Evaluating the effect of a community-based lay health advisor training curriculum to address immigrant children's caries disparities Yuan-Jung Hsu, Wu-Der Peng, Jen-Hao Chen, Ying-Chun Lin, Chin-Shun Chang, et al. Caries Research, 2015 Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.
Risk evaluation for the development of cervical intraepithelial neoplasia: Development and validation of risk-scoring schemes Chien-Hung Lee, Chiung-Yu Peng, Ruei-Nian Li, Yu-Chieh Chen, Hsiu-Ting Tsai, et al. International Journal of Cancer, 2015 Cervical cancer screening guidelines do not comprehensively define what constitutes high risk. This study developed and validated simple risk‐scoring schemes to improve Papanicolaou smear screening for women at high risk. Four cumulative risk score (CRS) schemes were derived respectively for the development of cervical intraepithelial neoplasia grade 1 (CIN1) and grade 2 or worse (CIN2+) using community‐based case‐control data (n = 1523). By calculating the area under the receiver operating characteristic (AU‐ROC) curve, these schemes were validated in a Papanicolaou smear follow‐up cohort (n = 967) and a hospital‐based cytology screening population (n = 217). A high DNA load of high‐risk human papillomavirus (HR‐HPV) was the main predictor for CIN1 and CIN2+, although age, married status combined with the number of sexual partners, active and passive smoking and age at sexual debut also affected associated lesions. In the training set, only the HPV‐testing‐contained CIN2+ CRS scheme presented an excellent discrimination for identifying CIN2+ (AU‐ROC = 0.866). Using a CRS cutoff value of 4 to identify CIN2+, the sensitivity and specificity of predicting CIN2+ for the 3‐ and 5‐year follow‐ups were 100% and 90.8%, and 83.3% and 90.4%, respectively, in the validation cohort. In the hospital‐based validation population, the CRS scheme showed comparable discrimination for CIN2+ detection (sensitivity 88.2% and specificity 84.6%). Women with CRS ≥4 had a 5.4% and 9.1% of 3‐ and 5‐year cumulative incidence, respectively, and a 40.5‐fold hazard ratio of developing CIN2+. In conclusion, combined with HR‐HPV testing and verified risk factors, a simple CRS scheme could effectively improve the implementation of CIN2+ screening.
Oral health disparities of children among southeast Asian immigrant women in arranged transnational marriages in Taiwan Y.C. Lin, Y.Y. Yen, C.S. Chang, C.C. Ting, P.H. Chen, et al. Caries Research, 2014 This study assessed the oral health disparities and oral health care needs of children whose parents are Southeast Asian immigrant women in arranged transnational marriages. We used the baseline data of the Lay Health Advisor Approach to Promote Oral Health Program (LHA-POHP) to explore the disparities in oral health between immigrant and native children, and the factors associated with their oral health. A cross-sectional community-based study was conducted to collect data from mothers and their preschool children in Southern Taiwan in 2011. A total of 590 (440 natives, 150 immigrants) children aged 4-6 years and their mothers completed the questionnaire and oral examination. Multiple regression models were used to analyze the association between children's oral health and their related factors. The caries index was 6.05 in immigrant children and 3.88 in native children (p < 0.001). The caries prevalence of maxillary anterior teeth in the labial surfaces was higher among immigrants, ranging from 14.7 to 22%. The factor associated with children's caries index was maternal tooth brushing frequency (adjusted odds ratio [aOR] = 8.95, 95% confidence interval [CI] 1.95-41.05). When the mothers did not direct children to brush teeth after eating sweets, their children were more likely to have decayed teeth (aOR = 3.54, 95% CI 1.04-12.03). Children's filled teeth were related to their dental regular check-ups (aOR = 2.28, 95% CI 1.26-4.10). Disparities in oral health among immigrant and native children were observed. The findings suggest that culturally adequate oral health promotion intervention programs should be implemented for immigrants.
