Advertisement

Quality of Life Research

, Volume 29, Issue 1, pp 141–151 | Cite as

Socioeconomic status, social support, oral health beliefs, psychosocial factors, health behaviours and health-related quality of life in adolescents

  • Andressa Coelho Gomes
  • Maria Augusta Bessa Rebelo
  • Adriana Correa de Queiroz
  • Ana Paula Correa de Queiroz Herkrath
  • Fernando José Herkrath
  • Janete Maria Rebelo Vieira
  • Juliana Vianna Pereira
  • Mario Vianna VettoreEmail author
Article
  • 173 Downloads

Abstract

Purpose

This study assessed the relationships between socioecononic status (SES), social support, oral health beliefs, psychosocial factors, health-related behaviours and health-related quality of life (HRQoL) in adolescents.

Methods

A school-based follow-up study involving 376 12-year-old adolescents was conducted in Manaus, Brazil. Baseline data included sociodemographic characteristics (sex, parental schooling, family income, household overcrowding and number of goods), social support (SSA questionnaire), oral health beliefs and psychosocial factors (Sense of Coherence [SOC-13 scale] and self-esteem [Rosenberg Self-Esteem Scale]). Health-related behaviours (toothbrushing frequency, sedentary behaviour, smoking and sugar consumption) and HRQoL [KINDL questionnaire] were assessed at 6-month follow-up. Structural Equation Modelling assessed the relationships between variables.

Results

Greater social support (β = 0.30), higher SOC (β = 0.23), higher self-esteem (β = 0.23), higher toothbrushing frequency (β = 0.14) and less smoking (β = − 0.14) were directly linked with better HRQoL. SES (β = 0.05), social support (β = 0.26), oral health beliefs (β = − 0.02) were indirectly linked to HRQoL. Higher SES directly predicted higher toothbrushing frequency (β = 0.14) and less smoking (β = − 0.22). Greater social support also directly predicted higher SOC (β = 0.55), positive oral health beliefs (β = − 0.31) and higher self-esteem (β = 0.58). Greater social support indirectly predicted less smoking via oral health beliefs (β = − 0.05) and less sugar consumption via SOC (β = − 0.07).

Conclusion

Socioeconomic status, social support, oral health beliefs and psychosocial factors were important predictors of adolescent’s health behaviours and HRQoL over 6-month period through direct and indirect mechanisms. Health behaviours also directly influenced HRQoL.

Keywords

Socioeconomic factors Psychosocial factors Health risk behaviour Quality of life 

Notes

Acknowledgements

The authors thank Coordination for the Improvement of Higher Education Personnel (CAPES), Ministry of Education, Brazil for the financial support to the Postgraduate Programme in Dentistry at the Federal University of Amazonas.

