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Oral Health Promoting School Environments Typology and Dental Caries Status in Quebec Children PDF
By:Anu Edasseri
Published on 2016 by

|Dental caries are highly prevalent among Canadian children. Limited evidence supports the effectiveness of school-based oral health promotion programs for dental caries reduction; we found one such study from Canada and none from Quebec. Objectives: 1) To identify distinct types of school environments among schools situated in the Montreal Census Metropolitan Area of the province of Quebec, drawing from a number of factors related to the provision of school-based oral health promotion programs, engagement in oral health promotion activities, and the social and built environment of the school neighbourhood; 2) To estimate the relation between types of oral health promoting school environments and dental caries incidence among 8-10-year-old children over a 2-year period. Methods: We used data from the baseline and 1st follow-up visits of the QUebec Adipose Lifestyle Investigation in Youth (QUALITY) cohort, which were completed in 2008 and 2011, respectively. This ongoing prospective study on the natural history of metabolic risk in children included 630 children and their families, living in three major urban centres in the province of Quebec. We used a school-based sampling strategy to recruit the participants. We also acquired data from a complimentary study added to the QUALITY cohort in 2008 (School Study), which provided data on schools located in Greater Montreal attended by cohort children. Structured questionnaires administered to school principals and parents were used to collect data on school environment and socio-demographic factors. In addition, we used 2006 Canadian Census data from a geographic information system to determine the school socio-economic status (SES) and an exhaustive list of businesses to classify the surrounding food environment. The outcome was 2-year dental caries incidence based on dental clinical exams and summarized by the Decayed, Missing-Surfaces (DMF-S) index.Among the 506 children attending schools in Greater Montreal, complete data were available for 330 children attending 200 schools. We used principal component and cluster analyses to classify school environment, and generalised estimating equations to model the association between school environment and dental caries incidence. Results: We identified three distinct types of school environments. Type 1 included schools with strong healthy eating policies, weak dental care programs, located in neighbourhoods with high SES and favourable surrounding food environments. Type 2 comprised schools with strong healthy eating policies and strong dental care programs, located in neighborhoods with low SES and unfavourable surrounding food environments. Type 3 included schools with weak healthy eating policies and average dental care programs, located in neighbourhoods with average SES and unfavourable surrounding food environments.Adjusting for age, sex, parental income and baseline DMF-S, children attending Types 1 and 2 schools had 21% (IRR: 0.79, 95% CI: 0.68 - 0.90) and 6% (IRR: 0.94, 95% CI: 0.83 - 1.07) reduced 2-year incidence of dental caries, respectively, compared to those attending Type 3 schools. Conclusion: A comprehensive approach to oral health promotion in schools targeting common risk factors (e.g., an unhealthy diet), and allowing the participation of prominent stakeholders (e.g., parents, teachers, school principals and communities) can have a positive effect on children's dental caries status. Neighbourhood SES and the food environment around the school seem to be important factors influencing the dental caries status of schoolchildren. This study adds to the evidence base showing the important role of school environments in oral health promotion and provides Quebec policy makers with directions for preventive action.| --

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Download Oral Health Promoting School Environments Typology and Dental Caries Status in Quebec Children PDF Free

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