Effectiveness of a theory of planned behavior-based intervention for promoting periodontal preventive behaviors among medical students in Taiwan.

OBJECTIVE: To evaluate the effectiveness of an oral self-care education intervention based on the Theory of Planned Behavior in Taiwanese undergraduates. PARTICIPANTS: We recruited 63 and 90 students in the experimental group (EG) and comparison group (CG), respectively, from a medical university. METHODS: A quasi-experimental design was employed. The EG received health education and a brief action and coping planning intervention. RESULTS: The EG was significantly more likely to brush for more than 3 minutes (adjusted odds ratio [aOR] = 2.52), use the modified Bass brushing technique (aOR = 7.81), and floss (aOR = 21.21) at the 2-week follow-up than was the CG. At the 6-week follow-up, the combined effect of high action and coping planning with high perceived power for predicting floss use was observed in the EG (p < 0.05). CONCLUSIONS: Intervention may promote periodontal-disease-preventing behaviors in undergraduates, particularly for achieving adherence to daily flossing.

Gender-specific factors associated with the suicidal ideation of children in Taiwan: A large-scale cross-sectional study.

We examined the relationship between suicidal ideation (SI) and the depressed mood, life stress and parenting styles in children. A large-scale survey was conducted including 5328 children from 65 elementary schools in Taiwan. SI was measured by asking children if any suicidal thoughts had occurred in the previous month. A series of regression models was analysed separately for male and female students. Compared with boys, girls demonstrated a higher proportion of SI. Among boys, SI was significantly associated with a high level of perceived environmental stress (adjusted odds ratio [aOR] = 2.61), a high degree of depressed mood (aOR = 2.39), authoritative (aOR = 1.72) and authoritarian (aOR = 2.53) parenting styles and two or more life-stress events (aOR = 1.45). A high level of perceived environmental stress (aOR = 2.09), a high degree of depressed mood (aOR = 2.89) and an authoritarian parenting style (aOR = 1.76) were significantly associated with the SI in girls. Gender-specific interventions aimed at preventing SI must enhance support systems at school and at home, particularly for students who suffer from a high degree of stress and depressed mood, and are subjected to an authoritarian parenting style.

Evaluating the effect of a community-based lay health advisor training curriculum to address immigrant children's caries disparities.

Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.

Area disparity in children's perceptions of access to tobacco and cigarette purchasing experiences in Taiwan.

BACKGROUND: Adolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren. METHODS: Data on children's tobacco-related variables were obtained from the Control of School-Aged Children Smoking Study Survey in Taiwan. A stratified random sample of 65 primary schools was included. Polytomous logistic regression analyzed factors associated with tobacco accessibility and purchasing experiences. RESULTS: More than half of the children reported that tobacco retailers often or always sold cigarettes to them. Rural and mountainous children were more likely to have access to cigarettes (adjusted odds ratio [AOR] = 2.01 and 3.01, respectively) and have cigarette purchasing experiences (AOR = 3.06 and 13.76, respectively). Cigarette purchasing from retailers (AOR = 1.84) was significantly associated with children's perceptions of access to tobacco. The factors associated with cigarette purchasing experiences were families smoking (AOR = 8.90), peers smoking (AOR = 2.22), frequent exposure to entertainer smoking on TV and in films (AOR = 2.15), and perceived access to tobacco (AOR = 1.51). CONCLUSIONS: The health department should strictly enforce laws regarding retailers selling tobacco to underage, particularly in remote areas. Schools can reinforce tobacco-use prevention messages.

Analysis of influential factors associated with the smoking behavior of aboriginal schoolchildren in remote Taiwanese mountainous areas.

BACKGROUND: A disparity in smoking behavior exists between the general and minority populations residing in Taiwan's mountainous areas. This study analyzed individual and environmental factors associated with children's smoking behavior in these areas of Taiwan. METHODS: In this school-based study, data on smoking behavior and related factors for mountain-dwelling students were obtained from the 2008 and 2009 Control of School-aged Children Smoking Study surveys. A representative sample (N = 1239) from 26 primary schools was included. The association among 3 groups (never-, former-, and current-smokers) and the potential variables were simultaneously examined using unordered polytomous logistic regression analysis. RESULTS: Between 13% and 34% of ever-smokers reported that their first smoking experience was in third grade. More than 70% were found to have bought cigarettes and 87% reported that the tobacco retailers had sold them cigarettes. The significant factors for current-smokers were predisposing factors, ie, attitude toward smoking (adjusted odds ratio [AOR] = 1.21); reinforcing factors, ie, family smoked in front of me (AOR = 2.44), friends smoked in front of me (AOR = 16.24), and school staff smoked in front of me (AOR = 2.98); and enabling factors, ie, cigarette availability and accessibility (AOR = 2.16 and 2.42, respectively). A student's perceived punishment for smoking at school had a positive significant effect on the risk of being former-smokers (AOR = 1.57). CONCLUSION: The findings provide a basis for school and community to design and implement effective anti-smoking programs for remote mountain-based students to further reduce youth smoking.