Perhetaustan ja sukupuolen yhteys koulunkäyntiin

Finnish education policy has aimed at providing equal educational pathways that level educational opportunities and aims at the equity of participation. Combined with the Finnish welfare state it has succeeded in sustaining social mobility. Yet the adolescents do not necessarily have equal possibilities to achieve these educational positions. Socio-economic differences in Finland are persistent and both education and poverty are still partly inherited. This thesis concentrated on prevailing socio-economic differences on school attendance and on studying the associations between family backgrounds, gender and school attendance. The key question for this thesis was formulated as: What kind of differences in school attendance there can be found among 9th graders from Helsinki according to their family background and their gender? The core data was a school-based survey carried on in Helsinki in 2004. There were two thirds of the schools of Helsinki and 2381 respondents. The questionnaire included questions on young people s school-related experiences, school attendance, school performance and their family. The analysis had three steps: after describing the respondents the associations between school attendance and family background were analyzed using MCA (Multiple Classification Analysis). Finally the associations between school attendance, family and school environment were studied using logistic regression analysis. The results showed that schooling (school attendance) was a variety of attitudes and experiences. The analysis showed also that all the family background factors had an effect on school attendance. From the family background measurements, it seems that the perceived parental support varied most with school attendance. Apart from the school environment factors, each family-related factor is statistically significantly related to two or more school attendance factors, even when adjusted with the school environment factors. There was also a gender-related difference in school attendance. Girls seem to like school attendance more than boys; they do better at school, but are also more worried about school work. Especially the expected associations with the parental educational level, but also with perceived parental support, gender and school attendance, are important results. When they are combined with the support pupils get from firm family structure and employment status it is possible to point out some factors that are relevant when discussing the ways educational achievements are moved to next generations in good and worse.

Nuorten henkilökohtaisten tavoitteiden profiilit ja subjektiivinen hyvinvointi

Personal goals offer an important aspect of personality and motivation. Personal goals are conscious and subjectively motivated objectives by which a person directs his or her life over time. Personal goals are related to adolescents' subjective well-being. The aim of the present research was to find out, what kinds of groups of adolescents can be formed by the content of personal goals and how these groups differ in goal appraisals, meaningful life events and subjective well-being. The second aim of the study was to detect gender differences and differences between vocational and high school students in goal appraisals, meaningful life events and subjective well-being. Adolescents in upper secondary education (N=1144) were grouped together by the content of their personal goals using a person oriented approach and a cluster analysis. Clusters found in the analysis were named by the centre goal as (1) a property group, (2) a vocation group, (3) a future education and personal relationships group and (4) a selffocused group. Adolescents in the property group put a little effort into their career goal, they were not exhausted in school work and their subjective well-being was average. Adolescents in the vocation group felt progress in their career goal and put effort into it. They had goals related to life-style. They did not feel exhausted and their subjective well-being was average. The future education and personal relationships group put effort into their career goal and considered progressing in it. Personal relationships were important in their lives. They were exhausted in their school work but they did not feel cynicism. Their own health was one of their goals and they felt satisfaction in their life. Adolescents in the self-focused group did not put effort into their career goal nor considered progressing in it. They were exhausted and especially cynical in their school work. They suffered from almost clinically significant depression. They had low life-satisfaction and low self-esteem. The following gender and educational differences were found. Compared with boys, girls felt their career goal was more important and stressful, and girls also put more effort into it. Girls were more exhausted, depressed and they had lower selfesteem than boys. High school students felt more stress with their career goal than vocational school students. High school students were more exhausted, but still they felt more satisfaction with their lives. In practice, to cover adolescents' personal goals is a possibility to find distressed individuals who might be in need for extra support.