Funding

This study was funded by the National Council for Scientific and Technological Development—CNPq, Brazil, research Grant No. 423309/2016.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Research Ethics Committee of the Federal University of Amazonas under Protocol No. 57273316.1.0000.5020. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Sawyer, S. M., Afifi, R. A., Bearinger, L. H., Blakemore, S. J., Dick, B., Ezeh, A. C., et al. (2012). Adolescence: A foundation for future health. The Lancet,379(9826), 1630–1640.Google Scholar
  2. 2.
    Jackson, C. A., Henderson, M., Frank, J. W., & Haw, S. J. (2012). An overview of prevention of multiple risk behaviour in adolescence and young adulthood. Journal of Public Health,34(suppl. 1), i31–i40.PubMedGoogle Scholar
  3. 3.
    Chu, P. S., Saucier, D. A., & Hafner, E. (2010). Meta-analysis of the relationships between social support and well-being in children and adolescents. Journal of Social and Clinical Psychology,29(6), 624–645.Google Scholar
  4. 4.
    Zambon, A., Morgan, A., Vereecken, C., Colombini, S., Boyce, W., Mazur, J., et al. (2010). The contribution of club participation to adolescent health: Evidence from six countries. Journal of Epidemiology and Community Health,64(01), 89–95.PubMedGoogle Scholar
  5. 5.
    Springer, A., Parcel, G., Baumler, E., & Ross, M. (2006). Supportive social relationships and adolescent health risk behavior among secondary school students in El Salvador. Social Science and Medicine,62(7), 1628–1640.PubMedGoogle Scholar
  6. 6.
    Länsimies, H., Pietilä, A. M., Hietasola-Husu, S., & Kangasniemi, M. (2017). A systematic review of adolescents’ sense of coherence and health. Scandinavian Journal of Caring Sciences,31(4), 651–661.PubMedGoogle Scholar
  7. 7.
    Erhart, M., Wille, N., & Ravens-Sieberer, U. (2008). Empowerment of children and adolescents-the role of personal and social resources and personal autonomy for subjective health. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany),70(12), 721–729.Google Scholar
  8. 8.
    Gaspar, T., Ribeiro, J. P., de Matos, M. G., Leal, I., & Ferreira, A. (2012). Health-related quality of life in children and adolescents: Subjective well being. The Spanish Journal of Psychology,15(1), 177–186.PubMedGoogle Scholar
  9. 9.
    Mohamadian, H., Eftekhar, H., Rahimi, A., Mohamad, H. T., Shojaiezade, D., & Montazeri, A. (2011). Predicting health-related quality of life by using a health promotion model among Iranian adolescent girls: A structural equation modeling approach. Nursing & Health Sciences,13(2), 141–148.Google Scholar
  10. 10.
    Broadbent, J. M., Zeng, J., Foster Page, L. A., Baker, S. R., Ramrakha, S., & Thomson, W. M. (2016). Oral health-related beliefs, behaviours, and outcomes through the life course. Journal of Dental Research,95(7), 808–813.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Broadbent, J. M., Thomson, W. M., & Poulton, R. (2006). Oral health beliefs in adolescence and oral health in young adulthood. Journal of Dental Research,85(4), 339–343.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Baker, S. R., Mat, A., & Robinson, P. G. (2010). What psychosocial factors influence adolescents’ oral health? Journal of Dental Research,89(11), 1230–1235.PubMedGoogle Scholar
  13. 13.
    Gill, T. M., & Feinstein, A. R. (1994). A critical appraisal of the quality of quality-of-life measurements. Journal of American Medical Association,272(8), 619–626.Google Scholar
  14. 14.
    Guyatt, G. H., & Cook, D. J. (1994). Health status, quality of life, and the individual. Journal of American Medical Association,272(8), 630–631.Google Scholar
  15. 15.
    Hays, R. D., & Reeve, B. B. (2010). Measurement and modeling of health-related quality of life. In J. Killewo, H. K. Heggenhougen, & S. R. Quah (Eds.), Epidemiology and demography in public health (pp. 195–205). San Diego: Academic Press.Google Scholar
  16. 16.
    Bakas, T., McLennon, S. M., Carpenter, J. S., Buelow, J. M., Otte, J. L., Kathleen, M., et al. (2012). Systematic review of health-related quality of life models. Health and Quality of Life Outcomes,10(1), 134.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Otto, C., Haller, A. C., Klasen, F., Hölling, H., Bullinger, M., Ravens-Sieberer, U., et al. (2017). Risk and protective factors of health-related quality of life in children and adolescents: Results of the longitudinal BELLA study. PLoS ONE,12(12), e0190363.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Riesch, S. K., Kedrowski, K., Brown, R. L., Temkin, B. M., Wang, K., Henriques, J., et al. (2013). Health-risk behaviors among a sample of US pre-adolescents: Types, frequency, and predictive factors. International Journal of Nursing Studies,50(8), 1067–1079.PubMedGoogle Scholar
  19. 19.
    Michel, G., Bisegger, C., Fuhr, D. C., & Abel, T. (2009). Age and gender differences in health-related quality of life of children and adolescents in Europe: A multilevel analysis. Quality of Life Research,18(9), 1147.PubMedGoogle Scholar
  20. 20.
