Alwadi Maram Ali M, Vettore Mario Vianna
Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Community Dent Oral Epidemiol. 2017 Aug;45(4):356-364. doi: 10.1111/cdoe.12298. Epub 2017 Mar 31.
The aim of this study was to test the association of contextual school and home environmental characteristics and individual factors with oral health-related quality of life (OHRQoL) in a representative sample of Brazilian adolescents and young adults.
Individual-level data from 3854 fifteen- to nineteen-year-olds who participated in the Brazilian Oral Health Survey were pooled with contextual city-level data. The dependent variable was the frequency of impacts of oral disorders on daily performances (OIDP extent), as a measure of OHRQoL. Contextual school and home environmental characteristics were categorized into three equal groups according to tertiles of the contextual variable's scores (low, moderate and high). Individual demographic, socioeconomic and oral clinical measures were the covariates. The association between contextual and individual characteristics and OIDP extent was estimated using multilevel Poisson regression models.
The mean of OIDP extent was 0.9 (standard error 0.1). Adolescents and young adults living in the cities with high levels of lack of security at school (RR 1.33; 95% CI=1.02-1.74), moderate levels of bullying at school (RR 1.56; 95% CI=1.20-2.03) and moderate levels of low maternal schooling (RR 1.43; 95% CI=1.06-1.92) had a higher mean OIDP extent. Male sex, higher age, skin colour, poor individual socioeconomic status and worse oral clinical measures were also associated with higher mean of OIDP extent.
Poor school and home environmental characteristics were independently associated with poor OHRQoL in individuals aged between 15 and 19 years. Our findings suggest the place where they study and the maternal level of education are meaningful aspects for their oral health.
本研究旨在检验巴西青少年和青年代表性样本中学校和家庭环境背景特征及个体因素与口腔健康相关生活质量（OHRQoL）之间的关联。
将参与巴西口腔健康调查的3854名15至19岁青少年的个体层面数据与城市层面的背景数据进行汇总。因变量是口腔疾病对日常表现的影响频率（OIDP程度），作为OHRQoL的一项指标。根据背景变量得分的三分位数，将学校和家庭环境背景特征分为三个相等的组（低、中、高）。个体人口统计学、社会经济和口腔临床指标为协变量。使用多水平泊松回归模型估计背景和个体特征与OIDP程度之间的关联。
OIDP程度的均值为0.9（标准误0.1）。生活在学校安全水平低（相对风险1.33；95%置信区间=1.02 - 1.74）、学校欺凌水平中等（相对风险1.56；95%置信区间=1.20 - 2.03）以及母亲受教育程度低水平中等（相对风险1.43；95%置信区间=1.06 - 1.92）城市的青少年和青年，其OIDP程度均值较高。男性、年龄较大、肤色、个体社会经济地位差以及口腔临床指标较差也与OIDP程度均值较高有关。
学校和家庭环境背景特征差与15至19岁个体的OHRQoL差独立相关。我们的研究结果表明，他们学习的场所和母亲的教育水平对其口腔健康具有重要意义。