Consumption of Sugar-sweetened beverages is associated with components of the metabolic syndrome in adolescents Te-Fu Chan, Wei-Ting Lin, Hsiao-Ling Huang, Chun-Ying Lee, Pei-Wen Wu, et al. Nutrients, 2014 Sugar-sweetened beverages (SSBs) are the principle source of added sugar in diets. Cardiometabolic disturbances can occur from early childhood to adulthood. The aim of this cross-sectional study was to examine the gender-specific association of SSB intake with metabolic syndrome (MetS) and its components among adolescents in Taiwan. A total of 2727 adolescents aged 12 to 16 years randomly selected from three diverse economic areas in Southern Taiwan by using a multistage-sampling strategy participated in this study. Demographic, dietary, physical and anthropometric parameters were measured, and serum lipid profiles and glucose levels were determined. The International Diabetes Federation (IDF) specifies that MetS requires abdominal obesity and ≥2 abnormal components, and Cook criteria for MetS require ≥3 abnormal components. We applied survey-data modules to data analyses, and used multiple regression and logistic models to adjust for covariates. An increased SSB intake was linked to a greater waist circumference in both sexes and to systolic blood pressure in boys (P for trend: ≤0.043). Male moderate and high consuming SSB drinkers exhibited triglyceride levels that were 8.0 and 8.2 mg/dL significantly higher, respectively, than those of nondrinkers. Compared with nondrinkers, boys who consumed >500 mL/day (high quantity) of SSBs exhibited 10.3-fold (95% confidence intervals (CIs): 1.2-90.2) and 5.1-fold (95% CIs: 1.01-25.5) risks of contracting MetS, as defined by the IDF and Cook criteria for MetS, respectively. In girls, the risk estimates for the same comparison were not significant by the IDF criteria (6.5-fold risk, 95% CIs: 0.9-∞) or Cook criteria (5.9-fold risk, 95% CIs: 0.8-43.8) for MetS. High SSB consumption was also linked to 1.9-fold (95% CIs: 1.1-3.1) and 2.7-fold (95% CIs: 1.3-5.7) higher risks of being at a greater overall metabolic risk in girls and boys, respectively. In conclusion, a high SSB intake is associated with adolescent MetS among boys but not girls in Taiwan.
Elevated serum triglyceride and retinol-binding protein 4 levels associated with fructose-sweetened beverages in adolescents Te-Fu Chan, Wei-Ting Lin, Yi-Ling Chen, Hsiao-Ling Huang, Wei-Zeng Yang, et al. Plos One, 2014 Background The metabolic effect of fructose in sugar-sweetened beverages (SSB) has been linked to de novo lipogenesis and uric acid (UA) production. Objectives This study investigated the biological effects of SSB consumption on serum lipid profiles and retinol-binding protein 4 (RBP4) among Taiwanese adolescents. Methods We evaluated the anthropometric parameters and biochemical outcomes of 200 representative adolescents (98 boys and 102 girls) who were randomly selected from a large-scale cross-sectional study. Data were analyzed using multiple regression models adjusted for covariates. Results Increased SSB consumption was associated with increased waist and hip circumferences, body mass index (BMI) values and serum UA, triglyceride (TG) and RBP4 levels. Adolescents who consumed >500 ml/day of beverages half-to-heavily sweetened with high-fructose corn syrup (HFCS) exhibited TG and RBP4 levels 22.7 mg/dl and 13.92 ng/ml higher than non-drinkers, respectively. HFCS drinkers with hyperuricemia had higher TG levels than HFCS drinkers with normal UA levels (98.6 vs. 81.6 mg/dl). The intake of HFCS-rich SSBs and high value of BMI (≥24) interactively reinforced RBP4 levels among overweight/obese adolescents. Circulating RBP4 levels were significantly correlated with weight-related outcomes and TG and UA concentration among HFCS drinkers (r = 0.253 to 0.404), but not among non-drinkers. Conclusions High-quantity HFCS-rich beverage consumption is associated with higher TG and RBP4 levels. Hyperuricemia is likely to intensify the influence of HFCS-rich SSB intake on elevated TG levels, and in overweight and obese adolescents, high BMI may modify the action of fructose on higher circulating levels of RBP4.
Immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors: A cross-sectional study in Taiwan Chih-Chang Chen, Shang-Jyh Chiou, Chun-Chan Ting, Ying-Chun Lin, Chih-Cheng Hsu, et al. BMC Oral Health, 2014 Background With the growing number of transnational marriages in Taiwan, oral health disparities have become a public health issue. This study assessed immigrant-native differences in oral health behaviors of urban mothers and their children. Methods We used the baseline data of an oral health promotion program to examine the immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors. A cross-sectional study was conducted to collect data from mothers in urban area, Taiwan. A total of 150 immigrant and 440 native mothers completed the self-report questionnaires. Logistic regression models analyzed the racial differences in oral health behaviors. Results Approximately 37% of immigrant mothers used dental floss, 25% used fluoride toothpaste, and only 13.5% of them regularly visited a dentist. Less that 40% of immigrant mothers brush their children’s teeth before aged one year, 45% replaced child’s toothbrush within 3 months, and only half of the mothers regularly took their child to the dentist. Immigrant mothers had lower level of caries-related knowledge and attitudes than native mothers (p < .001). Compared to native group, the immigrant mothers were less likely to use of dental floss ([Adjusted odds ratio (aOR) =0.35], fluoride toothpaste (aOR = 0.29), visit a dentist in the past 2 years (aOR = 0.26), and take their children to regular dental check-up (aOR = 0.38); whereas, they were more likely to not consume sweeten beverages (aOR = 3.13). Conclusions The level of caries-related knowledge, attitudes and oral health behaviors were found lower in immigrant mothers than native ones. The findings suggested cross-cultural caries prevention programs aimed at reducing immigrant-native disparities in child oral health care must be developed for these immigrant minorities.
