Objective: The purpose of this study was to investigate in the factors influencing high school students'' toothbrushing behavior using the Korea Youth Risk Behavior Web?based Survey data and Photovoice methodology, a visual qualitative research method.
Methods: This study conducted chi?squared test to confirm the one day toothbrushing behavior on factors influencing the toothbrushing behavior in the 11th Korea Youth Risk Behavior Web?based Survey, socio?demographic factors for the reasons of toothbrushing behavior after lunch and non?behavior of toothbrushing behavior after lunch, and the factors influencing socio?economic factors and social psychological factors, and performed multiple logistic regression analysis to analyze correlations. By using the photovoice methodology, this study identified the perception of toothbrushing behavior, the factors affecting the toothbrushing behavior, the reinforcement factors and obstacles for toothbrushing behavior, and the influencing factors for school toothbrushing behavior.
The subjects of this study were 11 high school students who were favorable for this study and selected from coeducational high schools among high schools located in Gangneung city. The purpose and necessity of this study were explained to the participants of the study, and the photographs were freely taken for 3 weeks and collected by mail. The group discussion was conducted based on the results of analyzing the first collected data that had been analyzed according to the procedure of grounded theory. 274 codes were extracted by combining all data, and twelve codes, which were judged not to be equivalent to the purpose of this study, were processed as missing values, resulting in the final 262 codes used for analysis. The results of Photovoice methodology are presented as subcategorization, and the in vivo coding is presented as the final visual data.
Results: In the 2015 Korea Youth Risk Behavior Web?based Survey, the number of toothbrushing behavior per day was 90% or more in both two and three sessions. Also, in the qualitative research results, the perception of toothbrushing behavior has been emphasized as a perception of a must?do for oral health. In addition, quantitative research results showed that socioeconomic factors and psychosocial factors were related to toothbrushing behavior. And qualitative research results confirmed social relations, tooth cleaning facilities and environmental conditions, use of dental clinics, and awareness of oral health as factors that strengthen toothbrushing behavior. And psychological stress, convenience of purchasing sugar, and social network were the factors that interfered with practice. The actual practice rate of school toothbrushing behavior was found to be 52%, and non?practicing factors were identified as boredom of oral hygiene products, lack of necessity, lack of time, and lack of facilities in that order. Through the photovoice method, convenient school environment, peer group relationship, and school dental health program were identified as necessary factors for school toothbrushing behavior.
Conclusion: Based on the above quantitative and qualitative research results, it was confirmed that there is a significant correlation between the sociodemographic factors, socioeconomic factors, and social psychological factors as factors influencing the toothbrushing behavior of high school students. However, it is suggested that high school students'' dental health programs should be reviewed through in?depth analysis and intervention based on perception factors, reinforcement factors, interference factors, and necessary factors for toothbrushing behavior at school that are additionally identified in qualitative research of this study.