Do schools put children's oral health at risk owing to lack of a health-promoting policy?
BACKGROUND
To achieve a healthy school environment with good nutrition as recommended by World Health Organization, health-promoting policies are needed.


OBJECTIVE
To ascertain whether Finnish schools had oral-health-promoting policies and whether the presence of the policy was associated with practical actions related to oral-health promotion. Another aim was to determine if and how the policy and the actions had changed in 2007-09.


METHODS
This longitudinal survey was implemented in Finnish upper comprehensive school classes 7-9 (n=970) in 2007-09. The questionnaire contained 32 questions concerning selling of sweet- and healthy products, school policy, and decision-makers of the policy. From the nine items on the questionnaire, three variables were formed by weighting the response categories: Policy, Exposure, and Enabling. The mean values of each variable were calculated and the statistical significances of the changes were analysed using nonparametric Friedman's test. The correlations between the variables were investigated by Spearman's correlation coefficients.


RESULTS
The majority of schools did not have clearly defined oral-health-promoting policies, then they improved in making them, decreased exposure of pupils to sweet products, and offered more oral-health-enabling factors (p<0.041). In 2009, the oral-health-promoting policy and enabling factors of the schools correlated positively (r=0.200; p=0.001) and pupil exposure to selling of sweet products and oral-health-enabling factors correlated negatively (r=-0.176; p=0.005).


CONCLUSIONS
As even a national recommendation do not seem to have a major effect in changing oral-health-promoting policies, schools need more support on their way towards healthier school environment.
Department of Community Dentistry, University of Oulu, Oulu, Finland. anttilja@mail.student.oulu.fi
Jaakko
J
Anttila
Rami
R
Kankaanpää
Mimmi
M
Tolvanen
Salla
S
Saranpää
Anne
A
Hiiri
Satu
S
Lahti
D000293:Adolescent; D005387:Finland; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D008137:Longitudinal Studies; D009909:Oral Health; D016134:Organizational Policy; D012306:Risk; D012574:Schools / Q000458:organization & administration*; D011795:Surveys and Questionnaires