Understanding Utilization of Basic Oral Health Services  Through the Health Belief Model: A Population-Based  Study in Kediri, East Java, Indonesia

Authors

  • Galih Reza Firmansyah Master’s Program in Public Health, Universitas Sebelas Maret, Indonesia
  • Arsita Eka Prasetyawati Faculty of Medicine, Universitas Sebelas Maret, Indonesia
  • Endang Sutisna Sulaeman Faculty of Medicine, Universitas Sebelas Maret, Indonesia
  • Erindra Budi Cahyanto Faculty of Medicine, Universitas Sebelas Maret, Indonesia
  • Selfi Handayani Faculty of Medicine, Universitas Sebelas Maret, Indonesia

DOI:

https://doi.org/10.26911/

Abstract

Background: The utilization of basic oral and dental health services remains suboptimal despite 
the availability of services within primary healthcare systems. This gap suggests that service 
utilization is influenced not only by access but also by individual health beliefs and perceptions. 
The Health Belief Model provides a theoretical framework to explain how cognitive and behavioral 
factors shape health-seeking behavior. This study aimed to examine determinants of basic oral 
health service utilization in Kediri Regency, Indonesia, using the Health Belief Model framework.

Subjects and Method: A cross-sectional study was conducted among 363 residents of Kediri 
Regency selected through multistage sampling. The dependent variable was the utilization of basic 
oral and dental health services. Independent variables included perceived susceptibility, perceived 
severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Data were collected 
using structured questionnaires and analyzed using multiple logistic regression with a significance 
level of p < 0.005.

Results: Perceived benefits showed a positive and significant association (OR = 1.30; 95% CI: 0.71 
to 2.44; p = 0.037), cues to action demonstrated a significant negative association (OR = 0.59; 95% 
CI: 0.31 to 1.13; p = 0.012), perceived susceptibility (OR = 2.42; 95% CI: 0.90 to 6.48; p = 0.074), 
perceived severity (OR = 0.84; 95% CI: 0.41–1.72; p = 0.062), perceived barriers (OR = 0.71; 95% 
CI: −0.41 to 1.22; p = 0.228), and self-efficacy (OR = 1.86; 95% CI: −0.82 to 4.37; p = 0.146) were 
not statistically significant predictors of dental service utilization.  

Conclusion: Utilization of basic oral health services was primarily influenced by perceived 
benefits and cues to action. Strengthening public awareness of the benefits of dental care and 
enhancing behavioral triggers may improve the utilization of oral health services in the community.

Keywords:

Oral health services, Service utilization, Health Behavioral, Health Belief Model

Published

2026-01-16

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How to Cite

Understanding Utilization of Basic Oral Health Services  Through the Health Belief Model: A Population-Based  Study in Kediri, East Java, Indonesia. (2026). Journal of Health Promotion and Behavior, 11(1), 66-76. https://doi.org/10.26911/

How to Cite

Understanding Utilization of Basic Oral Health Services  Through the Health Belief Model: A Population-Based  Study in Kediri, East Java, Indonesia. (2026). Journal of Health Promotion and Behavior, 11(1), 66-76. https://doi.org/10.26911/

References

Amarasena N, Luzzi L, Chrisopoulos S, Mejia G (2025). Dental visiting patterns and their associations with dental caries and periodontal diseases. Clin Exp Dent Res. 11(1). https://doi.org¬/10.1002/cre2.70087.

Bahramian H, Mohebbi SZ, Khami MR, Asadi-Lari M, Shamshiri AR, Hessari H. (2015). Psychosocial determinants of dental service utilization among adults: results from a population-based survey (urban HEART-2) in Tehran, Iran. Eur J Dent. 9(4): 542–550. https://doi.org/10.4103/1305-7456.172622.

Baiquni NA, Khidri Alwi M. (2022). Faktor yang mempengaruhi pemanfaatan pelayanan kesehatan gigi dan mulut di puskesmas Minasa Upa. J Muslim Community Health. 3(1): 166–177. https://doi.org/10.52103/jmch.v3i1.781.

Goldstein A, Matalon S, Fridenberg N, Slutzky H (2024). Seeking dental healthcare in the context of COVID-19 pandemic: a study examining the health belief model. Innov Aging. 8(10). https://doi.org/10.1093/gero-ni/igae089.

Hajek A, König HH, Lieske B, Wees L, Model T, Zwar L, Aarabi G. (2025). Determinants of the number of dental visits in the general adult population in Germany during the COVID-19 pandemic. BMC Health Serv Res. 25(1). https://doi.org/10.1186/s1291-3-025-12577-0.

