Relationship between oral health-related knowledge, attitudes, practice, self-rated oral health and oral health-related quality of life among Chinese college students: a structural equation modeling approach

BACKGROUND: This study aimed to evaluate the associations among oral health-related knowledge, attitudes, practice (KAP), self-rated oral health and oral health-related quality of life (OHRQoL) among Chinese college students. METHODS: Of the 2000 participants, 1751 (87.55%) students answered an online questionnaire between October 2019 and January 2020. The questionnaire included demographic characteristics, knowledge, attitudes, and practice related to oral health, self-rated oral health, and OHRQoL. Structural equation modelling was applied to assess the associations among study variables. RESULTS: Among the total students, oral health-related knowledge and attitudes were satisfactory, while the oral health practice was not optimistic. The final model showed satisfactory fitness to the data. Oral health knowledge was associated with attitudes directly and positively. Attitudes toward oral health had a direct and positive effect on practice. Oral health knowledge had an indirect effect on practice through attitudes. Oral health practice was directly associated with self-rated oral health. Oral health knowledge, practice, and self-rated oral health all affected OHRQoL directly and positively, while attitudes had a direct negative impact on OHRQoL. CONCLUSIONS: OHRQoL was influenced by oral health knowledge, attitudes, practice, and self-rated oral health. Our findings support the KAP theory. Limitations of the KAP model were also found.