Cost components of school-based oral health-promoting programs: A systematic review protocol.

INTRODUCTION: Oral health-promoting school programs play a crucial role in achieving universal coverage of oral health care, by addressing oral diseases and promoting the well-being and quality of life of children and adolescents. However, a lack of studies has evaluated the costs associated with implementing these programs, which hinders decision-makers in adopting them on a large scale. This review aims to assess the cost components involved in school-based oral health-promoting programs. METHODS: This review will include studies that have conducted either partial or full economic evaluations, focusing on describing the cost components of oral health-promoting programs implemented in primary schools involving students aged 6 to 14. A systematic search was conducted across multiple databases: MEDLINE, The Cochrane Library, the Virtual Health Library, the NHS Economic Evaluation Database, Web of Science, Scopus, and EMBASE. Additionally, gray literature was searched using the Health Technology Assessment Database. Two independent reviewers will screen the titles and abstracts, followed by a full-text review based on predefined inclusion criteria. Data extraction and critical appraisal evaluation will also be carried out independently by two reviewers. In case of disagreements, the reviewer team will resolve them through discussion. DISCUSSION: The systematic review resulting from this protocol aims to provide evidence regarding the cost components and necessary resources for implementing and maintaining oral health-promoting school programs. This information can assist decision-makers in adopting these programs on a larger scale and effectively addressing oral diseases among children and adolescents. PROTOCOL REGISTRATION: CRD42022363743.

Qualidade de vida no bairro: construção e validação de um instrumento genérico baseado na percepção de crianças brasileiras / Quality of life in the neighborhood: construction and validation of a generic instrument based on the perception of brazilian children

Trata-se de um estudo misto exploratório sequencial, realizado em duas fases, que teve como objetivo estruturar um instrumento de qualidade de vida no bairro (QV), embasado na percepção das crianças brasileiras. O público alvo do estudo foi crianças de 6 a 10 anos de idade, residentes em um município brasileiro de médio porte. A pesquisa foi conduzida em quatro escolas públicas e uma escola privada da cidade, selecionadas a partir da sua localização territorial e pelo Indicador de Nível Socioeconômico das Escolas de Educação Básica. Na primeira fase, realizou-se o estudo qualitativo para compreender a percepção das crianças de 6 a 10 anos em relação a QV no bairro. Em cada escola sorteou-se uma turma de cada ano do ensino fundamental. Todos escolares dessas turmas foram convidados a participar do estudo e aqueles que retornaram com Termo de Consentimento Livre e Esclarecido participaram da coleta de dados, que foi realizada pelo método desenhar, escrever e dizer. No primeiro momento, todas as crianças desenharam um bairro com QV e, na sequência, considerando a riqueza de detalhes das ilustrações, selecionou-se intencionalmente duas crianças de cada turma (n=49) para narrar o seu desenho. As narrativas foram gravadas, transcritas e avaliadas pela análise qualitativa de conteúdo. Da avaliação dos dados emergiram dois grandes temas: ambiente físico e ambiente social. O ambiente social incluiu as relações familiares e as de amizade e o ambiente físico explorou as necessidades de uma comunidade, como moradia, locais de lazer, serviços essenciais e elementos da natureza. A segunda etapa do estudo estruturou e validou um questionário genérico de QV no bairro, para crianças de 8 a 10 anos de idade. Nessa etapa, realizou-se a geração dos itens, validação do conteúdo por especialistas pelo método de Delphi (n=8), validação de face (n=30) e avaliação das medidas psicométricas (n=261), incluindo a avaliação da consistência interna (alfa de Cronbach), da estabilidade temporal (Kappa ponderado -KP e Coeficiente de Correlação Intraclasse - ICC), da validade de construto medida pela análise fatorial exploratória (AFE) e da validade discriminante, que comparou as diferenças do escore total entre os grupos determinados pelas variáveis sociodemográficas. Todos os testes estatísticos foram realizados com nível de significância de 5%. Dos 56 itens gerados, 39 foram retidos após a validação de conteúdo e a validação de face. A medida de 39 itens foi submetida aos testes de confiabilidade e a AFE, obtendo uma ferramenta com 27 itens distribuídos em cinco dimensões, que apresentou boa consistência interna (alfa de Cronbach = 0,80), boa estabilidade temporal (KP= 0,30 a 0,72 e ICC= 0,91) e validade discriminante capaz de apontar diferenças entre os grupos determinados pelas variáveis sexo, idade, renda e local de moradia (p<0,001). Com base na percepção das crianças foi possível criar uma medida de QV no bairro com medidas psicométricas satisfatórias.

This is a mixed, two-stage, exploratory, and sequential study that aimed to structure a neighborhood quality of life (QoL) instrument based on the perception of Brazilian children aged 6-10 years, living in a medium-sized Brazilian municipality. The research was conducted in four public schools and a private school in the city, selected from their territorial location and the Socioeconomic Level Indicator of Elementary Education Schools. In the first stage, a qualitative study was conducted to understand the perception of children aged 6-10 years concerning QoL in the neighborhood. A class was drawn for every elementary school year in each school. All students from these classes were invited to participate in the study, and those who returned with the Informed Consent Form participated in the data collection, which was carried out with the draw, write and say method. At first, all the children drew a neighborhood with QoL and, subsequently, considering the wealth of details in the illustrations, two children from each class were intentionally selected (n=49) to narrate their drawings. The narratives were recorded, transcribed, and evaluated by qualitative content analysis. Two major themes emerged from the data evaluation: physical environment and social environment. The social environment included family and friendship relationships, and the physical environment explored community needs, such as housing, leisure facilities, essential services, and natural elements. The second stage of the study structured and validated a generic QoL in the neighborhood questionnaire for children aged 8-10 years. This stage included the generation of items, validation of content by specialists using the Delphi method (n=8), face validation (n=30) and assessment of the psychometric measures (n=261), including internal consistency assessment (Cronbach's alpha), temporal stability (weighted Kappa - KP and Intraclass Correlation Coefficient - ICC), construct validity measured by exploratory factor analysis (EFA) and discriminant validity, which compared the differences in the total score between groups determined by sociodemographic variables. All statistical tests were performed with a 5% significance level. Of the 56 items generated, 39 were retained after content validation and face validation. The measurement of 39 items was submitted to reliability tests and the EFA, obtaining a tool with 27 items distributed into five dimensions, which showed good internal consistency (Cronbach's alpha = 0.80), good temporal stability (KP=0.30 to 0.72 and ICC=0.91) and discriminant validity capable of pointing out differences between groups determined by the variables gender, age, income and place of residence (p<0.001). The children's perception allowed creating a QoL in the neighborhood measure with satisfactory psychometric measurements.