Socioeconomic status, social support, oral health beliefs, psychosocial factors, health behaviours and health-related quality of life in adolescents
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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.
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.
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).
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.
KeywordsSocioeconomic factors Psychosocial factors Health risk behaviour Quality of life
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.
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.
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 was obtained from all individual participants included in the study.
- 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
- 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
- 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
- 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
- 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.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.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
- 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
- 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
- 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
- 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.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.WHO. (2010). A conceptual framework for action on the social determinants of health. Geneva: World Health Organization.Google Scholar
- 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.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.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
- 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.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.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.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.Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-bass.Google Scholar
- 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.Rosenberg, M. (1989). Society and the adolescent self-image. Middletown: Wesleyan University Press.Google Scholar
- 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.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.
- 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.Tan, S. (2009). Misuses of KR-20 and Cronbach’s alpha reliability coefficients. Education and Science,34(152), 101–112.Google Scholar
- 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
- 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
- 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.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
- 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