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基于安德森行为模型的伊朗德黑兰12岁及以下儿童预防性和治疗性牙科服务利用情况:广义结构方程模型

Preventive and curative dental services utilization among children aged 12 years and younger in Tehran, Iran, based on the Andersen behavioral model: A generalized structural equation modeling.

作者信息

Amirian Elaheh, Razeghi Samaneh, Molaei Alireza, Shamshiri Ahmad R, Mohebbi Simin Z

机构信息

Dentistry Research Institute, Research Center for Caries Prevention, Tehran University of Medical Sciences, Tehran, Iran.

Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

PLoS One. 2025 Jan 16;20(1):e0312043. doi: 10.1371/journal.pone.0312043. eCollection 2025.

Abstract

World Health Organization invites the nations to progress towards universal health care coverage. This study evaluated preventive and curative dental services utilization among children aged 12 years and younger in Tehran, Iran, based on the Andersen behavioral model using a generalized structural equation modeling. A phone-based cross-sectional study was conducted in Tehran, Iran, on 886 children in 2023. Information on curative and preventive/consultation dental service utilization and associated factors was collected by a standard questionnaire. We used a generalized structural equation model (GSEM) to build a model based on Andersen's behavioral model. Of 886 children, 22.1% used curative dental services, and 19.9% used preventive/consultation services in the past year. Among children aged 6 years and younger, age (OR = 1.87, p-value <0.001) and parent-perceived oral health need (OR = 54.77, p-value <0.001) predicted curative services utilization and age (OR = 1.45, p-value <0.001), knowledge (OR = 1.36, p-value <0.001), dental visit before the age of one (OR = 6.05, p-value = 0.04), and socioeconomic status (OR = 1.65, p-value = 0.03) predicted preventive/consultation services utilization. Regarding children aged 7 to 12, knowledge (OR = 1.28, p-value = 0.03), dental visit before the age of one (OR = 11.12, p-value = 0.02), socioeconomic status (OR = 2.53, p-value = 0.01), dental insurance (OR = 4.17, p-value <0.001), and parent-perceived oral health need (OR = 19.48, p-value <0.001) associated with curative dental services utilization, and dental visit before the age of one (OR = 10.05, p-value = 0.02), oral health behavior (OR = 1.25, p-value = 0.04), socioeconomic status (OR = 3.74, p-value <0.001), and parent-perceived oral health need (OR = 4.62, p-value <0.001) related to preventive/consultation services utilization. The findings of this study underscore the significant influence of predisposing, enabling, and need factors on dental services utilization among children aged 12 years and younger. These results provide a valuable perspective for policymakers, highlighting the modifiable determinants that could be targeted to improve dental services utilization in this age group.

摘要

世界卫生组织邀请各国朝着全民健康覆盖的方向迈进。本研究基于安徒生行为模型,使用广义结构方程模型评估了伊朗德黑兰12岁及以下儿童的预防和治疗性牙科服务利用情况。2023年在伊朗德黑兰进行了一项基于电话的横断面研究,涉及886名儿童。通过标准问卷收集了有关治疗性和预防性/咨询性牙科服务利用情况及相关因素的信息。我们使用广义结构方程模型(GSEM)基于安徒生行为模型构建了一个模型。在886名儿童中,22.1%在过去一年中使用了治疗性牙科服务,19.9%使用了预防性/咨询性服务。在6岁及以下儿童中,年龄(OR = 1.87,p值<0.001)和家长感知的口腔健康需求(OR = 54.77,p值<0.001)预测了治疗性服务的利用情况,年龄(OR = 1.45,p值<0.001)、知识(OR = 1.36,p值<0.001)、一岁前的牙科就诊(OR = 6.05,p值 = 0.04)和社会经济地位(OR = 1.65,p值 = 0.03)预测了预防性/咨询性服务的利用情况。对于7至12岁儿童而言,知识(OR = 1.28,p值 = 0.03)、一岁前的牙科就诊(OR = 11.12,p值 = 0.02)、社会经济地位(OR = 2.53,p值 = 0.01)、牙科保险(OR = 4.17,p值<0.001)和家长感知的口腔健康需求(OR = 19.48,p值<0.001)与治疗性牙科服务利用相关,一岁前的牙科就诊(OR = 10.05,p值 = 0.02)、口腔健康行为(OR = 1.25,p值 = 0.04)、社会经济地位(OR = 3.74,p值<0.001)和家长感知的口腔健康需求(OR = 4.62,p值<0.001)与预防性/咨询性服务利用相关。本研究结果强调了易患因素、促成因素和需求因素对12岁及以下儿童牙科服务利用的重大影响。这些结果为政策制定者提供了有价值的视角,突出了可针对改善该年龄组牙科服务利用的可改变决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fd3/11737785/3dc70e2ae7ef/pone.0312043.g001.jpg

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