title: Behavioral pathways explaining oral health disparity in children.
abstract: Policymakers' understanding of and ability to reduce health disparities are pivotal for health promotion worldwide. This study aimed to verify the behavioral pathways leading to oral health disparities. Oral examinations were conducted for 1782 randomly selected preschoolers (3-6 yrs), and 1576 (88.4%) participants were followed up after 12 months. Parents were surveyed on their knowledge (K), attitude (A), and practices (P) regarding their children's oral health homecare (infant feeding, diet, and oral hygiene) and dental attendance. Structural equation modeling substantiated the links between specific KAs and corresponding practices, while generic KA did not affect practices. KAP pathways partly explained the ethnic and socio-economic disparities in oral health. Deprivation had a direct effect (not mediated by KA) on dental attendance, but not on oral health homecare. Ethnicity directly influenced oral health homecare practices, but not dental attendance. These behavioral pathways, furthering our understanding of health disparity, may have practical implications for health promotion and policy-making.
authors.affiliation: Dental Public Health, Faculty of Dentistry, The University of Hong Kong.
authors.forename: X-L
authors.initials: XL
authors.lastname: Gao
authors.forename: C-Y S
authors.initials: CY
authors.lastname: Hsu
authors.forename: Y C
authors.initials: YC
authors.lastname: Xu
authors.forename: T
authors.initials: T
authors.lastname: Loh
authors.forename: D
authors.initials: D
authors.lastname: Koh
authors.forename: H B
authors.initials: HB
authors.lastname: Hwarng
mesh_terms: D002648:Child; D002675:Child, Preschool; D002681:China / Q000208:ethnology; D003731:Dental Caries / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D004037:Diet, Cariogenic; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007194:India / Q000208:ethnology; D016018:Least-Squares Analysis; D008296:Malaysia / Q000208:ethnology; D008297:Male; D009910:Oral Hygiene / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology; D025341:Principal Component Analysis; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000706:statistics & numerical data