{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:25:27Z","timestamp":1783074327142,"version":"3.54.6"},"reference-count":45,"publisher":"American Public Health Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:p> Objectives. We evaluated relationships among physical and psychological indicators and oral health\u2013related quality of life (OHRQOL) in youths with cleft. <\/jats:p><jats:p> Methods. We recruited youths aged 7 to 18 years with cleft palate (n\u2009=\u2009282) or cleft lip and palate (n\u2009=\u2009918) and their caregivers into a 5-year observational investigation at 6 US treatment centers from 2009 to 2011. At baseline, youths completed surveys to assess psychological status. After clinical evaluation, 433 youths received a recommendation for surgery. We developed structural models from the baseline data incorporating age, gender, race, and cleft diagnosis to examine direct relationships between depressive symptoms and, in separate models, self-concept and sense of mastery and OHRQOL. Subsequent models examined the possible mediating effect of surgical recommendation. <\/jats:p><jats:p> Results. Depressive symptoms were negatively and self-concept and self-efficacy were positively associated with OHRQOL. Surgical recommendation appeared to mediate the effect of psychological well-being, but not depression, on OHRQOL, even after adjustment for cleft diagnosis. In some models, individual-level characteristics were significant. <\/jats:p><jats:p> Conclusions. Path analyses support the theoretical model and underscore the importance of examining positive psychosocial characteristics such as resiliency and self-concept in this patient population. <\/jats:p>","DOI":"10.2105\/ajph.2013.301686","type":"journal-article","created":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T20:06:48Z","timestamp":1394741208000},"page":"865-871","source":"Crossref","is-referenced-by-count":26,"title":["Examination of a Theoretical Model for Oral Health\u2013Related Quality of Life Among Youths With Cleft"],"prefix":"10.2105","volume":"104","author":[{"given":"Hillary L.","family":"Broder","sequence":"first","affiliation":[{"name":"Hillary L. Broder and Lacey Sischo are with the Department of Comprehensive Care, College of Dentistry, New York University, NY. Maureen Wilson-Genderson is with the Department of Social and Behavioral Health, Virginia Commonwealth University Medical Center, Richmond."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Wilson-Genderson","sequence":"additional","affiliation":[{"name":"Hillary L. Broder and Lacey Sischo are with the Department of Comprehensive Care, College of Dentistry, New York University, NY. Maureen Wilson-Genderson is with the Department of Social and Behavioral Health, Virginia Commonwealth University Medical Center, Richmond."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lacey","family":"Sischo","sequence":"additional","affiliation":[{"name":"Hillary L. Broder and Lacey Sischo are with the Department of Comprehensive Care, College of Dentistry, New York University, NY. 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