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School‐level contextual factors associated with betel quid chewing among schoolchildren in Taiwan
Author(s) -
Huang HsiaoLing,
Lee ChienHung,
Yen YeaYin,
Chen Ted,
Chen FuLi,
Ho PeiShan,
Lai TaiCheng,
Tsai WenLing,
Hsu ChihCheng
Publication year - 2009
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/j.1600-0528.2008.00442.x
Subject(s) - medicine , betel , logistic regression , environmental health , intervention (counseling) , demography , stratified sampling , dentistry , nursing , structural engineering , sociology , nut , engineering , pathology
– Objectives: Previous to this research, no literature had explored the clustering of betel quid chewing at the school‐level and the contextual factors contributing to this behavior among elementary schoolchildren. This study therefore examines this in clusters stratified according to school geography and the rate of aboriginal students in each school. Individual‐level characteristics are controlled in the study. Methods: The data used derive from student and parent surveys of the School Smoking Survey Project from a sampling of third and fourth grade children from 13 elementary schools in Tao‐Yuan County, Taiwan ( n = 1585). The individual‐ and school‐level characteristics regarding betel quid chewing were estimated using multi‐level logistic regression analysis. Results: Compared to their counterparts, students attending schools with higher percentages of aboriginal students (OR = 3.60, 95% CI: 1.31–9.95), or those schools located in a mountainous region (OR = 2.82, 95% CI: 1.19–6.70), were found to have a greater risk of chewing behavior. Other observed characteristics having a significant relationship to student chewing behavior were drinking alcohol and smoking cigarettes. Conclusions: The new findings from this study suggest that the specific school attended is an important point of intervention. Therefore, effective policies and preventive programs should be strongly considered for implementation in schools that are putting students at the greatest risk for betel quid chewing behavior. Our study also confirmed the relationship between betel quid chewing, cigarette smoking, and alcohol drinking, suggesting that multifaceted intervention strategies need to be considered in regard to such behaviors among elementary schoolchildren.