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ORIGINAL ARTICLE
Year : 2016  |  Volume : 34  |  Issue : 3  |  Page : 223-226
 

Health camps in schools and content analysis of the school textbooks: A cross-sectional study in Tamil Nadu


1 Department of Pediatric Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
2 Department of Conservative Dentistry, Sri Ramachandra Dental College and Hospital, Porur, Chennai, Tamil Nadu, India
3 Department of Pediatric Dentistry, Interns From KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India

Date of Web Publication25-Jul-2016

Correspondence Address:
P R Geetha Priya
Department of Pediatric Dentistry, KSR Institute of Dental Science and Research, Tiruchengode - 637 215, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.186756

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   Abstract 

Background: School textbooks have been considered as an effective platform for promoting oral health. The information on oral health in the Indian school textbooks has not been evaluated. Aim: The aim of this study was to evaluate the contents of school textbooks on oral health and to quantitatively analyze the school health camps and guest lectures/demonstrations conducted in the schools of three districts in Tamil Nadu. Methodology: Twenty schools which participated in the study followed the Central Board of Secondary Education, matriculation, or the state board syllabus. A questionnaire was designed to collect information about the medical camps, dental camps, guest lectures, and demonstrations conducted in the last academic year from the schools. The questionnaires were distributed among the school teachers of grades I–V. They were asked to provide photocopies of the topics on oral health which were included in the syllabus. Content analysis of the information on oral health-related topics in the school textbooks was done. Descriptive statistics of the details of the camps and lectures was done using Pearson's Chi-square test (SPSS version 17) (SPSS Inc. Chicago, Illinois, USA). Results: There was no significant difference in the number of medical camps (P = 0.445), dental camps (P = 0.055), and guest lectures (P = 0.069) organized among the three boards of schools. Basic information on the parts and type of teeth, tooth decay, and brushing were present in the textbooks of all three boards of schools. Conclusion: The school textbooks of all the three boards contained basic and adequate information on oral health. Periodic revisions of the content and quality of information in the school textbooks are essential. To make the information sticky for long-term, reinforcements in the form of school health education is needed.


Keywords: Content analysis, oral health, school dental camps, school textbooks


How to cite this article:
Geetha Priya P R, Asokan S, Kandaswamy D, Malliga S, Arthi G. Health camps in schools and content analysis of the school textbooks: A cross-sectional study in Tamil Nadu. J Indian Soc Pedod Prev Dent 2016;34:223-6

How to cite this URL:
Geetha Priya P R, Asokan S, Kandaswamy D, Malliga S, Arthi G. Health camps in schools and content analysis of the school textbooks: A cross-sectional study in Tamil Nadu. J Indian Soc Pedod Prev Dent [serial online] 2016 [cited 2020 Oct 22];34:223-6. Available from: https://www.jisppd.com/text.asp?2016/34/3/223/186756



   Introduction Top


An increasing prevalence of oral diseases is seen in children. This is a major public health problem which warrants an urgent need for oral health promotion.[1] The oral health behaviors of children begin with parents at home.[2] Hence, oral health of children is believed to be greatly influenced by their parents. As they go to school, they get additional influences from their school environment, teachers, classmates, friends, and the school textbooks. School is an effective platform for promoting knowledge and improving health-related beliefs and behaviors in children. The United Nations International Children Emergency Fund explained school as the widest world channel for broadcasting information to the families, school staffs, community members, and the students themselves.[3]

The most influential stages of children's development are the school days, during which they attain lifelong beliefs, attitude, and skills. Health behaviors are easily learned and are more sustainable, when developed at young age.[4] The health camps and school health education programs also contribute actively to the child's well-being. The school textbooks and curriculum include information on general and oral health. The basic health education received from the school textbooks is believed to influence the knowledge, attitude, and practice behavior of these children. Hence, the school textbooks have been considered as an effective tool for health education and they form the platform for promoting oral health, particularly in resource-limited settings.[5] Many worldwide organizations have acknowledged the importance of school textbooks for health promotion.[6] The United Nations Educational, Scientific, and Cultural Organization in its “Education for all” framework emphasized on improving the quality of textbooks.[7] However, most of the studies have evaluated the general health topics in school textbooks and rarely on the oral health aspects.[3],[8] Some studies have concluded that the information in the school text books was inadequate, inaccurate, and needed improvement.[8],[9] In Indian scenario, literature search has shown scanty information regarding the contents of school textbooks on oral health. Hence, the present study was planned with the following aims: (i) To evaluate the content of school textbooks of the academic year 2014–2015, on oral health and (ii) quantitative analysis of dental camps, guest lecturers, and demonstrations conducted in the schools of three districts in Tamil Nadu, India.


