Predicting the oral health-related behaviors of the Iranian elderly based on the extended theory of planned behavior

Saeid Bashirian; Sahar Khoshravesh; Erfan Ayubi; Mahrokh Amiri; Akram Karimi-Shahanjarini; Majid Barati; Parshang Faghih Solaymani

doi:10.1186/s12903-025-06180-2

Predicting the oral health-related behaviors of the Iranian elderly based on the extended theory of planned behavior

BMC Oral Health. 2025 Jul 9;25(1):1137. doi: 10.1186/s12903-025-06180-2.

Authors

Saeid Bashirian¹, Sahar Khoshravesh², Erfan Ayubi¹, Mahrokh Amiri³, Akram Karimi-Shahanjarini¹, Majid Barati¹, Parshang Faghih Solaymani⁴

Affiliations

¹ Social Determinants of Health Research Center, Institute of Health Sciences and Technologies, Hamadan University of Medical Sciences, Hamadan, Iran.
² Chronic Diseases (Home Care) Research Center, Institute of Cancer, Hamadan University of Medical Sciences, Hamadan, Iran.
³ Department of Community Oral Health, School of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
⁴ Social Determinants of Health Research Center, Institute of Health Sciences and Technologies, Hamadan University of Medical Sciences, Hamadan, Iran. p.solaymani@edu.umsha.ac.ir.

Abstract

Introduction: Understanding the predictors of oral health behaviors in older adults helps to design effective interventions. This will improve their oral health and overall well-being. The present study aimed to determine the predictors of oral health-related behaviors in Iranian elderly based on the Extended Theory of Planned Behavior (ETPB).

Materials and methods: This cross-sectional study was conducted in Sanandaj City, western Iran, in 2024. In this research, 360 elderly people from retirement centers in Sanandaj City were surveyed using a multi-stage random sampling method. The data collection tools were the demographic characteristics questionnaire, the Extended Theory of Planned Behavior (ETPB) questionnaires, the Oral Health Literacy Adult Questionnaire (OHL-AQ), and clinical oral and dental examination. SPSS software version 26 was used for data analysis. The significance level was considered to be p < 0.05.

Results: A mean age of 63.82 (± 5.15) years was estimated for the 360 elderly. The linear regression results showed that all ETPB constructs predicted oral health behaviors in the studied elderly. This model could explain 40% of the variance in the oral health behaviors of the elderly. The strongest predictor of oral health behaviors was the behavioral intention construct (β = 0.404, p < 0.001. The Decayed, Missing, Filled Teeth (DMFT) crown index showed a significant positive correlation with oral health behaviors (r = 0.278, p < 0.001) and OHL (r = 0.230, p < 0.001) as well as a significant negative correlation with attitude (r = -0.257, p < 0.001).

Conclusion: The ETPB effectively identifies and predicts oral health behaviors in the elderly, with behavioral intention emerging as the strongest predictor. The DMFT-crown index correlated positively with oral health behaviors and oral health literacy, while attitude showed a significant negative association. Based on these results, interventions should prioritize strengthening behavioral intention, improving attitudes, and enhancing oral health literacy through theory-based educational programs to promote sustainable health practices in this population.

Keywords: Aged; Iran; Oral health; Theory of Planned Behavior.

MeSH terms

Aged
Cross-Sectional Studies
Female
Health Behavior*
Health Literacy
Humans
Intention
Iran
Male
Middle Aged
Oral Health*
Psychological Theory*
Surveys and Questionnaires
Theory of Planned Behavior

Grants and funding

No. 140110138639/the Vice Chancellor for Research and Technology, Hamadan University of Medical Sciences, Iran