Kadonneet pojat : Monitapaustutkimus ESY-poikien kompleksisesta koulu-urasta ja elämänkulusta

Lost boys. A multiple case study of the complex school career and life-course of male students who have attended special classes for the emotionally and behaviourally maladjusted The purpose of this thesis is to describe the school career and the life-course of eight former special-class students from the comprehensive school to their further education and into adulthood. The members of the target group have been students of special classes for pupils with emotional and behavioural difficulties in southern Finland. The interviews were made 1994-1997 at school and for follow-up interviews 2002-2003, when the participants were already adults. Six mothers were also interviewed. The qualitative data was gathered using individual interviews and Adult Attachment Interview. The aim was to explore the life-histories of subjects from early childhood to early adulthood. Information was gathered also from the documents concerning the students´ school attendance. Every single life-history is illustrated as a life-course graphic. The data has been analysed using different frames of reference and combining different theories. In addition to theories considering developmental risk factors and protective factors, the data is considered using theories of control over life, attribution, self-efficacy and identity and attitudes towards education. The experiential living mode of the students has been studied, as well. The results of this study show that the frames of references which are used complement each other. The target students clustered identically in spite of the frames of reference. As a result, the study has illustrated the same phenomenon from different points of view. The results of the study consist of three types of school careers: The winding career, the vicious circle career and the straight career. The three careers differ from each other in developmental risk and protective factors and post-school life-courses of the students. The type of childhood families and especially the fathers´ attention to the school education as well as the free time of their sons was important. Keywords: Pupils with emotional and behavioural difficulties, maladjustment to school, life-course, identity

Kasvilajien tunnistaminen, oppiminen ja opettaminen yleissivistävän koulutuksen näkökulmasta

The purpose of the research was to determine how well Finnish pupils and students of different ages recognize plant species, which variables explain recognition of plant species, what plants and nature mean to the subjects and how plant species identification should be taught in general education in Finland. The subjects were pupils from: every class level of the primary schools (grades 1 6); lower- secondary school (grades 7 9); high school (grades I II); university departments of teacher education and classroom teachers and teachers from university involved with environmental teaching and also experts from education and botany. A total of 883 people took part in the research. Both quantitative and qualitative research methods were used. The quantitative methods were: a) plant species recognition test, where 70 plant species photos were shown to subjects and b) an experiment in which three experimental groups had a plant recognition test on the nature trail and the three comparison groups were tested on recognition of the same species in classroom. The testing materials consisted of 31 real plants outdoors and 31 photos taken of these real plant species that were shown to pupils from fourth, fifth and sixth classes (grade levels) from primary school. The qualitative methods were a questionnaire administered to pupils from elementary school and high school and students from the department of teacher education, to teachers from university and interviews, where 3 5 pupils and students who recognized the plant species best or worst in the recognition test were selected to be interviewed. Furthermore, classroom teachers from primary school and experts were interviewed. The research results showed that on average plant species were recognized insufficiently on every level of education. There was also variation between answers from primary school to university teachers. However, species recognition skills improved from primary school to university teachers. Among other things, sex and place of residence explained species recognition skills, because girls and pupils from rural areas knew plant species statistically significantly better than boys or pupil from cities. Almost every pupil, student and all classroom teachers wanted to recognize plant species better. Many pupils mentioned that a motivating teaching method would be to go outdoors and investigate the plant species themselves. University teachers and experts also mentioned that the best and most efficient learning and teaching method for species recognition skills, is to practice in nature. We should teach plant species in nature, using many senses and teaching methods. Also new technology could be used in teaching species recognition skills. Keywords: plant species recognition, plant species education, general education

Lukemisen vaikeuden kuntoutus ensiluokkalaisilla : Kolme pedagogista interventiota

