1 Department of Community Dentistry, University of Turku, Finland.
2 Turku Clinical Research Centre, Turku University Hospital, Turku, Finland.
Scand J Public Health. 2019 Jul;47(5):576-582. doi: 10.1177/1403494818812641. Epub 2018 Nov 29.
In 2007, Finnish authorities gave a national recommendation that schools should not sell sweet products. This study aimed to determine the effects of the national recommendation on school-level intermediary determinants (factors related to oral health inequalities) and if the changes were different according to school-level socio-economic position (SEP). : This ecological and longitudinal study combined school-level data from two independent studies from Finnish upper comprehensive schools ( = 970): the School Health Promotion study (SHPS) and the School Sweet Selling survey (SSSS). The baseline data (SHPS from 2006-2007 and SSSS from 2007) and the post-intervention data (SHPS and SSSS from 2008-2009) were combined into a longitudinal school-level data set ( = 360 and response rate = 37%). The intermediary determinants were: attitudes and access to intoxicants, school health services, school environment, home environment, schools' health-promoting actions (including sweet product selling) and pupils' eating habits. Three equal-sized school-level SEP group - slow, middle and high - were formed. The changes in the intermediary determinants were analysed using Wilcoxon Signed Ranks test. Differences between school SEP groups were analysed the using Kruskal-Wallis test. Longitudinal linear mixed modelling was used to determine the contribution of intermediary determinants to the changes in pupils' eating habits. : The national recommendation was effective in decreasing sweet product selling at schools and the effect was equal in each school-level SEP group. Intermediary determinants contributed differently to eating habits in the three SEP groups.
2007 年，芬兰当局发布了一项全国性建议，要求学校停止销售含糖产品。本研究旨在确定该建议对学校层面中间决定因素（与口腔健康不平等相关的因素）的影响，以及这些变化是否因学校层面的社会经济地位（SEP）而异。本生态纵向研究结合了芬兰综合性高中的两项独立研究（=970）的学校层面数据：学校健康促进研究（SHPS）和学校甜食销售调查（SSSS）。将基线数据（SHPS 来自 2006-2007 年，SSSS 来自 2007 年）和干预后数据（SHPS 和 SSSS 来自 2008-2009 年）合并到一个纵向学校层面数据集（=360，响应率=37%）。中间决定因素包括：态度和接触成瘾物质、学校卫生服务、学校环境、家庭环境、学校促进健康的行动（包括销售甜食）和学生的饮食习惯。根据 SEP 形成了三个均等规模的学校层面组：慢、中、高。使用 Wilcoxon 符号秩检验分析中间决定因素的变化。使用 Kruskal-Wallis 检验分析学校 SEP 组之间的差异。使用纵向线性混合模型确定中间决定因素对学生饮食习惯变化的贡献。全国性建议在减少学校销售含糖产品方面是有效的，而且在每个学校层面的 SEP 组中效果都是均等的。中间决定因素在三个 SEP 组中对饮食习惯的贡献不同。
