Reasons for dental visits and needs for oral health/disease after 50 years in the arsenic poisoning patients caused by dried milk

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To clarify causal relationships between health promotion activities in the Hikari association and the after-50-year oral health of the arsenic poisoning patients caused by dried milk using the PRECEDE-PROCEED (P-P) model. 523 patients answered the questionnaire regarding oral health and health promotion activities in the association (recovery rate 60%). Methods: The present data regarding oral health circumstances of the patients were compared with those of 1987. The P-P model was tested by a linear structural relations (LISREL) program. Results: More than 80% of the participants reported that they put off going to the dentist until they had toothache in the 1987 survey, whereas 66% agreed with this statement in the 2007 survey. The percent of this irregular attendance pattern decreased from 80% in 1987 to 66% in 2007. 36% of the participants reported that they brush each of their teeth carefully in the 1987, whereas 47% agreed with this statement. The P-P model was not found initially … More , to be consistent with the actual data collected from study participants. The “enabling factors " did not have significant effects on “environment" and/or “health behavior". Similarly, neither “health behavior" nor “environment" had significant effects on health (problem). LISREL diagnostic information revealed that the “predisposing factors" affected “health" and QOL, and that the “environment" affected the “reinforcing factors", “enabling factors" to affect “health". In the light of these findings, changes to the P-P model were made. The overall fit of the modified model was improved and judged to be satisfactory (GFI=0.973, AGFI=0.935, RMSEA=0.075). Conclusions: The modified P-P model showed that the QOL would be improved by strengthening health behavior and/or the predisposing factors within the community. Under the conditions of this study, health promotion activities might not fit the reality of patient's behavioral change without consideration to re-orienting the variables within the P-P model. Less