   Methodology Top


A cross-sectional descriptive study was planned and the protocol was approved by the Institutional Review Board and the Institutional Ethics Committee. Thirty schools (10 state board, 10 matriculation board, and 10 central board) in and around Tiruchengode, Tamil Nadu, were randomly accessed. The schools were located at three adjoining districts of Tamil Nadu (Erode, Salem, and Namakkal). The schools were at a maximum distance of <50 km from Tiruchengode. Permission was obtained from 20 schools (7 state board, 6 matriculation board, and 7 central board) to carry out the study and informed consent was obtained from the school authorities. A questionnaire was designed to collect information about the medical camps, dental camps, guest lectures, and demonstrations conducted in the last academic year (2014–2015) from the schools. The questionnaires were distributed among the school teachers of I–V grade, who gave the informed consent to participate in the study. Information on the number and type of medical/dental camps (screening or treatment camp) was also obtained. The school teachers were asked to provide the details of the topics on oral health, taught in grades I–V in the last academic year. The photocopies of information on oral health (pictures, figures, and texts) in the textbooks and the questionnaires were collected back from the respective schools after 5 days. Content analysis of the information on oral health-related topics in the school textbooks was done. Descriptive statistics of the details of the camps and lectures were done using Pearson's Chi-square test (SPSS version 17) (SPSS Inc. Chicago, Illinois, USA).


   Results Top


The flowchart of the protocol followed in the study has been shown in [Figure 1]. Four schools were not included in the final statistical analysis as they returned unfilled questionnaires and did not provide adequate information. Hence, a total of 16 schools (3 state board, 6 matriculation board, and 7 central board schools) were included. There was no significant difference in the number of medical camps (P = 0.445) organized among the three boards of schools. There was no significant difference in the number (P = 0.055) and type (P = 0.064) of dental camps organized among the three boards of schools as shown in [Table 1]. Children in the public schools alone received the dental treatment camps. [Table 2] shows that there was no statistically significant difference in the demonstrations and lectures (P = 0.069) conducted between the schools. The contents about oral health in the school textbooks were broadly classified under three headings: (i) Anatomy (ii) oral diseases (iii) practice behavior. Basic information on parts and type of teeth, tooth decay, and brushing were present in the textbooks of all three boards of schools. The topics discussed in the textbooks have been tabulated in [Table 3].
Figure 1: Flowchart of the study protocols

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Table 1: Details of dental camps organized in the three boards of schools

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Table 2: Guest lectures and demonstrations organized in the three boards of schools

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Table 3: Content analysis of school textbooks on oral health

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   Discussion Top


Education is provided to children by both public and private sectors. In India, 29% of the students in the age group of 6–14 years receive education from private sector.[10] In Tamil Nadu, based on the syllabus, the schools are generally divided into State board, Matriculation, Central Board of Secondary Education (CBSE), International General Certificate of Secondary Education, and Indian Certificate of Secondary Education. The public sector includes only state board schools and the private sectors follow either of the syllabi mentioned above. All public schools in Tamil Nadu follow a unique syllabus called the “Samacheer Kalvi.” Some state board and matriculation schools of the private sector also follow the Samacheer Kalvi system by choice, along with additional textbooks of their choice. This study was planned to assess the contents on oral health in the school textbooks of different boards of schools in Tamil Nadu.

Organizing camps in schools greatly depend on a lot of factors. Challenges commonly encountered include: Inadequate screening instruments, lack of audiovisual aids, promotional materials, and inadequate transportation facilities.[1] Some private schools make it mandatory to conduct health education camps and this may be due to the school management's interest in the welfare of their children. Some nongovernment organizations and corporate hospitals voluntarily sponsor and conduct health camps in schools and at a community level. Involvement of dental colleges in school dental health education programs plays a vital role in educating children about oral health. The Ministry of Health and Family Welfare, Government of India, included “National Oral Health Policy” in the National Health Policy (1995) and implemented oral health education, preventive and curative services.[11] In the present study, it was found that the CBSE schools and matriculation schools had only screening camps. But, children from the public schools had both screening and treatment camps. This may be attributed to the low socioeconomic status of the parents of these children, who readily gave informed consent for receiving the free dental treatment.

