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The impact of health promotion policies in schools on oral health in Curitiba, Brazil

Moyses, Simone Tetu; (1999) The impact of health promotion policies in schools on oral health in Curitiba, Brazil. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Health Promoting Schools have been established because they are supposed to enhance children's health. No analyses have been done on their effects on oral health. The aim of this study was to focus on the school level of influence on children's oral health and self-concepts in terms of self-esteem and lifestyle. It was hypothesised that children in supportive schools, where health promoting policies had been developed, have better oral health and more positive self-concepts. A sample of 1823 12-year-old children, studying in 33 schools, was selected in deprived areas of Curitiba, Brazil. The study was divided in two phases. Phase 1, a cross-sectional survey, when data were collected from children and schools through questionnaires and clinical examination. Phase 2 encompassed case studies, where interviews and focus group methods were used to collect information from members of selected schools' communities. Principal Component Analysis, multiple regression, meta-analysis, and meta-regression were used in the data analysis. Children in supportive schools had better oral health results than in non-supportive schools. More homogeneous results were found in supportive schools. A comprehensive curriculum directed to health promotion was associated with children's caries-free status, DMF-T index, dental trauma, and Ufestyle. Schools with a comprehensive curriculum were more likely to have a higher percentage of caries-free children (β=6.27, p=0.02); children with low DMF-T (β=7.61, p=0.01); less children with dental trauma (β=-5.04, p=0.02); and less children reporting a healthy lifestyle (β=- 12.05, p=0.00). The commitment towards health and safety at school was strongly associated with dental trauma and recent caries experience. 9.7% less children with dental trauma (p=0.00), and 3.9% less children with recent caries experience (p=0.04) are expected in schools which demonstrated commitment towards health and safety. At a school level, mothers' education was independently associated with children caries experience and lifestyle. Family income was independently associated with dental trauma at school level. It was concluded that the school had an important impact on children's oral health and how children perceived their health-related lifestyle. Furthermore, supportive schools appear to be able to reduce oral health inequalities in deprived children's population.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: The impact of health promotion policies in schools on oral health in Curitiba, Brazil
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
URI: https://discovery.ucl.ac.uk/id/eprint/10099976
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