    Dube, S. R., Thompson, W., Homa, D. M., & Zack, M. M. (2012). Smoking and health-related quality of life among US adolescents. Nicotine & Tobacco Research,15(2), 492–500.Google Scholar
  21. 21.
    Hanson, M. D., & Chen, E. (2007). Socioeconomic status and health behaviors in adolescence: A review of the literature. Journal of Behavioral Medicine,30(3), 263.PubMedGoogle Scholar
  22. 22.
    Lowry, R., Kann, L., Collins, J. L., & Kolbe, L. J. (1996). The effect of socioeconomic status on chronic disease risk behaviors among US adolescents. Journal of American Medical Association,276(10), 792–797.Google Scholar
  23. 23.
    Sajjadi, H., Jorjoran Shushtari, Z., Mahboubi, S., Rafiey, H., & Salimi, Y. (2018). Effect of socio-economic status, family smoking and mental health through social network on the substance use potential in adolescents: A mediation analysis. Public Health,157, 14–19.PubMedGoogle Scholar
  24. 24.
    Von Rueden, U., Gosch, A., Rajmil, L., Bisegger, C., & Ravens-Sieberer, U. (2006). Socioeconomic determinants of health related quality of life in childhood and adolescence: Results from a European study. Journal of Epidemiology and Community Health,60(2), 130–135.Google Scholar
  25. 25.
    Erhart, M., Ottova, V., Gaspar, T., Jericek, H., Schnohr, C., Alikasifoglu, M., et al. (2009). Measuring mental health and well-being of school-children in 15 European countries using the KIDSCREEN-10 Index. International Journal of Public Health,54(2), 160–166.PubMedGoogle Scholar
  26. 26.
    Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine,38(5), 300–314.PubMedGoogle Scholar
  27. 27.
    Draper, C. E., Grobler, L., Micklesfield, L. K., & Norris, S. A. (2015). Impact of social norms and social support on diet, physical activity and sedentary behaviour of adolescents: A scoping review. Child: Care, Health and Development,41(5), 654–667.Google Scholar
  28. 28.
    Viner, R. M., Ozer, E. M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., et al. (2012). Adolescence and the social determinants of health. The Lancet,379(9826), 1641–1652.Google Scholar
  29. 29.
    WHO. (2010). A conceptual framework for action on the social determinants of health. Geneva: World Health Organization.Google Scholar
  30. 30.
    Umberson, D. (1987). Family status and health behaviors: Social control as a dimension of social integration. Journal of Health and Social Behavior,28(3), 306–319.PubMedGoogle Scholar
  31. 31.
    Phongsavan, P., Chey, T., Bauman, A., Brooks, R., & Silove, D. (2006). Social capital, socio-economic status and psychological distress among Australian adults. Social Science and Medicine,63(10), 2546–2561.PubMedGoogle Scholar
  32. 32.
    Sisson, K. L. (2007). Theoretical explanations for social inequalities in oral health. Community Dentistry and Oral Epidemiology,35(2), 81–88.PubMedGoogle Scholar
  33. 33.
    Berkman, L. S., & Glass, T. (2006). Social integration, social networks, social support, and health. In M. Marmot & R. G. Wilkinson (Eds.), Social determinants of health (pp. 137–173). London: Oxford University Press.Google Scholar
  34. 34.
    Franco-Paredes, K., Díaz-Reséndiz, F. J., Hidalgo-Rasmussen, C. A., & Bosques-Brugada, L. E. (2019). Health-related quality-of-life model in adolescents with different body composition. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity,24(1), 143–150.Google Scholar
  35. 35.
    Wu, X. Y., Han, L. H., Zhang, J. H., Luo, S., Hu, J. W., & Sun, K. (2017). The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PLoS ONE,12(11), e0187668.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Muros, J. J., Salvador Pérez, F., Zurita Ortega, F., Gámez Sánchez, V. M., & Knox, E. (2017). The association between healthy lifestyle behaviors and health-related quality of life among adolescents. Jornal de Pediatria,93(4), 406–412.PubMedGoogle Scholar
  37. 37.
    Chen, X., Sekine, M., Hamanishi, S., Wang, H., Gaina, A., Yamagami, T., et al. (2005). Lifestyles and health-related quality of life in Japanese school children: A cross-sectional study. Preventive Medicine,40(6), 668–678.PubMedGoogle Scholar
  38. 38.
    Dumuid, D., Olds, T., Lewis, L. K., Martin-Fernández, J. A., Katzmarzyk, P. T., Barreira, T., et al. (2017). Health-related quality of life and lifestyle behavior clusters in school-aged children from 12 countries. The Journal of Pediatrics,183, 178–183.PubMedGoogle Scholar
  39. 39.
    Jaworska, N., & MacQueen, G. (2015). Adolescence as a unique developmental period. Journal of Psychiatry and Neuroscience,40(5), 291–293.PubMedGoogle Scholar
  40. 40.
    Westland, J. C. (2010). Lower bounds on sample size in structural equation modeling. Electronic Commerce Research and Applications,9(6), 476–487.Google Scholar
  41. 41.
    Exchange rates. World Currency Exchange Rates and Currency Exchange Rate History. https://www.exchange-rates.org/Rate/USD/BRL/8-31-2016. Accessed 11 June 2018.
  42. 42.