Remediation of Reading Difficulties in Grade 1. Three Pedagogical Interventions Keywords: initial teaching, learning to read, reading difficulties, intervention, dyslexia, remediation of dyslexia, home reading, computerized training In this study three different reading interventions were tested for first-graders at risk of reading difficulties at school commencement. The intervention groups were compared together and with a control group receiving special education provided by the school. First intervention was a new approach called syllable rhythmics in which syllabic rhythm, phonological knowledge and letter-phoneme correspondence are emphasized. Syllable rhythmics is based on multi-sensory training elements aimed at finding the most functional modality for every child. The second intervention was computerized training of letter-sound correspondence with the Ekapeli learning game. The third intervention was home-based shared book reading, where every family was given a story book, and dialogic reading style reading and writing exercises were prepared for each chapter of the book. The participants were 80 first-graders in 19 classes in nine schools. The children were matched in four groups according to pre-test results: three intervention and one control. The interventions took ten weeks starting from September in grade 1. The first post-test including several measures of reading abilities was administered in December. The first delayed post-test was administered in March, the second in September in grade 2, and the third, “ALLU” test (reading test for primary school) was administered in March in grade 2. The intervention and control groups differed only slightly from each other in grade 1. However, girls progressed significantly more than boys in both word reading and reading comprehension in December and this difference remained in March. The children who had been cited as inattentive by their teachers also lagged behind the others in the post-tests in December and March. When participants were divided into two groups according to their initial letter knowledge at school entry, the weaker group (maximum 17 correctly named letters in pre-test) progressed more slowly in both word reading and reading comprehension in grade 1. Intervention group and gender had no interaction effect in grade 1. Instead, intervention group and attentiveness had an interaction effect on most test measures the inattentive students in the syllable rhythmic group doing worst and attentive students in the control group doing best in grade 1. The smallest difference between results of attentive and inattentive students was in the Ekapeli group. In grade 2 still only minor differences were found between the intervention groups and control group. The only significant difference was in non-word reading, with the syllable rhythmics group outperforming the other groups in the fall. The difference between girls’ and boys’ performances in both technical reading and text comprehension disappeared in grade 2. The difference between the inattentive and attentive students cold no longer be found in technical reading, and the difference became smaller in text comprehension as well. The difference between two groups divided according to their initial letter knowledge disappeared in technical reading but remained significant in text comprehension measures in the ALLU test in the spring of grade 2. In all, the children in the study did better in the ALLU test than expected according to ALLU test norms. Being the weakest readers in their classes in the pre-test, 52.3 % reached the normal reading ability level. In the norm group 72.3 % of all students attained normal reading ability. The results of this study indicate that different types of remediation programs can be effective, and that special education has been apparently useful. The results suggest careful consideration of first-graders’ initial reading abilities (especially letter knowledge) and possible failure of attention; remediation should be individually targeted while flexibly using different methods.

Is a Majority Enough? Psychological Well-being and Its Relation to Academic and Prosocial Motivation, Self-regulation and Achievement at school

This cross-sectional study analyzed psychological well-being at school using the Self-Determination theory as a theoretical frame-work. The study explored basic psychological needs fulfillment (BPNS), academic (SRQ-A), prosocial self-regulation (SRQ-P) and motivation, and their relationship with achievement in general, special and selective education (N=786, 444 boys, 345 girls, mean age 12 yrs 8 mths). Motivation starts behavior which becomes guided by self-regulation. The perceived locus of control (PLOC) affects how self-determined this behavior will be; in other words, to what extent it is autonomously regulated. In order learn and thus to be able to accept external goals, a student has to feel emotionally safe and have sufficient ego-flexibility—all of which builds on satisfied psychological needs. In this study those conditions were explored. In addition to traditional methods Self-organizing maps (SOM), was used in order to cluster the students according to their well-being, self-regulation, motivation and achievement scores. The main impacts of this research were: a presentation of the theory based alternative of studying psychological well-being at school and usage of both the variable and person-oriented approach. In this Finnish sample the results showed that the majority of students felt well, but the well-being varied by group. Overall about for 11–15% the basic needs were deprived depending on the educational group. Age and educational group were the most effective factors; gender was important in relation to prosocial identified behavior. Although the person-oriented SOM-approach, was in a large extent confirming what was no-ticed by using comparison of the variables: the SEN groups had lower levels of basic needs fulfillment and less autonomous self-regulation, interesting deviations of that rule appeared. Some of the SEL- and GEN-group members ended up in the more unfavorable SOM-clusters, and not all SEN-group members belonged to the poorest clusters (although not to the best either). This evidence refines the well-being and self-regulation picture, and may re-direct intervention plans, and turn our focus also on students who might otherwise remain unnoticed. On the other hand, these results imply simultaneously that in special education groups the average is not the whole truth. On the basis of theoretical and empirical considerations an intervention model was sug-gested. The aim of the model was to shift amotivation or external motivation in a more intrinsic direction. According to the theoretical and empirical evidence this can be achieved first by studying the self-concept a student has, and then trying to affect both inner and environmental factors—including a consideration of the basic psychological needs. Keywords: academic self-regulation, prosocial self-regulation, basic psychological needs, moti-vation, achievement

