Association of oral health knowledge, self-efficacy and behaviours with oral health-related quality of life in Chinese primary school children: a cross-sectional study

Abstract

ObjectiveAchieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This study aimed to explore the inter-relations between these oral health behaviour-related factors and OHRQOL in primary school children.MethodsIn this cross-sectional study, 651 children in grades 2 and 3 were recruited in October 2020 from two primary schools in Minhang District, Shanghai, China. Data were collected through self-reported questionnaires, consisting of demographic characteristics, oral health knowledge, self-efficacy, oral health behaviours and OHRQOL. Pearson’s correlation analyses were used to analyse the relationship between study variables. Structural equation models were used to test the inter-relations between OHRQOL and oral health behaviour-related factors.ResultsFour hypothetical structural equation models were tested and one of them was selected as the most appropriate model, which explained 15.0% of the variance in OHRQOL. This selected model showed that oral health behaviours were directly related to OHRQOL. Oral health knowledge was indirectly associated with OHRQOL through both self-efficacy and oral health behaviours. Self-efficacy was directly associated with OHRQOL or was indirectly associated with OHRQOL through oral health behaviours.ConclusionThis study revealed a pathway of association between children’s oral health knowledge and their OHRQOL, in which children’s oral health self-efficacy and behaviours had indirect effects. This provides a basis for understanding the mechanism of oral health promotion interventions to improve children’s OHRQOL and helps to identify direct or indirect intervention targets.

Social support, oral health knowledge, attitudes, practice, self-efficacy and oral health-related quality of life in Chinese college students

“…In the fsQCA positive solution, the higher coverage solution (C1 in Table 4 ) show that individual self-efficacy, oral knowledge and attitude can be considered important conditions affecting OHRQoL, but the results do not reflect the impact of practice. This is slightly different from previous studies 61 . The possible reason is that Chinese college students in this study are still in the sensitive period of constructing oral health practice, have strong plasticity, and are influenced by knowledge and attitude.…”

Variables associated with oral health-related self-efficacy – results of a cross-sectional study

“…In our study, approximately one-fifth of the sample qualified for manifest to moderate DF/A [ 51 ]. According to expectations, OH-SE was positively correlated with OHRQoL, self-perceived dental condition, satisfaction with general health, number of annual dentist appointments, and socioeconomic status, confirming that a more pronounced OH-SE is associated with greater quality of life, as well as overall health in general and oral health specifically [ 3 , 14 ]. Additionally, significant negative correlations were found between OH-SE and DF/A, as well as OH-SE and the number of canceled dentist appointments due to DF/A (trend level), suggesting that increased OH-SE is accompanied by reduced DF/A and reduced avoidance behaviors.…”

“…With regards to oral health specifically, OH-SE has been positively linked to frequency of toothbrushing in children [ 13 ]. In addition, it has been shown that OHRQoL was indirectly associated with oral health knowledge through both self-efficacy and DHB [ 14 ]. Furthermore, a negative correlation between OH-SE and DF/A has been reported [ 15 ].…”

“…Since strengthening perceived self-efficacy is a well-established mechanism for improving health and health-related behaviors [ 7 , 8 , 11 , 23 , 24 ] in a wide variety of diseases [ 12 , 25 , 26 ], improving OH-SE might also be a promising approach in the context of oral health. Recent research has also documented a protective effect of more pronounced OH-SE on oral health, suggesting that strengthening OH-SE might reduce oral health-related problems in the future [ 3 , 13 , 14 , 27 ].…”

“…Measuring OH-SE comes with some challenges, as related scales mostly address specific behaviors (e.g. toothbrushing, flossing) or aim at capturing this construct in specific populations [ 3 , 13 , 14 , 27 , 31 ]. Because these measurements seemed inappropriate for our population, we followed Bandura’s original definition [ 7 ] and developed a new question (see methods section) to capture OH-SE.…”