    Vaux, A., Phillips, J., Holly, L., Thomson, B., Williams, D., & Stewart, D. (1986). The social support appraisals (SS-A) scale: Studies of reliability and validity. American Journal of Community Psychology,14(2), 195–218.Google Scholar
  43. 43.
    Squassoni, C. E., & Matsukura, T. S. (2014). Adaptacao transcultural da versao Portuguesa do social support appraisals para o Brasil. Psicologia: Reflexao & Critica,27(1), 71–80.Google Scholar
  44. 44.
    Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-bass.Google Scholar
  45. 45.
    Bonanato, K., Branco, D. B. T., Mota, J. P. T., Ramos-Jorge, M. L., Paiva, S. M., Pordeus, I. A., et al. (2009). Trans-cultural adaptation and psychometric properties of the Sense of Coherence Scale’in mothers of preschool children. Interamerican Journal of Psychology,43(1), 144–153.Google Scholar
  46. 46.
    Rosenberg, M. (1989). Society and the adolescent self-image. Middletown: Wesleyan University Press.Google Scholar
  47. 47.
    Hutz, C. S., & Zanon, C. (2011). Revisão da adaptação, validação e normatização da Escala de Autoestima de Rosenberg. Avaliacao Psicologica,10(1), 41–49.Google Scholar
  48. 48.
    IBGE (2013) Pesquisa Nacional de Saude Escolar-PeNSE. Banco de dados agregados. Rio de Janeiro: Instituto Brasileiro de Geografia and Estatistica. http://biblioteca.ibge.gov.br/visualizacao/livros/liv64436.pdf. Accessed 9 July 2017.
  49. 49.
    Peres, M. A., Sheiham, A., Liu, P., Demarco, F. F., Silva, A. E. R., Assunção, M. C., et al. (2016). Sugar consumption and changes in dental caries from childhood to adolescence. Journal of Dental Research,95(4), 388–394.PubMedGoogle Scholar
  50. 50.
    Chaffee, B. W., Feldens, C. A., Rodrigues, P. H., & Vítolo, M. R. (2015). Feeding practices in infancy associated with caries incidence in early childhood. Community Dentistry and Oral Epidemiology,43(4), 338–348.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Teixeira, I. P., Novais, I. D. P., Pinto, R. D. M. C., & Cheik, N. C. (2012). Cultural adaptation and validation of the KINDL questionnaire in Brazil for adolescents between 12 and 16 years of age. Revista Brasileira de Epidemiologia,15(4), 845–857.PubMedGoogle Scholar
  52. 52.
    Ravens-Sieberer, U., & Bullinger, M. (1998). News from the KINDL-questionnaire: A new version for adolescents. Quality of Life Research,7, 653.Google Scholar
  53. 53.
    Tan, S. (2009). Misuses of KR-20 and Cronbach’s alpha reliability coefficients. Education and Science,34(152), 101–112.Google Scholar
  54. 54.
    Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractice Medicine,15(2), 155–163.Google Scholar
  55. 55.
    MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. A. (2002). Comparison of methods to test mediation and other intervening variable effects. Psychological Methods,7(1), 83–104.PubMedPubMedCentralGoogle Scholar
  56. 56.
    Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling,6, 1–55.Google Scholar
  57. 57.
    Park, Y. D., Patton, L. L., & Kim, H. Y. (2010). Clustering of oral and general health risk behaviors in Korean adolescents: A national representative sample. Journal of Adolescent Health,47(3), 277–281.PubMedGoogle Scholar
  58. 58.
    Vettore, M. V., Moysés, S. J., Sardinha, L. M. V., & Iser, B. P. M. (2012). Condição socioeconômica, frequência de escovação dentária e comportamentos em saúde em adolescentes brasileiros: Uma análise a partir da Pesquisa Nacional de Saúde do Escolar (PeNSE). Cadernos de Saúde Pública,28, s101–s113.PubMedGoogle Scholar
  59. 59.
    Pikhart, H., & Pikhartova, J. (2015). The relationship between psychosocial risk factors and health outcomes of chronic diseases: A review of the evidence for cancer and cardiovascular diseases. WHO Regional Office for Europe.Google Scholar
  60. 60.
    Tian, J., Venn, A. J., Blizzard, L., Patton, G. C., Dwyer, T., & Gall, S. L. (2016). Smoking status and health-related quality of life: A longitudinal study in young adults. Quality of Life Research,25(3), 669–685.PubMedGoogle Scholar
  61. 61.
    Mbawalla, H. S., Masalu, J. R., & Åstrøm, A. N. (2010). Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo-Arusha school health project (LASH): A cross-sectional study. BMC Pediatrics,10(1), 1–10.Google Scholar
  62. 62.
    Broadbent, J. M., Zeng, J., Foster Page, L. A., Baker, S. R., Ramrakha, S., & Thomson, W. M. (2016). Oral health-related beliefs, behaviors, and outcomes through the life course. Journal of Dental Research,95(7), 808–813.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andressa Coelho Gomes
    • 1
  • Maria Augusta Bessa Rebelo
    • 1
  • Adriana Correa de Queiroz
    • 1
  • Ana Paula Correa de Queiroz Herkrath
    • 1
  • Fernando José Herkrath
    • 2
  • Janete Maria Rebelo Vieira
    • 1
  • Juliana Vianna Pereira
    • 1
  • Mario Vianna Vettore
    • 3
    Email author
  1. 1.School of DentistryFederal University of AmazonasManausBrazil
  2. 2.Fundação Oswaldo CruzInstituto Leônidas & Maria DeaneManausBrazil
  3. 3.Academic Unit of Oral Health, Dentistry and Society, School of Clinical DentistryUniversity of SheffieldSheffieldUK

Personalised recommendations