Young, gifted and spiritual -The case of Finnish sixth-grade pupils

The aim of this study was to explore the spirituality of Finnish academically gifted 12 13-year old pre-adolescents (N = 101). Their spirituality was investigated through the following three questions: (1) What is their relationship to religion? (2) How do they perceive transcendence? and (3) How does their search for meaning integrate into their lives? A total of 60 girls and 41 boys participated in the study. They attend a special school, Helsingin Suomalainen yhteiskoulu, in Helsinki, Finland. The school includes classes from grade 3 to upper secondary school and has an entrance test. This study is part of a research project called Actualizing Finnish Giftedness which is funded by the Finnish Academy between 2000 2007 and is led by Professor Tirri. The research project is based on Gardner s Multiple Intelligences theory (Gardner 1993) and on Hay s (1998) work on spirituality. The data in this study was gathered in 2003 and 2004. It includes both qualitative and quantitative material. The emphasis is on data gathered with interviews. The mixed method approach was used as the methodological framework for connecting the qualitative content analysis, phenomenological approach and the quantitative tests of this study. The results of the sub-studies are reported in full in the four original articles. First, the articles show that the pupils connect religion mainly with Christian institutions and do not consider religion and spirituality to overlap. Second, the articles show that the pupils believe in God and the interference of God in their lives and they think that reality includes a spiritual dimension. Third, the pupils had four kinds of existentially significant interests: personal, transcendental, cosmic and ethical. Cosmic interests were especially highlighted in the article concerning boys as nature and science were reported to be integral sources for their existential thinking. In addition, perceptions on God seemed to be connected to the individual s perception on the meaning of life. In RE, spiritual development has been a constant topic of interest since the late eighties. Likewise, recently in gifted education there have been discussions concerning spiritual intelligence (Gardner 1999) and spirituality of the gifted (Kerr & Cohn 2001). Based on the empirical results of the study, this study concludes that education wishing to promote spiritual development should aim at being existentially relevant to the pupils and use their existential search as an integrative framework for their individual talents and skills.

Yhteinen käsityö peruskoulun 7. luokalla : Opettajien kokemuksia yhteisen käsityön opetuksesta ja organisoinnista

Finnish education politics presume that basic education should be equal to all students. While organising craft education equality can be understood as similarity or as possibility to choose. The possibility to be able to choose whether textile or technical craft despite of one´s gender has been the aim of laws and curriculums already over 30 years. In practice it´s almost impossible to students to ignore feminine and masculine roles that go deep into our culture. Choosing craft has been divided by gender, which is the reason why possibility to choose has not been good enough to educationalists of equality. The latest guidelines for the National core curriculum for bacis education were issued in 2004. According to curriculum craft education consists parts of both technical and textile craft. All students should take part in both sectors of crafts. Furthermore, one can be given a possibility to consentrate his studies in whether textile or technical craft. The curriculum does not set the rules how the education should be organised, which means that it can be organised in many ways depending on city, school or teacher. Teachers and other specialists have contradictory feelings towards shared craft education, because traditional way to see craft in Finland is to separate textile craft from technical craft. Both crafts have some common features that are introduced in curriculum. Besides there is many equal things in craft theories that bind textile and technical craft to each other. The main purpose of this research was to find out, how shared craft education has been organised at the 7.th grade in Finnish comprehensive school, and which things affect in the settlements. Second goal was to describe and compare teachers´ experiences in teaching shared craft education. Third aim of this study was how shared craft has changed craft education. I collected the research material in May 2006 by interviewing both textile and technical craft teachers who teach shared craft. The material consists of fourteen theme interviews. In the analysis of the material I used theoretic bounded document analysis. According to the research there are three different ways to organise shared craft education: 50 50-arrangement, exchanging period and project week. In the schools that carried out 50 50-arrangement teaching was realised mainly in heterogenous groups. Principals had usual a lot of authorization on how to arrange craft education, which means that their views on equality, laws and curriculum affected in the settlemets more than teachers´ opinions. Teachers´ attitudes to shared craft were mainly positive. The changing of craft education can be divided in two parts: the aims and the containings of the curriculum have changed, as well as the meaning of the craft as core subject. Teachers have been forced to decrease the containings of both textile and technical crafts. Despite of eliminations both crafts still have comprehensive containings. Teachers decided what to teach by these argumets: Students should learn some basic things or produce a certain product. Usually teachers had also a lot of experience and special intrests in crafts. According to this research there is four significant meanings for shared craft education: 1) developing readiness for doing things, 2) developing skills of thinking, 3) delight of doing things and 4) teaching attitude.

