Existing conceptual models of oral health have attempted to describe the many dimensions of and complex relationships between psychosocial, behavioral, and environmental factors and oral health. However, such models are limited because they narrowly focus on either the person or the environment as the dominant factor for predicting the likelihood of a change in health behavior. They fail to recognize the central role of health perception and belief (e.g., perceived risks, needs and benefits), and of self-care in delineating the underlying complex relationships between the large number of predictors and oral-health outcomes. Traditional health belief models, for example, focus on the likelihood of taking action, but they do not directly link beliefs and self-care actions with oral-health outcomes. Instead, they assume that the probability of performing a health behavior is a function of what is expected to be the outcome of behavior and the values related to those outcomes;the variables that are involved are presumed to remain constant from the time one learns of a health threat until the time that a health action is taken. A recent explanatory oral-health model has used a biopsychosocial framework that links health, function, and disablement. Although based upon the International Classification of Functioning Disability and Health, this model uses ethnographic research to understand personalized perspectives on sociocultural dimensions, such as impairment, disability, and handicap, which may be stigmatizing. To address the challenges of the many and complex factors in oral health and to overcome the weakness of existing oral-health models, we propose an oral- health model, for adults, that is driven by perceptions and beliefs and self-care and is confounded by personal and environmental factors. Using existing oral-health data from the National Health and Nutrition Examination Survey (NHANES), which contains detailed self-report, clinical-examination, and laboratory data, the overarching goals of the proposed study are to evaluate and test the newly proposed oral-health behavioral model, which considers the nature of oral health as reflecting the central role of health perceptions and beliefs, and self-care for oral health. Specifically, we will: (1) conduct literature reviews on domains of culture, personal identity, social and health resources, oral-health beliefs, and self-care and professional care to identify the core items that measure each domain, and to refine and develop composite indices, which can summarize multiple items from different aspects for the same concept, for each of these domains;(2) examine the effect of personal characteristics, culture, personal identity, social and health resources, and professional care on oral-health perceptions and beliefs and self-care;(3) examine the marginal predictive power of oral-health perceptions and beliefs, and self-care on oral health outcomes;and (4) evaluate the joint predictive power of oral-health perceptions and beliefs, and self-care on oral health, controlling for personal characteristics, culture, personal identity, social and health resources, and professional care.
This project proposes and evaluates a health perception and belief, and self-care centered oral health behavioral model that reflects the nature of oral health and recognizes the critical role of health perceptions, beliefs and self care among the complex relationships between personal characteristics, culture, behavior, social and health resources, professional care, and oral health outcomes. The findings from this newly proposed oral health behavioral model will inform the necessary and efficient interventions to improve public oral health.
| Liu, Honghu; Marcus, Marvin; Maida, Carl A et al. (2013) Predictive power of the severity measure of attachment loss for periodontal care need. J Periodontol 84:1409-15 |
| Gironda, Melanie W; Maida, Carl; Marcus, Marvin et al. (2013) Social support and dental visits. J Am Dent Assoc 144:188-94 |
