The Influence of Parents' Multiple Perceived Beliefs on Dental Service Utilization among Chinese Children.

BACKGROUND AND OBJECTIVES: Caries-preventive dental services are essential during the mixed dentition stage, yet utilization disparities persist in China despite universal coverage. This study examined the independent influence of parental health beliefs, conceptualized within a five-construct operationalization of the Health Belief Model (HBM), on preventive dental service utilization after adjusting for socioeconomic position (SEP). METHODS: A cross-sectional study was conducted among 1,254 parent-child dyads (second-grade schoolchildren, predominantly aged 7-8 years) within a government-funded free oral health program. Preventive service utilization was measured via a parent-reported composite index of three services (regular dental check-ups, pit-and-fissure sealants, and fluoride varnish; total score range 3-15). Parental beliefs were assessed using a 23-item HBM questionnaire covering five constructs (Cronbach's α = 0.835-0.931). Data were analyzed using a saturated structural path model. RESULTS: The model explained 15.4% of the variance in utilization. After adjusting for SEP (β = 0.287, P < 0.001), perceived benefits (β = 0.131, P < 0.001) and perceived susceptibility (β = 0.115, P < 0.001) were positively associated with service use, and self-efficacy showed a modest positive association (β = 0.075, P = 0.016). Perceived barriers demonstrated a negative association (β = -0.118, P < 0.001). Perceived severity was not significant (β = -0.033, P = 0.340). CONCLUSIONS: Preventive dental service utilization reflects both the structural context indexed by SEP and value-based motivation. Interventions should complement financial support with strategies targeting practical access constraints and strengthening prevention-oriented health communication, rather than relying solely on fear-based messaging.