"Haluan tuonne heti!" : Tulevaisuuskuvia ghanalaisten, isobritannialaisten,suomalaisten ja tansanialaisten lasten piirustuksissa

"I want there now!" Images of the future in the drawings of Ghanaian, British, Finnish and Tanzanian children The aim of the Thesis is to examine what kind of images children aged between 8 and 12 years in Ghana, Great Britain, Finland and Tanzania hold of their future. The study is a qualitative analysis based on data that consists of 214 drawings, digitally photographed and analysed using AtlasTI computer program. The data was coded and divided into " families " whose frequencies were compared in order to maintain results. The assignment was given to the children in the language used in the school and it was similar in each country. The children were introduced to the idea with a set of stimulating questions and after that they were asked to draw and colour with a pen a picture of 1) him/herself as an adult, 2) his/her future home and 3) the people and the animals they think they will be living with. The children were also asked to write down the country and the place they believe to live in their future. They were also encouraged to write down e.g. their dream profession, what they would like to have as hobbies in their adulthood and other important things in their lives. The analysis focuses on the content of the drawings instead of artistic or psychological interpretations. The differences between the drawings from different countries as well as the differences in a single country were significant. The current trends and the experiences children had lived through were present in the drawings. There were no differences in the colour of the skin and the most popular professions were doctor, police and football player. The football was very strongly present in all of the data; almost fourth of the children had either drawn or mentioned football as their future profession or hobby. Different flora was present in 84% of Tanzanian and 70% of Ghanaian drawings compared to the 23% of British and 17% of Finnish drawings. Of all the family forms a dream of the traditional nuclear family could be found among 29% of the drawings. Compared to that a total of 30% wanted either a child of their own without a spouse (15%) or a spouse without a child (15%). Also grandparents, childhood friends, other adults, animals or even space aliens were present and sharing a home with the children in the drawings. Of all children 15% wanted to live totally alone in the future. This was most typical (38%) among the Finnish boys. The cat and the dog were the most popular animals to appear in the drawings. Moving abroad proved to be purely a western phenomenon, dreamed by 57% of the British and 18% of the Finnish children. As results, a negative self-image, violence, lack of expressions of positive feelings and solitude among the Finnish boys in the data were very concerning. Keywords: Images of the future, future studies, future-education, picture analysis

Koulutuksellisen syrjäytymisriskin ennustettavuus yhteishakuvalintojen kautta tarkasteltuna : koulupudokkuusriskin yhteys oppilaan kognitiiviseen kompetenssiin, koulumenestykseen sekä itseä ja vanhempia koskeviin uskomuksiin

