race and educational status the best discriminators among sociodemographic and economic variables. The negative attitude group reported the least preventive care and the largest oral health decrements on clinical examination at baseline and 24 months. The group with favorable attitudes about dental care reported the highest number of preventive and restorative visits and the lowest point-prevalence of toothache pain, temperature sensitivity, and painful gums. The frustrated believers have access to dental care equivalent to the favorable attitude group, but may delay seeking dental care until oral disease becomes more severe, based on their pattern of preventive, restorative, and dental extraction visits. Additional group differences on oral health and dental care are reported.
This study takes a novel approach to examining oral healthy disparities. Differences in oral health behaviors support the validity of the groups.
行为科学假定，人群的潜在特征而非社会人口统计学分组，是通过不同的口腔健康行为导致口腔健康差异的更直接原因。据我们所知，这是文献中首份使用持有相似态度和信念的人群组来研究口腔健康和牙科护理纵向相关性的报告。
研究对象为佛罗里达牙科护理研究中的873名参与者，该研究是一项针对有牙成年人的口腔健康纵向研究。分层聚类分析确定了四组具有相似牙科态度的人群，分别标记为“对牙科护理持积极态度”、“对牙科护理感到沮丧的相信者”、“消极态度和成本担忧”、“对个人和专业口腔护理持悲观态度”。
态度分组跨越种族、性别和年龄，其中种族和教育程度是社会人口统计学和经济变量中最佳的区分因素。消极态度组在基线和24个月时报告的预防性护理最少，临床检查中口腔健康下降幅度最大。对牙科护理持积极态度的组报告的预防性和修复性就诊次数最多，牙痛、温度敏感和牙龈疼痛的时点患病率最低。感到沮丧的相信者获得的牙科护理与积极态度组相当，但根据他们的预防性、修复性和拔牙就诊模式，他们可能会推迟寻求牙科护理，直到口腔疾病变得更严重。报告了在口腔健康和牙科护理方面的其他组间差异。
本研究采用了一种新颖的方法来研究口腔健康差异。口腔健康行为的差异支持了这些分组的有效性。
