RESUMO
Aim. To test the efficiency and acceptance of school-based dental education for improving oral self-care in Mexican elementary school-aged children. Method. A total of 408 students from 4 schools were examined at the baseline, 3 months (follow-up rate was 94%) and 6 months observations (follow-up rate 91%). Group 1 served as a control, Group 2 received a lecture-based education, and Group 3 consisted of trained peer-leaders who educated their peers. Oral self-care practice and oral self-care skills were assessed at the baseline and both follow-ups. A number of sociodemographic and oral health behavior/knowledge characteristics were tested as predictors of oral self-care outcomes at different observation periods. Results. Oral self-care outcomes improved in Groups 2 and 3, but not in the control group. The selected child population, their caregivers and teachers perceived the school-based educational strategy as important and necessary. There was no consistent pattern of predictors explaining variations in oral self-care outcomes at any of the observation periods. Oral self-care improvement observed at the 6 months observation was mainly predicted by the baseline oral self-care levels, dental education, and age. Conclusions. The school-based dental education was easy to implement, and it was effective for improving children's oral self-care practice and skills.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/organização & administração , Saúde Bucal/educação , Serviços de Saúde Escolar/organização & administração , Autocuidado/métodos , Cuidadores , Criança , Feminino , Humanos , Masculino , México , Grupo AssociadoRESUMO
INTRODUCTION: The objective of our study was to evaluate the cost-effectiveness of a community-based intervention designed to improve physical activity levels and dietary intake and to reduce diabetes risk in a largely Hispanic population residing along the U.S.-Mexico border. METHOD: We forecasted disease outcomes, quality-adjusted life-years (QALYs) gained, and lifetime costs associated with actual and projected attainment of 2% and 5% weight loss taking a societal cost perspective. We extrapolated changes in beverage calorie consumption between baseline and 6-month follow-up to attain projected weight loss measures. Outcomes were projected 5, 10, and 20 years into the future and discounted at a 3.0% rate. RESULTS: The incremental cost-effectiveness ratio was $57,430 and $61,893, respectively, per QALY gained when compared with usual care for the 2% and 5% weight loss scenarios. The intervention was particularly cost-effective for morbidly obese participants. Cost-effectiveness improves when using 3-year weight loss projections based on changes in sugar-sweetened beverage caloric consumption to $49,478 and $24,092 for the 2% and 5% weight loss scenarios. CONCLUSIONS: This analysis demonstrates that a culturally sensitive community-based weight loss and maintenance intervention can be cost-effective even when healthy weight individuals participate.