Factor structure of health and oral health-related behaviors among adolescents in Arusha, northern Tanzania

Abstract

Objective. This study aimed to evaluate the factor structure of health and oral health-related behaviors and it's invariance across gender and to identify factors associated with behavioral patterns. Materials and methods . A cross-sectional study included 2412 students attending 20 secondary schools in Arusha. Self-administered questionnaires were completed at school. Results . Principal component analysis of seven single health and oral health-related behaviors (tooth brushing, hand wash after latrine, hand wash before eating, using soap, intake of sugared mineral water, intake of fast foods and intake of sweets) suggested two factors labeled hygiene behavior and snacking. Confirmatory factor analyses, CFA, provided acceptable fit for the hypothesized two-factor model; CFI = 0.97. Multiple group CFA across gender showed no statistically significant difference in fit between unconstrained and constrained models (p = 0.203). Logistic regression revealed ORs for hygiene behaviors of 1.5, 0.5, 1.5, 1.5 and 0.6 if being a girl, current smoker, reporting good relationship with school, access to hygiene facilities and bad life satisfaction, respectively. ORs for snacking were 1.3, 1.4, 0.4 and 0.5 if female, in the least poor household quartile, low family socio-economic status and high perceived control, respectively. Conclusion . The two factors suggest that behaviors within each might be approached jointly in health promoting programs. A positive relationship with school and access to hygiene facilities might play a role in health promotion. Provision of healthy snacks and improved perceived behavioral control regarding sugar avoidance might restrict snacking during school hours.

Key Words::

• Schoolchildren
• factorial structure
• oral health behavior
• health behavior
• Tanzania

Acknowledgements

This work was in part funded by a grant from the Norwegian Cooperation Programme for Development, Research and Education (NUFU) and in part from the Faculty of Medicine and Dentistry, University of Bergen. It was facilitated by the collaborating institutions: Muhimbili University of Health and Allied Sciences and Centre for Educational Development in Health, Arusha, Tanzania, the University of Limpopo, South Africa, and the Universities of Oslo and Bergen, Norway. The authors acknowledge and appreciate Arusha municipality, Arusha rural and Meru administrative councils' authorities, Muhimbili University of Health and Allied Sciences (MUHAS), Ministries of Health and Social Welfare and Education in Tanzania, and REK VEST of Norway for permission to conduct the study. They are indebted to the study participants, parents and their school administrations for making this study a reality.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.