西藏那曲儿童青少年口腔健康素养横断面调查

Report on oral health literacy of children and adolescents in Nagqu，Xizang

摘要

目的：了解西藏自治区那曲市儿童青少年的口腔健康素养，评估单次线上数字化融媒体科普课提升口腔健康素养的效果。方法：对西藏自治区那曲市色尼区406名9~15岁的学生采用整群抽样的方法以班级为单位进行线下问卷调查，然后对学生进行远程单次数字化融媒体口腔健康科普课程教育，并在课后再次线下问卷调查，对比评估线上课程对口腔健康素养是否有提升效果。问卷内容包括人口学资料、口腔健康基本知识、信念、自我保健和就医行为。对变量的缺失值、异常值、逻辑错误进行清理后，采用 R4.4.1 和 SPSS 27.0 统计软件进行统计分析。结果：西藏自治区儿童青少年的口腔健康知识知晓率未达 50% ，超 50% 的青少年每天会摄入甜点、甜饮料等高含糖食物，每天刷牙两次及以上的青少年只有 15.98% ，课程前每天使用牙线的被调查者仅7.71％，课程前含氟牙膏的使用率为45.45％。西藏自治区儿童青少年口腔问题影响进食、发音等。单次口腔健康课程虽受到支持和欢迎，但对口腔知识知晓率和保健行为转化率未见明显影响。结论：西藏自治区儿童青少年口腔健康知识知晓率较全国十年前平均水平低，大部分儿童青少年尚未形成良好的个人口腔卫生习惯。单次远程线上口腔健康教育课程对素养提升效果不显著，应当开展其他更有影响且有地区针对性措施让儿童青少年重视口腔疾病预防，提高西藏自治区儿童青少年口腔健康知识知晓率与知识向行为转化率。

Abstract

Objective：To understand the oral health literacy of children and adolescents in Nagqu City， and to evaluate the effect of a single online digital integrated media science popularization course on im- proving oral health literacy. Methods：A cluster sampling method was employed in which all students aged 9-15 years in the Seni District of Naqu City，Xizang Autonomous Region， 406 students were sur- veyed class-by-class using a paper questionnaire.After baseline data collection，the students received a single remote digital-multimedia oral-health education lesson；a follow-up questionnaire was administered one week later to evaluate whether the online course improved oral-health literacy.The instrument col-lected demographic information，basic oral-health knowledge，beliefs，self-care practices，and dental- service utilization.Data were analyzed with R 4.4.1 and SPSS 27.0. Results：The awareness rate of oral health knowledge among the children and adolescents in Xizang was less than 50％.More than half of the adolescents consumed high-sugar foods，such as desserts and sugary beverages daily.Only 15.98％of the adolescents brushed their teeth twice or more daily，7.71％used dental floss daily before the course，and the usage rate of fluoride toothpaste was 45.45％.Oral health issues among the children and adolescents in Xizang severely impacted their daily lives，particularly in eating，pronunciation，and brushing.A sin- gle oral health education session showed no significant impact on the awareness rate or the conversion of knowledge into behavior. Conclusion：The awareness rate of oral health knowledge among the children and adolescents in Xizang is lower than the national average a decade ago，and a significant portion has yet to develop good personal oral hygiene habits.Targeted measures are needed to improve oral health awareness among the children and adolescents in Xizang.These may include utilizing interactive digital education tools and emphasizing oral disease prevention to enhance both the awareness rate of oral health knowledge and the conversion of knowledge into behavior.

关键词

口腔健康素养 / 儿童和青少年 / 口腔健康教育 / 横断面调查 / 西藏自治区

Key words

Oral health literacy / Children and adolescents / Oral health education / Cross-sectional study / Xizang Autonomous Region

参考文献

[1] Ceylan D, Akan-Çelen FN, Özkan S, et al. Promoting adolescent health:Health literacy,self-efficacy and internet use[J]. Turk J Pediatr, 2022, 64(1):110-121.

