The different roles of neighbourhood and individual social capital on oral health-related quality of life during pregnancy and postpartum: a multilevel analysis.

OBJECTIVE: Social capital incorporates neighbourhood and individual levels of interactions and influences health. The objective of this was to assess the association of neighbourhood and individual social capital with oral health-related quality of life (OHRQoL) in pregnant and postpartum women. METHODS: This was a follow-up prevalence multilevel study on a representative sample of 1248 women grouped into 55 neighbourhoods. OHRQoL was assessed in the postpartum period using the Oral Health Impact Profile questionnaire (OHIP-14). Exploratory variables were gathered during the first trimester of pregnancy and included neighbourhood social capital (neighbourhood-level measure), individual social capital (social support and social networks), demographic and socio-economic variables, oral health measures, and health-related behaviours. RESULTS: The multilevel ordered multinomial logistic regression showed that neighbourhood social capital did not significantly affect women's OHRQoL during pregnancy and postpartum period. Individual social capital measures were independently associated with high OHRQoL. Lack of family social network increased the odds for high OHRQoL (OR = 1.44, 95% CI: 1.08-1.92). Individuals with high levels of positive social interaction were less likely to report high scores of OHRQoL (OR = 0.90, 95% CI: 0.82-0.98). CONCLUSION: Individual social capital was of greater relevance to women's OHRQoL in and after pregnancy than neighbourhood social capital. These findings suggest that quality of personal and social resources of pregnant women are more important for OHRQoL than the neighbourhoods where the women live.

Assessing the responsiveness of the Brazilian FIS to treatment for traumatic dental injury.

OBJECTIVE: This study aimed to assess the responsiveness of the Brazilian version of the Family Impact Scale (B-FIS) to describe changes in the quality of life (QoL) after treatment for traumatic dental injury (TDI). METHODS: After applying the eligibility criteria, 156 patients from 2 to 14 years old, who were attending a dental trauma center, were selected over an 18-month period. QoL was evaluated at two different appointments: A1 (after TDI) and A2 (after TDI treatment). The B-FIS scores were calculated using the additive method. The responsiveness was analyzed by standardized response means (SRMs). RESULTS: Mean B-FIS scores were 12.1 (7.5 SD) and 2.7 (4.4 SD), while the median scores were 12.0 and 2.0, at A1 and A2 (P < 0.01), respectively. The B-FIS responsiveness scores dropped 9.4 points after TDI treatment. The change was observed as a decrease in the impact after TDI treatment, demonstrating a positive reduction in its absolute number as well as an improvement in the family's QoL. The SRM achieved was as follows: 1.2 total scale, 1.1 parental emotions, 0.5 family conflicts, 0.9 parental/family activity, 0.1 financial burden. The B-FIS scores indicated that TDI has significant impact on the family's QoL in A1 and still has impact in A2. The change was observed as a positive decrease in the impact after TDI treatment. CONCLUSIONS: The responsiveness of the FIS (Brazilian version) in detecting the family's change in QoL after TDI treatment was confirmed by SRM.

Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks.

BACKGROUND: Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. METHODS: A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group--employed women with paid work, and, 2. home-based social network group--women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. RESULTS: There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥ 4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥ 4 [OR 1.73 (95% CI: 1.23-2.42)]. CONCLUSIONS: Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.