Area disparity in children's perceptions of access to tobacco and cigarette purchasing experiences in Taiwan Heng Lee, Chih‐Cheng Hsu, Fu‐Li Chen, Yea‐Yin Yen, Pi‐Li Lin, et al. Journal of School Health, 2014 BACKGROUNDAdolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren.METHODSData on children's tobacco‐related variables were obtained from the Control of School‐Aged Children Smoking Study Survey in Taiwan. A stratified random sample of 65 primary schools was included. Polytomous logistic regression analyzed factors associated with tobacco accessibility and purchasing experiences.RESULTSMore than half of the children reported that tobacco retailers often or always sold cigarettes to them. Rural and mountainous children were more likely to have access to cigarettes (adjusted odds ratio [AOR] = 2.01 and 3.01, respectively) and have cigarette purchasing experiences (AOR = 3.06 and 13.76, respectively). Cigarette purchasing from retailers (AOR = 1.84) was significantly associated with children's perceptions of access to tobacco. The factors associated with cigarette purchasing experiences were families smoking (AOR = 8.90), peers smoking (AOR = 2.22), frequent exposure to entertainer smoking on TV and in films (AOR = 2.15), and perceived access to tobacco (AOR = 1.51).CONCLUSIONSThe health department should strictly enforce laws regarding retailers selling tobacco to underage, particularly in remote areas. Schools can reinforce tobacco‐use prevention messages.
School-Level policy for tobacco control and individual-Level characteristics in relation to cigarette smoking among children: A multilevel study of elementary schools in pingtung county Taiwan Journal of Public Health, 2010
Augmented and virtual reality training versus conventional teaching methods for geriatric oral care practices in nursing assistants: A randomized controlled trial YC Lin, PC Lin, PC Lin, Y Kabasawa, SR Liao, CY Lin, HL Huang Nurse Education Today, 107047 , 2026 2026
The Effects of Simulation‐Based Interprofessional Education on Oncology Oral Care Competencies Among Dental and Dental Hygiene Students SR Liao, PC Lin, AH Chang, KT Lee, PY Lu, HL Huang, JH Wu European Journal of Dental Education , 2026 2026
Oral Frailty and Physical Frailty Associated With Sleep Quality in Community‐Dwelling Adults: A Cross‐Sectional Study PC Lin, AH Chang, SR Liao, K Matsuo, Y Kabasawa, JH Wu, PC Lin, ... Journal of Oral Rehabilitation , 2026 2026 Citations: 1
Experience of Foreign Domestic Caregivers in Oral Hygiene Care for Older Adults With Dementia in Taiwan: A Qualitative Study Sumandar, KH Lu, MT Hsu, HL Huang, SF Wung, CC Chen, PC Lin Gerodontology 42 (4), 571-579 , 2025 2025
Effects of mobile-based AI-enhanced health counseling on protection motivation, self-care behaviors, and periodontal treatment outcomes in patients with periodontitis … YJ Hu, PC Lin, PC Lin, CL Huang, CC Chen, K Matsuo, CH Lee, ... Journal of Medical Internet Research 27, e78211 , 2025 2025 Citations: 7
Long‐Term Effects of an Oral Rehabilitation Programme on the Oral Function of Male Patients With or Without Tongue Cancer PC Lin, WC Wang, YH Kao, K Matsuo, YC Lin, HL Huang Journal of Oral Rehabilitation 52 (10), 1810-1818 , 2025 2025 Citations: 1
Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients FT You, PC Lin, CL Huang, JH Wu, Y Kabasawa, CC Chen, HL Huang Journal of Periodontology 96 (7), 781-793 , 2025 2025 Citations: 10
Oral Functions and Various Cooking Methods Associated With Chewing‐To‐Swallowing Time in Community‐Dwelling Older Adults PC Lin, CH Huang, JH Wu, YC Lin, K Matsuo, HL Huang Journal of Oral Rehabilitation 52 (6), 883-895 , 2025 2025 Citations: 3
Chinese version of the oral frailty five-item checklist H Huang, K Matsuo, ST Huang, PS Ho, PC Lin, PC Lin, AH Chang Geriatrics & gerontology international 25 (5), 709-710 , 2025 2025 Citations: 3
