Abstract
OBJECTIVE: This study aims to explore the influencing factors of oral health behaviors among lower primary school students based on Social Cognitive Theory (SCT), with the goal of providing both theoretical insights and practical guidance for future oral health education and intervention programs targeting children. METHODS: A cross-sectional study was conducted in November 2023 in Minhang District, Shanghai. A total of 1180 students from Grade 2 and 3 of 6 primary schools were selected to participate in the study by cluster sampling. Data were collected using a self-developed oral health behavior questionnaire and an SCT-based oral health behavior scale, which included dimensions such as situational perception, outcome expectations, self-efficacy, and perceived barriers. Descriptive statistics, exploratory factor analysis, Pearson correlation analysis, and multiple regression analysis were employed to analyze the data. RESULTS: In this study, there were differences in oral health behavior scores among lower-grade elementary school students based on factors such as grade level, gender, mother's education level, father's education level, whether they had undergone oral health examinations, and whether they had received oral health education. Factor analysis revealed 8 key factors in SCT model explaining 58.85% of the variance, with good internal consistency (Cronbach's α = 0.90). The final model revealed that outcome expectations (β = 0.08, p = 0.003), family experiential learning (β = 0.18, p < 0.001), and self-efficacy (β = 0.28, p < 0.001) were significantly positively correlated with oral health behaviors in lower primary school students. In contrast, perceived barriers (β = -0.08, p = 0.008) were significantly negatively correlated with oral health behaviors. CONCLUSIONS: This study underscores the significant role of parental involvement and education in overcoming barriers to oral health and enhancing self-efficacy and outcome expectations in oral health of lower primary school students. Future interventions should prioritize cultivating supportive family environments, reducing the negative impact of perceived barriers on lower primary school students, and enhancing their self-efficacy to improve children's oral hygiene habits.