We conducted a multilevel analysis to identify the individual- and school-level factors that affect Korean high school students’ tooth brushing, soda intake, smoking, and high-intensity physical activity. We sampled 27,919 high school students from the 15th Korea Youth Risk Behavior Web-Based Survey. The individual-level variables included demographic, socioeconomic, and health-related factors. The school-level variables included school system and school type. Regarding the individual-level factors, economic level and academic performance had a significant effect on health behavior when the demographic variables were adjusted. In the final model, the school-level factors had a significant effect on health behavior. The odds ratio (OR) of brushing less than twice a day in vocational schools compared to general schools was 1.63 (p < 0.001), and the OR of soda intake more than three times a week in vocational schools was 1.33 (p < 0.001). In addition, the OR of smoking in vocational schools was 2.89 (p < 0.001), and the OR of high-intensity physical activity in vocational schools was 0.80 (p < 0.001). Therefore, both individual- and school-level factors affect Korean students’ health behaviors. A school-based comprehensive health promotion strategy should be developed that considers schools’ characteristics to equip all students with health awareness, regardless of socioeconomic status.

We conducted a multilevel analysis to identify factors affecting adolescents’ preventive dental treatment experience in South Korea. We sampled 72,435 students who participated in the 9th Korea Youth Risk Behavior Web-based Survey. The individual-level variables were divided into demographic factors, socioeconomic factors, oral health behavioral factors, and oral symptom experience factors. The regional-level variables included oral health resources, rate of students receiving oral health education at school by region, social deprivation index, and the number of private educational institutions. A higher rate of receiving oral health education in school by region was associated with increased fluoride application (1.04 times, p = 0.003). However, the number of private educational institutes per 1000 people was negatively associated with fluoride application experienced by students (0.64 times, p = 0.039). Students underwent more scaling when there were more dentists per 10,000 individuals (1.14 times, p = 0.008) and less scaling in areas with a higher social deprivation index (0.88 times, p = 0.024). To increase the access to preventive care for oral diseases among adolescents, a preventive system should be established in schools, and a primary dental care system should be established through the cooperation of the government, private dental clinics, and schools.

This study investigated factors affecting the subjective experience of oral symptoms among 2,285 elementary school students in the fourth and sixth grades using the Korean survey on the Health of Youth and Children in 2010. After conducting chi-square and Mann-Whitney U tests, we performed multiple logistic regression analysis to determine the factors affecting children's experience of oral symptoms. We found that the factors most frequently associated with the subjective experience of more oral symptoms were lower tooth brushing frequency, greater intake of foods that cause dental caries, higher stress levels, and lower levels of support from friends. In conclusion, determinants of children's oral health, such as children's oral health behaviors and psychological factors must be considered in a multifaceted approach to developing programs to promote oral health among children.

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Objectives: This study conducted a multilevel analysis to identify individual and school-level factors that affect brushing, soda intake, smoking, and high-intensity physical activity in Korean high school students. Methods: We sampled 27,919 high school students who participated in the 15th Korea Youth Risk Behavior Web-based Survey. The individual-level variables were divided into demographic factors (gender, grade), socioeconomic factors (self-reported economic status, academic performance), health-related factors (self-reported health and oral health status, experience of stress or depression, oral symptoms). The school-level variables included school system (general high school, vocational high schools) and school type (boys' school, girls' school, and co-ed school). Results: For individual-level factors, socioeconomic factors such as economic level and academic performance had a significant effect when demographic variables were adjusted. In the final model including significant individual-level variables and school-level variables, school-level factors had a significant effect on school system and school type. The OR for brushing less than twice a day in vocational high schools compared to general high schools was 1.63 (p<0.001), and the OR for soda intake more than three times a week in vocational high schools was 1.33 (p<0.001). In addition, the OR for current smoking in vocational high schools was 2.89 (p<0.001), and the OR for high-intensity physical activity in vocational high schools was 0.80 (p<0.001). Conclusions: School factors as well as individual socioeconomic factors have a common influence on Korean adolescents' toothbrushing, soda intake, smoking, and high-intensity physical activity. Schools are best health setting, regardless of socioeconomic level, providing students with supportive environment for controlling risk factors such as toothbrushing, sugar intake and smoking. Therefore, for the adolescents' health promotion, it is necessary to provide a preventive strategy to comprehensively deal with common risk factors based on school.