The objective of this study was to find factors that could predict educational dropout. Dropout risk was assessed against pupil’s cognitive competence, success in school, and personal beliefs regarding self and parents, while taking into account the pupil’s background and gender. Based on earlier research, an assumption was made that a pupil’s gender, success in school, and parent’s education would be related with dropping out. This study is part of a project funded by the Academy of Finland and led by Professor Jarkko Hautamäki. The project aims to use longitudinal study to assess the development of pupils’ skills in learning to learn. The target group of this study consisted all Finnish speaking ninth graders of a municipality in Southern Finland. There were in total 1534 pupils, of which 809 were girls and 725 boys. The assessment of learning to learn skills was performed about ninth graders in spring 2004. “Opiopi” test material was used in the assessment, consisting of cognitive tests and questions measuring beliefs. At the same time, pupils’ background information was collected together with their self-reported average grade of all school subjects. During spring 2009, the pupils’ joint application data from years 2004 and 2005 was collected from the Finnish joint application registers. The data were analyzed using quantitative methods assisted by the SPSS for Windows computer software. Analysis was conducted through statistical indices, differences in grade averages, multilevel model, multivariate analysis of variance, and logistic regression analysis. Based on earlier research, dropouts were defined as pupils that had not been admitted to or had not applied to second degree education under the joint application system. Using this definition, 157 students in the target group were classified as dropouts (10 % of the target group): 88 girls and 69 boys. The study showed that the school does not affect the drop-out risk but the school class explains 7,5 % of variation in dropout risk. Among girls, dropping out is predicted by a poor average grade, a lack of beliefs supporting learning, and an unrealistic primary choice in joint application system compared to one’s success in school. Among boys, a poor average grade, unrealistic choices in joint application system, and the belief of parent’s low appreciation of education were related to dropout risk. Keywords educational exclusion, school dropout, success in school, comprehensive school, learning to learn

Violence against the adolescents of Kolkata: A study in relation to the socio-economic background and mental health

This study attempts to understand the nature of violence suffered by the adolescents of Kolkata (erstwhile Calcutta) and to identify its relation with their socio-economic background and mental health variables such as anxiety, adjustment, and self-concept. It is a cross-sectional study covering a total of 370 adolescents (182 boys and 188 girls) from six higher secondary schools in Kolkata. The data was gathered by way of a semi-structured questionnaire and three standard psychological tests. Findings revealed that 52.4%, 25.1%, and 12.7% adolescents suffered psychological, physical, and sexual violence in the last year. Older adolescents (aged 17–18 years) suffered more psychological violence than the younger ones (15–16 years) (p < 0.05). Sixty nine (18.6%) adolescent students stood witness to violence between adult members in the family. More than three-fifth (61.9%) adolescents experienced at least one type of violence, while one-third (32.7%) experienced physical or sexual violence or both. Whatever its nature is, violence leaves a scar on the mental health of the victims. Those who have been through regular psychological violence reported high anxiety, emotional adjustment problem, and low self-concept. Sexual abuse left a damaging effect on self-concept (p < 0.05), while psychological violence or the witnessing of violence prompted high anxiety scores (p < 0.05), poor emotional adjustment (p < 0.05), and low self-concept (p < 0.05). This study stresses the need to provide individual counselling services to the maltreated adolescents of Kolkata so that their psychological traumas can heal and that they can move on in life with new hopes and dreams.

Developmental, functional brain imaging and electrophysiological evidence of visual and auditory working memory

