互动式口腔健康教育对青岛市280名小学生刷牙行为改善的效果评价

Evaluation of the Effect of Interactive Oral Health Education on the Brushing Behavior of 280 Primary School Students in Qingdao

摘要: 目的：本研究旨在构建并验证一种融合日常打卡监测、游戏化教学与家校医三方联动的互动式口腔健康教育模式，追踪评估其对小学生的实际应用效果，并挖掘影响行为转化的核心驱动因素。方法：本研究在青岛市市南区三所公立小学中随机抽取了280名一年级新生作为纵向追踪样本队列。通过实施包括互动打卡、多媒体科普与家校联动在内的创新教育干预，收集了基线期(T0)与随访期(T1)的调查数据。利用潜在类别分析(LCA)对儿童的基线特征进行潜类别划分，使用McNemar检验评估干预前后刷牙行为的差异，并引入分类模型结合SHAP框架解析特征重要性。结果：1) 干预效果显著：经过干预，儿童坚持“每天早晚刷牙”的比例由基线的13.2%极显著提升至70.4% (p < 0.001)；每次刷牙时长达标(>1分钟)的比例由45.0%提升至77.9%。2) 潜类别分析识别出三类异质性群体，其中多数属于具有改善潜力的过渡转化人群。3) 预测模型揭示，除基线刷牙习惯外，“对窝沟封闭防龋的认知”和“氟化物认知”是驱动随访期形成优良行为的最强正向预测因子。结论：互动式教育干预模式能有效改善学龄儿童的口腔清洁依从性。研究证实，“防龋医学认知(如窝沟封闭)”的前置科普对后续行为养成具有决定性的催化作用，为未来校园公共卫生干预提供了重要的数据支撑和新路径。

Abstract: Objective: The purpose of this study is to construct and verify an interactive oral health education model that integrates daily punch-in monitoring, game-based teaching and home-school-doctor linkage, track and evaluate its practical application effect on primary school students, and explore the core driving factors that affect behavior transformation. Methods: In this study, 280 freshmen were randomly selected from three public primary schools in Shinan District of Qingdao as a longitudinal follow-up sample queue. Through the implementation of innovative education intervention, including interactive punching, multimedia science popularization and home-school linkage, the survey data of baseline period (T0) and follow-up period (T1) were collected. The latent category analysis (LCA) was used to classify children’s baseline characteristics, and McNemar test was used to evaluate the difference in brushing behavior before and after intervention, and the classification model combined with SHAP framework was introduced to analyze the importance of characteristics. Results: 1) The intervention effect was remarkable: after the intervention, the proportion of children who insisted on “brushing their teeth every morning and evening” increased significantly from 13.2% of the baseline to 70.4% (p < 0.001); the proportion of brushing time reaching the standard (>1 minute) increased from 45.0% to 77.9%. 2) The latent category analysis identifies three heterogeneous groups, most of which belong to the transitional transformation population with improvement potential. 3) The prediction model reveals that besides the baseline brushing habit, “cognition of pit and fissure sealing to prevent caries” and “cognition of fluoride” are the strongest positive predictors to drive the formation of excellent behavior during the follow-up period. Conclusion: Interactive educational intervention model can effectively improve the compliance of school-age children in oral cleaning. The research confirmed that the pre-popular science of “caries prevention medical cognition (such as pit and fissure sealing)” has a decisive catalytic effect on the subsequent behavior development, and provides important data support and new paths for future campus public health intervention.