The association between organizational factors of health promoting schools and teachers' health lifestyles: A multilevel analysis DL Luh, HL Huang, SY Chiou, KY Lo, FL Chen Journal of School Health 95 (2), 126-133 , 2025 2025 Citations: 8
Effectiveness of Virtual Reality-Based Training on Dental Plaque in Female High School Students AH Chang, PC Lin, PC Lin, YC Lin, Y Kabasawa, CY Lin, HL Huang Turkish Journal of Dental Hygiene 5 (1-2025), 16-23 , 2025 2025
Salivary antimicrobial peptide in patients with dementia before and after clinical oral rehabilitation programme: A randomised controlled trial MA Chen, YH Yang, CK Liu, K Matsuo, CC Hsu, YC Lin, HL Huang Journal of Oral Rehabilitation 52 (1), 1-8 , 2025 2025
A delphi study on the feasibility of community-based oral function rehabilitation exercises and the dental hygienist workforce adequacy YK Choi, HL Huang, JH Yun Journal of Korean Academy of Oral Health 48 (4), 201-209 , 2024 2024 Citations: 1
Parental health belief model constructs associated with oral health behaviors, dental caries, and quality of life among preschool children in China: a cross-sectional study SM Liu, YM Xin, F Wang, PC Lin, HL Huang BMC Oral Health 24 (1), 1497 , 2024 2024 Citations: 23
Virtual reality-based simulation learning on geriatric oral health care for nursing students: a pilot study PC Lin, SF Wung, PC Lin, YC Lin, CY Lin, HL Huang BMC Oral Health 24 (1), 627 , 2024 2024 Citations: 24
Effectiveness of the lay health advisor program on oral function and quality of life in aboriginal older adults: A randomized controlled trial BH Cheng, PS Ho, CC Hsu, FL Chen, MA Chen, Y Kabasawa, HL Huang Journal of Oral Rehabilitation 51 (5), 840-850 , 2024 2024 Citations: 6
Effects of a hybrid teaching program on lower limb muscle strength, knee function, and depression in older adults after total knee replacement: A randomized controlled trial HL Chang, MF Hsu, TH Wong, YC Chung, HL Huang Research in Gerontological Nursing 17 (1), 31-40 , 2024 2024 Citations: 8
Effects of a health literacy education program on mental health and renal function in patients with chronic kidney disease: A randomized controlled trial HL Huang, HSU Ya-Hui, Y Chung-Wei, HSU Min-Fang, YC Chung Journal of Nursing Research 32 (1), e310 , 2024 2024 Citations: 13
Effect of non-pharmacological interventions on the prevention of sarcopenia in menopausal women: a systematic review and meta-analysis of randomized controlled trials TW Tan, HL Tan, MF Hsu, HL Huang, YC Chung BMC women's health 23 (1), 606 , 2023 2023 Citations: 21
Effects of hypochlorous acid mouthwash on salivary bacteria including Staphylococcus aureus in patients with periodontal disease: a randomized controlled trial YC Lin, CF Tsai, HL Huang BMC Oral Health 23 (1), 698 , 2023 2023 Citations: 10
MOST CITED SCHOLAR PUBLICATIONS
The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan CH Lee, YC Ko, HL Huang, YY Chao, CC Tsai, TY Shieh, LM Lin British journal of cancer 88 (3), 366-372 , 2003 2003 Citations: 392
Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cancer in Taiwan CH Lee, JM Lee, DC Wu, HK Hsu, EL Kao, HL Huang, TN Wang, ... International Journal of Cancer 113 (3), 475-482 , 2005 2005 Citations: 286
Poverty increases type 2 diabetes incidence and inequality of care despite universal health coverage CC Hsu, CH Lee, ML Wahlqvist, HL Huang, HY Chang, L Chen, SF Shih, ... Diabetes care 35 (11), 2286-2292 , 2012 2012 Citations: 247
Consumption of sugar-sweetened beverages is associated with components of the metabolic syndrome in adolescents TF Chan, WT Lin, HL Huang, CY Lee, PW Wu, YW Chiu, CC Huang, ... Nutrients 6 (5), 2088-2103 , 2014 2014 Citations: 180
Carcinogenetic impact of ADH1B and ALDH2 genes on squamous cell carcinoma risk of the esophagus with regard to the consumption of alcohol, tobacco and betel quid CH Lee, JM Lee, DC Wu, YG Goan, SH Chou, IC Wu, EL Kao, TF Chan, ... International journal of cancer 122 (6), 1347-1356 , 2008 2008 Citations: 130
