促进健康学校策略对台湾高龋农村地区学童牙菌斑控制和预防行为的影响：一项准实验设计。

Effects of health-promoting school strategy on dental plaque control and preventive behaviors in schoolchildren in high-caries, rural areas of Taiwan: a quasi-experimental design.

机构信息

Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City, 80708, Taiwan.

Department of Oral Hygiene, Tzu Hui Institute of Technology, No.367 Sanmin Rd., Nanzhou, Pingtung, 92641, Taiwan.

出版信息

BMC Oral Health. 2021 Nov 8;21(1):573. doi: 10.1186/s12903-021-01927-z.

DOI:10.1186/s12903-021-01927-z

PMID:34749720

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8573891/

Abstract

BACKGROUND

We evaluated the effects of health-promoting school (HPS) strategy on plaque control and behavior change in high-caries schoolchildren in Taitung, Taiwan.

METHODS

A quasi-experimental design was adopted; six intervention schools (intervention group [IG]) and six comparison schools (comparison group [CG]) were selected from elementary schools with higher-than-average caries rates (> 68%). The IG was selected using cluster sampling, and the CG was selected to match the IG. In total, the IG and CG groups included 166 and 174 children each. The selected schools implemented the HPS framework for 3 months in the 2019 academic year. An oral examination of dental plaque was administered, and a self-administered questionnaire regarding knowledge, attitude, self-efficacy, and behaviors was distributed at baseline and at 2-week follow-up. A linear and logistic regression model using generalized estimating equations (GEEs) was used to analyze the differences between baseline and the follow-up data.

RESULTS

Compared with the CG, the IG had a greater reduction in plaque index among second graders (β = - 0.36) and plaque control record scores among second, fourth, and sixth graders (β = - 27.48, - 26.04, and - 18.38, respectively). The IG also exhibited a greater increase at follow-up with respect to oral health-related knowledge among second graders and fourth graders (β = 1.46 and β = 0.92, respectively), attitude toward oral hygiene behaviors among sixth graders (β = 1.78), and self-efficacy regarding flossing for sixth graders (β = 1.43). Sixth graders in the IG were significantly more likely to brush before sleeping (adjusted odds ratio [aOR] = 2.99) and use fluoride toothpaste (aOR = 5.88) than those in the CG.

CONCLUSIONS

The HPS strategy was effective in reducing dental plaque and promoting preventing behaviors in rural high-caries schoolchildren.

摘要

背景

我们评估了健康促进学校（HPS）策略对台东台东县高龋学生菌斑控制和行为改变的影响。

方法

采用准实验设计；从龋病发病率高于平均水平（>68%）的小学中选择了六所干预学校（干预组[IG]）和六所对照学校（对照组[CG]）。采用聚类抽样选择 IG，选择 CG 以匹配 IG。IG 和 CG 组各包括 166 名和 174 名儿童。所选学校在 2019 学年实施了 HPS 框架 3 个月。进行了口腔菌斑检查，并在基线和 2 周随访时发放了关于知识、态度、自我效能和行为的自我管理问卷。使用广义估计方程（GEEs）的线性和逻辑回归模型分析了基线和随访数据之间的差异。

结果

与 CG 相比，IG 二年级学生的菌斑指数降低（β=-0.36），二、四、六年级学生的菌斑控制记录评分降低（β=-27.48，β=-26.04，β=-18.38）。IG 还表现出随访时二年级和四年级学生口腔健康相关知识增加（β=1.46 和β=0.92），六年级学生对口腔卫生行为的态度增加（β=1.78），六年级学生对牙线使用的自我效能增加（β=1.43）。IG 中的六年级学生在睡前刷牙（调整后的优势比[aOR]=2.99）和使用含氟牙膏（aOR=5.88）的可能性明显高于 CG 中的学生。