ArticleJournal of preventive medicine and public health = Yebang Uihakhoe chi2026
Changes in Adolescents' Compliance Rate in Response to Policy Changes: COVID-19 Toothbrushing Restrictions in Schools for Korea.
Article in Journal of preventive medicine and public health = Yebang Uihakhoe chi, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study investigated changes in toothbrushing in adolescents in response to public health policy changes during coronavirus disease 2019 (COVID-19) focusing on behavioral trends before, during, and after policy enforcement according to socio-demographic subgroups.
methodsData from the Korean Youth Risk Behavior Survey (2018-2024) were divided into 3 periods: before (2018-2019), during (2020-2022), and after (2023-2024) the implementation of COVID-19 school restrictions. A total of 354 943 middle and high school students were included. The primary outcome variable was self-reported toothbrushing after lunch at school. Multivariable logistic regression was conducted, adjusting for confounders such as sex, academic performance, school level, school type, handwashing, and oral health status (toothache and gum bleeding).
resultsThe compliance rate for toothbrushing declined significantly during the restriction period across all groups. It varied by sex, school type, school level, health-related behaviors (drinking, smoking, handwashing), and oral health status. Female students, middle schoolers, students in single-sex schools, non-smokers, and those practicing hand hygiene showed higher compliance. After restrictions were lifted, toothbrushing rates improved but remained lower than pre-pandemic levels. Recovery of the toothbrushing rate was observed in most groups, particularly among female students, high schoolers, and those with positive health-related behaviors. However, academic performance and oral health status were not significantly associated with recovery rate in adjusted analyses.
conclusionsThis study highlights that adolescents' health behaviors are highly sensitive to environmental and policy changes. Variations in compliance and recovery rates underscore the need for adolescent-centered policies that account for both compliance and recovery, especially during crises such as pandemics.
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