The World Health Organization (2003) specified oral health education curriculum for primary school children. It mainly emphasized on (a) dental plaque and healthy foods, (b) demonstrating a positive attitude toward oral health and dental team, and (c) appreciating the importance of teeth.[12] Oral health education has become a part of the school syllabus and the present research has been conducted to identify the contents on oral heath in school textbooks. Content analysis uses quantitative or qualitative techniques to analyze information and messages in detail. Nomoto et al.[5] categorized the content analysis of school textbooks into three main patterns: (i) Information about a topic of interest in the form of words, pictures, or illustrations; (ii) accuracy of the health information; and (iii) identifying health-related topics. In this study, identification of the oral health-related topics in the school textbooks was done. Though beyond the scope of the present study, there was another characteristic finding seen in this study. The textbooks of lower grade children had more pictures, activities, and illustrations, compared to the textbooks of the older children, which had more detailed texts. The school textbooks can improve the knowledge on oral health in children, but changing the attitude and practice behavior is still questionable. Adequate knowledge is not reflected as behavior, as modern education in India is more rote learning rather than problem-based learning. Express India suggests that students are focused on cramming the information provided in the textbooks.[10] Hence, there is an urgent need for education which enhances knowledge, attitude, and the practice behavior of children. A systematic review by Lister-Sharp et al.[13] has shown that a

multifaceted approach of health education is likely to be most effective. To make the information sticky for long-term, reinforcements through school health education programs may be needed. Activity- and game-based school health education can significantly influence the practice behavior of the child. The health education programs should involve the teachers and parents, as they play a vital role in creating a positive attitude in the child's mind. Periodic revisions of the content and quality of information in the school textbooks are essential.


   Conclusion Top


There were no significant differences in the medical camps, dental camps, guest lecturers, or demonstrations conducted in the last academic year among the three boards of schools. Children in the public schools alone received the dental treatment camps. The school textbooks of all the three boards contained basic and adequate information on oral health.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Lawal FB, Taiwo JO. An audit of school oral health education program in a developing country. J Int Soc Prev Community Dent 2014;4 Suppl 1:S49-55.  Back to cited text no. 1
    
2.
Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children's oral health: A systematic review. J Pediatr (Rio J) 2013;89:116-23.  Back to cited text no. 2
    
3.
Kazemian R, Ghasemi H, Movahhed T, Kazemian A. Health education in primary school textbooks in Iran in school year 2010-2011. J Dent (Tehran) 2014;11:536-44.  Back to cited text no. 3
    
4.
Kwan SY, Petersen PE, Pine CM, Borutta A. Health-promoting schools: An opportunity for oral health promotion. Bull World Health Organ 2005;83:677-85.  Back to cited text no. 4
    
5.
Nomoto M, Nonaka D, Mizoue T, Kobayashi J, Jimba M. Content analysis of school textbooks on health topics: A systematic review. Biosci Trends 2011;5:61-8.  Back to cited text no. 5
    
6.
Oakes J, Saunders M. Education's most basic tools: Access to textbooks and instructional materials in California's public schools. Teach Coll Rec 2004;106:1967-88.  Back to cited text no. 6
    
7.
UNESCO. A Comprehensive Strategy for Textbooks and Learning Materials. Division for the Promotion of Quality Education, United Nations Educational Scientific and Cultural Organisation (UNESCO); 2005. http://www.unesdoc.unesco.org/images/0014/001437/143736fb.pdf. [Last accessed on 2015 Nov 14].  Back to cited text no. 7
    
8.
de Irala J, Urdiain IG, López Del Burgo C. Analysis of content about sexuality and human reproduction in school textbooks in Spain. Public Health 2008;122:1093-103.  Back to cited text no. 8
    
9.
Barrio-Cantalejo IM, Ayudarte-Larios LM, Hernán-García M, Simón-Lorda P, García-Gutiérrez JF, Martínez-Tapias J. Are the health messages in schoolbooks based on scientific evidence? A descriptive study. BMC Public Health 2011;11:54.  Back to cited text no. 9
    
10.
Available from: . [Last cited on 2015 Nov 13].  Back to cited text no. 10
    
11.
Sekhar V, Sivsankar P, Easwaran MA, Subitha L, Bharath N, Rajeswary K, et al. Knowledge, attitude and practice of school teachers towards oral health in Pondicherry. J Clin Diagn Res 2014;8:12-5.  Back to cited text no. 11
    
12.
World Health Organization. Oral Health Promotion through Schools WHO Information Series on School Health Document 11. Geneva: World Health Organization; 2003.  Back to cited text no. 12
    
13.
Lister-Sharp D, Chapman S, Stewart-Brown S, Sowden A. Health promoting schools and health promotion in schools: Two systematic reviews. Health Technol Assess 1999;3:1-207.  Back to cited text no. 13
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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