[2] 李丹琳, 杨蓉, 王锦, 等. 健康素养与中国青少年健康危险行为关系的 Meta 分析[J]. 中国健康教育, 2019, 35(7):596-600.

[3] Prihanto JB, Nurhayati F, Wahjuni ES, et al. Health literacy and health behavior:Associated factors in surabaya high school students,Indonesia[J]. Int J Environ Res Public Health, 2021, 18(15): 8111.

[4] Jamieson LM, Divaris K, Parker EJ, et al. Oral health literacy comparisons between Indigenous Australians and American Indians[J]. Comm Dent Health, 2013, 30 (1):52-57.

[5] Dickson-Swift V, Kenny A, Farmer J, et al. Measuring oral health literacy:A scoping review of existing tools[J]. BMC Oral Health, 2014, 14(1): 148.

[6] Sabbahi DA, Lawrence HP, Limeback H, et al. Development and evaluation of an oral health literacy instrument for adults[J]. Comm Dent Oral Epid, 2009, 37(5):451-462.

[7] Quan J K, Wang XZ, Sun XY, et al. Permanent teeth caries sta- tus of 12-to 15-year-olds in China:Findings from the 4th nationaloral health survey[J]. Chin J Dent Res, 2018, 21 (3): 181 - 193.

[8] 黄克强, 高秀秋, 席焕久, 等. 西藏那曲镇藏族学生口腔健康知识与行为调查[J]. 中国学校卫生, 2006, 27(3):187-188.

[9] 杨乐, 林天卫, 卢业明. 林芝市区藏族中学生口腔健康知识态度行为现状[J]. 中国学校卫生, 2017, 38(6):923-926.

[10] Duan S, Tang R, Zhang C, et al. The correlation of region- specific lifestyle and subjective perception of oral health with oral health-related quality of life among Tibetan early adolescents in Ganzi:A cross-sectional study[J]. PeerJ, 2025, 13:e18842.

[11] Hou R, Mi Y, Xu Q, et al. Oral health survey and oral health questionnaire for high school students in Tibet,China[J]. Head Face Med, 2014, 10(1): 17.

[12] 张睿, 程立, 张桃, 等. 甘孜藏族自治州12岁藏族儿童口腔健康状况及分析[C]// 2018 年中华口腔医学会第十八次口腔预防医学学术年会论文汇编. 2018.

[13] Apel Z, Fagundes NCF, Sharmin N, et al. Social media in oral health education:A scoping review[J]. Eur J Dent Educ, 2025, 29(1):50-63.

[14] Luai AF, Malek AA, Hassan EH, et al. Effectiveness of immer- sive technologies in oral health promotion and education:A sys- tematic review[J]. J Dent, 2024, 150: 105324.

[15] Geetha Priya PR, Asokan S, Janani RG, et al. Effectiveness of school dental health education on the oral health status and knowledge of children:A systematic review[J]. Indian J Dent Res, 2019, 30(3): 437.

[16] Kim S, Kim SY. Effectiveness of school-based oral health educa- tion for children and adolescents in low-and middle-income coun- tries:A systematic review and meta-analysis[J]. Asia Pac J Public Health, 2024, 36 (4):312-321.

[17] Sun HB, Zhang W, Zhou XB. Risk factors associated with early childhood caries[J]. Chin J Dent Res, 2017, 20(2):97-104.

[18] Honkala E. Primary oral health care[J]. Med Princ Pract, 2014, 23(Suppl 1):17-23.

基金资助

首都卫生发展科研专项(2024-2G-4106)

2023年度人卫创新发展研究项目(RWCY23D II 007007)

北京大学口腔医学院教育教学研究项目(2024-ZC-07)

＂北京研究型病房卓越计划＂项目(BRWEP2024W194100100)

北京大学口腔医院临床新技术新疗法项目(PKUSSNCT-25B05)

北京市自然科学基金-海淀原始创新联合基金(L222001)