Intact function of working memory (WM) is essential for children and adults to cope with every day life. Children with deficits in WM mechanisms have learning difficulties that are often accompanied by behavioral problems. The neural processes subserving WM, and brain structures underlying this system, continue to develop during childhood till adolescence and young adulthood. With functional magnetic resonance imaging (fMRI) it is possible to investigate the organization and development of WM. The present thesis aimed to investigate, using behavioral and neuroimaging methods, whether mnemonic processing of spatial and nonspatial visual information is segregated in the developing and mature human brain. A further aim in this research was to investigate the organization and development of audiospatial and visuospatial information processing in WM. The behavioral results showed that spatial and nonspatial visual WM processing is segregated in the adult brain. The fMRI result in children suggested that memory load related processing of spatial and nonspatial visual information engages common cortical networks, whereas selective attention to either type of stimuli recruits partially segregated areas in the frontal, parietal and occipital cortices. Deactivation mechanisms that are important in the performance of WM tasks in adults are already operational in healthy school-aged children. Electrophysiological evidence suggested segregated mnemonic processing of visual and auditory location information. The results of the development of audiospatial and visuospatial WM demonstrate that WM performance improves with age, suggesting functional maturation of underlying cognitive processes and brain areas. The development of the performance of spatial WM tasks follows a different time course in boys and girls indicating a larger degree of immaturity in the male than female WM systems. Furthermore, the differences in mastering auditory and visual WM tasks may indicate that visual WM reaches functional maturity earlier than the corresponding auditory system. Spatial WM deficits may underlie some learning difficulties and behavioral problems related to impulsivity, difficulties in concentration, and hyperactivity. Alternatively, anxiety or depressive symptoms may affect WM function and the ability to concentrate, being thus the primary cause of poor academic achievement in children.

Family and guests at Aenny Catzenstein nee Gottschalk's 80th birthday; London.

Front row l-r: Beatrice Durand, Francine Durand and Aenny Catzenstein, the boys are Ara-Serge Donabedian and Patrick Matthiesen and the adults are Susan Prior, Francis Matthiesen, Maren Matthiesen, Nino Fabri and Olga Matthiesen,

Family and guests at Aenny Catzenstein nee Gottschalk's 80th birthday; London.

Front row l-r: Francine Durand, Beatrice Durand and Aenny Catzenstein, the boys are Ara-Serge Donabedian and Patrick Matthiesen and the adults are Susan Prior, Francis Matthiesen, Maren Matthiesen, Nino Fabri and Olga Matthiesen,

Oral Health among Iranian Preadolescents : A School-Based Health Education Intervention

The present study assessed oral health and its determinants among Iranian preadolescents, and evaluated a school-based health education programme aimed to promote their oral health. The target population of this study comprised a random sample of the third-grade school children (n = 459) of all public primary schools in 19 areas of Tehran city. The data came from a clinical examination of the children and two self-administered questionnaires: one for children, and one for mothers. The clinical dental examination was performed for recording children's oral health. The mothers' questionnaires covered background factors, oral self-care (OSC) behaviours and oral health-related knowledge and attitude statements. After baseline data collection, a community trial was designed as a 3-month school-based intervention study. For the intervention trial, the third-grade classes as the clusters were randomly assigned to the intervention and control groups. Three kinds of intervention were implemented, one in class, one via the parents, and one as a combination of these. One group served as controls with no intervention. The outcome measures of the study were changes in plaque and bleeding scores recorded. The results showed that mean dmft was 3.75 (SD = 2.8) for the primary teeth and mean DMFT was 0.4 (SD = 0.9) for the permanent teeth. All children had plaque on at least one index tooth and bleeding on probing in at least one index tooth occurred in 81%. About one-third (34%) of the children reported favourable OSC and less than half (46%) of the children reported brushing their teeth at least twice daily. Girls reported favourable OSC (OR = 2.0), had decay-free teeth (OR = 1.8) and treated permanent teeth (OR = 3.3) more than did boys. Mother's oral health-related aspects, i.e., mother's favourable OSC, high knowledge levels of and positive attitudes towards oral health, and active supervision of the child's tooth brushing had a positive effect on all aspects of children's oral health status and behaviours (ORs from 1.3 to 1.9). After the intervention, the results showed a strong intervention effect on healthy gingiva in both groups where parents were involved: the parental-aid group (OR = 7.7, 95% CI 2.2-27.7) and combined group (OR = 6.6, 95% CI 2.0-22.1). To improve children's oral health, community school-based oral health educational programmes should be established to include all primary schools. These programmes should benefit from the common risk factor approach and a multi-sectored approach to employ for communication between the community, the school, and the family. Oral health interventions should empower the parents' ability to improve their own oral health behaviour and then to transfer that healthy behaviour to their children.