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- Changes in Adolescents’ Compliance Rate in Response to Policy Changes: COVID-19 Toothbrushing Restrictions in Schools for Korea
- Suhyun Choi, Yubeen Kim, Joo Mi Kim, Joohyeon Kim, Jaewon Jeon, Jae-Seok Song, Yeunhee Kwak, Se-Hwan Jung, Nam-jun Kim
- J Prev Med Public Health. 2026;59(1):35-45. Published online September 8, 2025
- DOI: https://doi.org/10.3961/jpmph.25.448
- 833 View
- 115 Download
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Abstract
Summary
PDF - Objectives
This study investigated changes in toothbrushing in adolescents in response to public health policy changes during coronavirus disease 2019 (COVID-19) focusing on behavioral trends before, during, and after policy enforcement according to socio-demographic subgroups.
Methods
Data from the Korean Youth Risk Behavior Survey (2018–2024) were divided into 3 periods: before (2018–2019), during (2020–2022), and after (2023–2024) the implementation of COVID-19 school restrictions. A total of 354 943 middle and high school students were included. The primary outcome variable was self-reported toothbrushing after lunch at school. Multivariable logistic regression was conducted, adjusting for confounders such as sex, academic performance, school level, school type, handwashing, and oral health status (toothache and gum bleeding).
Results
The compliance rate for toothbrushing declined significantly during the restriction period across all groups. It varied by sex, school type, school level, health-related behaviors (drinking, smoking, handwashing), and oral health status. Female students, middle schoolers, students in single-sex schools, non-smokers, and those practicing hand hygiene showed higher compliance. After restrictions were lifted, toothbrushing rates improved but remained lower than pre-pandemic levels. Recovery of the toothbrushing rate was observed in most groups, particularly among female students, high schoolers, and those with positive health-related behaviors. However, academic performance and oral health status were not significantly associated with recovery rate in adjusted analyses.
Conclusions
This study highlights that adolescents’ health behaviors are highly sensitive to environmental and policy changes. Variations in compliance and recovery rates underscore the need for adolescent-centered policies that account for both compliance and recovery, especially during crises such as pandemics. -
SummaryKorean summary
청소년의 점심식사 후 칫솔질 행동은 COVID-19 학교 방역 제한 기간 동안 감소하였으며, 제한 해제 이후에도 부분적인 회복에 그쳤다. 순응도와 회복 양상은 집단별 특성에 따라 다르게 나타났다. 따라서 공중보건 정책은 행동의 순응뿐 아니라 회복까지 고려하여, 집단별 특성에 맞게 설계할 필요가 있다.Key Message
Adolescents’ toothbrushing after lunch declined during COVID-19 school restrictions and showed only partial recovery after restrictions were lifted. Patterns of compliance rate and recovery rate varied according to subgroup characteristics. Therefore, public health policies should be designed to consider both compliance and recovery rates, tailored to subgroup-specific characteristics.
- Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon’s Health-Plus Community Program
- Joon-Hyeong Kim, Nam-Jun Kim, Soo-Hyeong Kim, Woong-Sub Park
- J Prev Med Public Health. 2023;56(6):487-494. Published online August 17, 2023
- DOI: https://doi.org/10.3961/jpmph.23.121
- 5,919 View
- 269 Download
- 3 Web of Science
- 3 Crossref
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Abstract
Summary
PDF
- Objectives
Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon’s Health-Plus community program, implemented from 2013 to 2019 on residents’ health behaviors.
Methods
This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.
Results
HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.
Conclusions
The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed. -
SummaryKorean summary
건강주민운동은 지역사회 건강지표 향상에 기여한 것으로 보여진다. 따라서 주민참여형 건강증진사업이 주민들의 건강을 향상하기 위해서는 주민이 주체가 되어 조직화된 힘으로 지역사회의 근본적인 변화를 만들어가는 주민운동의 관점으로 시행될 필요가 있다.Key Message
The Health Community Organization (HCO) appears to contribute to the enhancement of community health indicators. Therefore, in order to improve the health of residents through community-based participatory health promotion programs, it is necessary to implement them from the perspective of the HCO in which residents organize themselves as a mobilized force to bring about fundamental changes in the community. -
Citations
Citations to this article as recorded by
- Comparative analysis of oral health behaviour and utilisation of oral health care services in the general population and among patients with non-communicable diseases in Korea: a repeated cross-sectional survey conducted from 2008 to 2022
Jeehee Pyo, Hyeran Jeong, Noor Afif Mahmudah, Young-Kwon Park, Minsu Ock, Pracheth Raghuveer
PLOS One.2025; 20(4): e0321816. CrossRef - Cumulative social-ecological risk factors and health-risk behaviors among Chinese adolescents: A latent class analysis
Xianwei Zhang, Xiaoyang Wang, Fengqin Li, Zhiying Sun, Ke Xu, Zhonghui Liu
Journal of Affective Disorders.2025; 388: 119614. CrossRef - Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung Park, Yoonyoung Jang, Taehwa Kim, Yunsu Choi, Kyoung Hwan Ahn, Jung Ho Kim, Hye Seong, Jun Yong Choi, Hyo Youl Kim, Joon Young Song, Shin-Woo Kim, Hee Jung Choi, Dae Won Park, Young Kyung Yoon, Sang Il Kim
Epidemiology and Health.2024; 46: e2024097. CrossRef
- Comparative analysis of oral health behaviour and utilisation of oral health care services in the general population and among patients with non-communicable diseases in Korea: a repeated cross-sectional survey conducted from 2008 to 2022
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