Carcinogenetic impact of alcohol intake on squamous cell carcinoma risk of the oesophagus in relation to tobacco smoking CH Lee, DC Wu, JM Lee, IC Wu, YG Goan, EL Kao, HL Huang, TF Chan, ... European journal of cancer 43 (7), 1188-1199 , 2007 2007 Citations: 130
Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup WT Lin, HL Huang, MC Huang, TF Chan, SY Ciou, CY Lee, YW Chiu, ... International journal of obesity 37 (4), 532-539 , 2013 2013 Citations: 112
Fructose-rich beverage intake and central adiposity, uric acid, and pediatric insulin resistance WT Lin, TF Chan, HL Huang, CY Lee, S Tsai, PW Wu, YC Yang, TN Wang, ... The Journal of pediatrics 171, 90-96. e1 , 2016 2016 Citations: 106
Effects of artificial intelligence‐assisted dental monitoring intervention in patients with periodontitis: a randomized controlled trial KL Shen, CL Huang, YC Lin, JK Du, FL Chen, Y Kabasawa, CC Chen, ... Journal of clinical periodontology 49 (10), 988-998 , 2022 2022 Citations: 86
Anatomical subsite discrepancy in relation to the impact of the consumption of alcohol, tobacco and betel quid on esophageal cancer CH Lee, DC Wu, JM Lee, IC Wu, YG Goan, EL Kao, HL Huang, TF Chan, ... International journal of cancer 120 (8), 1755-1762 , 2007 2007 Citations: 77
Dysphagia and masticatory performance as a mediator of the xerostomia to quality of life relation in the older population TY Lu, JH Chen, JK Du, YC Lin, PS Ho, CH Lee, CY Hu, HL Huang BMC geriatrics 20 (1), 521 , 2020 2020 Citations: 76
Physical frailty and oral frailty associated with late-life depression in community-dwelling older adults YC Lin, SS Huang, CW Yen, Y Kabasawa, CH Lee, HL Huang Journal of personalized medicine 12 (3), 459 , 2022 2022 Citations: 65
The neoplastic impact of tobacco‐free betel‐quid on the histological type and the anatomical site of aerodigestive tract cancers CH Lee, KW Lee, FM Fang, DC Wu, SM Tsai, PH Chen, TY Shieh, ... International journal of cancer 131 (5), E733-E743 , 2012 2012 Citations: 65
Association of parental overweight and cardiometabolic diseases and pediatric adiposity and lifestyle factors with cardiovascular risk factor clustering in adolescents CY Lee, WT Lin, S Tsai, YC Hung, PW Wu, YC Yang, TF Chan, HL Huang, ... Nutrients 8 (9), 567 , 2016 2016 Citations: 59
Effectiveness of virtual reality-based training on oral healthcare for disabled elderly persons: a randomized controlled trial AH Chang, PC Lin, PC Lin, YC Lin, Y Kabasawa, CY Lin, HL Huang Journal of personalized medicine 12 (2), 218 , 2022 2022 Citations: 53
Immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors: a cross-sectional study in Taiwan CC Chen, SJ Chiou, CC Ting, YC Lin, CC Hsu, FL Chen, CH Lee, T Chen, ... BMC Oral Health 14 (1), 3 , 2014 2014 Citations: 51
The precancerous effect of emitted cooking oil fumes on precursor lesions of cervical cancer CH Lee, SF Yang, CY Peng, RN Li, YC Chen, TF Chan, EM Tsai, FC Kuo, ... International journal of cancer 127 (4), 932-941 , 2010 2010 Citations: 51
Risk evaluation for the development of cervical intraepithelial neoplasia: Development and validation of risk‐scoring schemes CH Lee, CY Peng, RN Li, YC Chen, HT Tsai, YH Hung, TF Chan, ... International journal of cancer 136 (2), 340-349 , 2015 2015 Citations: 48
Second-hand smoke exposure and the factors associated with avoidance behavior among the mothers of pre-school children: a school-based cross-sectional study PL Lin, HL Huang, KY Lu, T Chen, WT Lin, CH Lee, HM Hsu BMC Public Health 10 (1), 606 , 2010 2010 Citations: 48
Child dental fear in low-income and non-low-income families: A school-based survey study YL Lin, YY Yen, HS Chen, YC Liu, CS Chang, CM Chen, FL Chen, ... Journal of Dental Sciences 9 (2), 165-171 , 2014 2014 Citations: 44
