Self-perceived neighborhood factors and OHRQoL among adolescents: a population-based study in southern Brazil

Abstract This study aimed to assess the relationship between self-perceived neighborhood factors and oral health-related quality of life (OHRQoL) among adolescents from southern Brazil. A representative sample of 15-19-year-old students from Santa Maria, Brazil, was included. The Oral Health Impact Profile (OHIP-14) was used to assess the OHRQoL. Self-perceived neighborhood factors were assessed through a structured questionnaire and included characteristics of the neighborhood where the adolescents lived, such as the presence of paved streets, tap water, community social networks, and availability of dental services and the Family Health Strategy (FHS). In addition, socioeconomic, behavioral, and clinical variables (dental caries and malocclusion) were also evaluated. Multilevel Poisson regression analysis with a hierarchical approach was used to assess the association between predictors and OHIP-14. The rate ratio (RR) and 95% confidence intervals (CIs) were estimated. A total of 1,197 adolescents were included in this study (participation rate: 72.3%). The mean OHIP-14 score was 8.4 (standard error = 0.2), ranging from 0 to 49. Living in residences with unpaved streets (RR = 1.11, 95%CI:1.06−1.17), no tap water (RR = 1.11, 95%CI: 1.02−1.20), absence of the FHS services (RR = 1.15, 95%CI: 1.09−1.20), and the availability of dental services (RR = 1.08, 95%CI: 1.03−1.14) were associated with higher OHIP-14 scores, indicating a poorer OHRQoL. In addition, lower socioeconomic status, visiting the dentist for curative reasons, lower frequency of brushing teeth, and higher sugar consumption were also associated with higher OHIP-14 scores. In conclusion, self-perceived neighborhood characteristics were associated with OHRQoL in adolescents. Adolescents who perceived their neighborhood as deprived had poorer OHRQoL.摘要 本研究旨在探讨巴西南部青少年自我感知的社区因素与口腔健康相关生活质量（Oral Health-related Quality of Life，OHRQoL）之间的关联。本研究纳入了巴西圣玛丽亚市15至19岁学生的代表性样本。采用口腔健康影响量表（Oral Health Impact Profile，OHIP-14）评估研究对象的OHRQoL。研究通过结构化问卷评估青少年自我感知的社区因素，涵盖其居住社区的多项特征，包括铺装街道的存在情况、自来水供应情况、社区社交网络的覆盖情况，以及牙科服务与家庭健康策略（Family Health Strategy，FHS）的可及性。此外，本研究同时评估了研究对象的社会经济、行为及临床变量，包括龋齿与错𬌗畸形。本研究采用带有分层分析框架的多水平泊松回归分析，探究各预测因子与OHIP-14评分之间的关联，并估算率比（Rate Ratio，RR）及95%置信区间（Confidence Intervals，CI）。本研究共纳入1197名青少年，应答率为72.3%。研究对象的OHIP-14评分平均值为8.4（标准误=0.2），评分范围为0至49。居住在未铺装街道的社区、无自来水供应、未覆盖FHS服务，以及可获取牙科服务的青少年，其OHIP-14评分更高，提示其OHRQoL更差。此外，较低的社会经济地位、因治疗需求就诊牙医、较低的刷牙频率以及较高的糖分摄入，同样与更高的OHIP-14评分相关。综上，自我感知的社区特征与青少年的OHRQoL存在关联。感知自身社区处于匮乏状态的青少年，其OHRQoL更差。