Hajek A, Kretzler B, König HH. (2021a). Factors associated with dental service use based on the Andersen model: a systematic review. Int J Environ Res Public Health. 18(5): 1–26. https://-doi.org/10.3390/ijerph18052491.

Hajek A, Kretzler B, König HH. (2021b). Factors associated with dental service use based on the Andersen model: a systematic review. Int J Environ Res Public Health. 18(5): 1–26. https://-doi.org/10.3390/ijerph18052491.

Idrees DS, Mahmood DH, Habib DMF, Khizer DA, Azka DA, Pervaiz DF. (2024). Factors associated with dental service utilization based on Andersen model among adults (18 to 64 years) in PIMS hospital, Islamabad. J Surv Fish Sci. 11(1): 27–36. https://doi.org-/10.53555/sfs.v11i01.1972.

Lee C, Ting C, Wu J, Lee K, Chen H, Chang Y. (2018). Dental visiting behaviours among primary schoolchildren: appli-cation of the health belief model. Int J Dent Hyg. 16(2). https://doi.org/10.-1111/idh.12319.

Leggett H, Vinall-Collier K, Csika J, Owen J, Edwebi S, Douglas GVA. (2024). A scoping review of dental practitioners’ perspectives on perceived barriers and facilitators to preventive oral health care. BMC Oral Health. 24: 249. https://doi.org/10.1186/s12903-024-04022-1.

Liu SM, Xin YM, Wang F, Lin PC, Huang HL (2024). Parental health belief model constructs associated with oral health behaviors, dental caries, and quality of life among preschool children in China: a cross-sectional study. BMC Oral Health. 24(1): 1497. https://doi.org/10.1186/s12903-024-05290-7.

Lukis PA, Setiawan F, Prakosa BR, Khafid M, Handajani J, Hanindriyo L, Irnawati D, et al. (2025). Pengabdian masyarakat tentang peningkatan kesehatan gigi dan mulut di pondok pesantren Ta’lim Sabilu Taubah kecamatan Srengat kabupaten Blitar. J Abdi Masy Indones. 5(2): 565–572. https://doi.org/10.54082/jamsi.1825.

Nagdev P, Iyer MR, Naik S, Khanagar SB, Awawdeh M, Al Kheraif AA, Anil S, et al. (2023). Andersen health care utili-zation model: a survey on factors affecting the utilization of dental health services among school children. PLoS One. 18(6). https://-doi.org/10.1371/journal.pone.0286945.

Nasir E, Suliman, Nada MA. (2022). Appli-cation of the health belief model in oral hygiene practice (brushing /flossing): a narrative review. J Int Oral Health. 14(4): 342. https://doi.-org/10.4103/JIOH.JIOH_204_21.

Negi S, Mathur A, Udhaya E, Rani N, Mehta V. (2025). Factors influencing dental care services utilization in India using Andersen health behaviour model: a systematic review. BMC Health Serv Res. https://doi.org/10.1186/s12913-025-13252-0.

Ojok S, Musinguzi M, Kigongo E, Akello AR, Kabunga A, Opollo MS, Okello N. (2024). Factors associated with utilization of oral health services among adults aged 18–70 years in Lira district, Northern Uganda: a community based cross-sectional study. BMC Oral Health. 24(1): 1322. https://doi.org/10.1186/s12903-024-05082-z.

Petersen PE, Baez RJ, Ogawa H. (2020). Global application of oral disease prevention and health promotion as measured 10 years after the 2007 World Health Assembly statement on oral health. Community Dent Oral Epidemiol. 48(4): 338–348. https://-doi.org/10.1111/cdoe.12538.

Radiani SG, Santoso O, Prabowo YB, Skripsa TH (2021). Faktor yang ber-hubungan dengan pemanfaatan pela-yanan kesehatan gigi dan mulut di puskesmas Karanganyar Purba¬lingga Jawa Tengah. e-GiGi. 9(2): 273. https://doi.org/10.35790/eg.v9i2.34535.

Sidharthan S, Ramanarayanan V, Karuveet¬til V, Ravindran GC. (2024). Utiliza¬tion of dental health services and its associated factors among adult popu¬lation in Ernakulam district, Kerala, India: a mixed-method analysis. J Oral Biol Craniofac Res. 14(2): 133–142. https://doi.org/10.1016/j.jobc r.-2024.01.010.

Spinler K, Aarabi G, Valdez R, Kofahl C, Heydecke G, König HH, Hajek A. (2019). Prevalence and determinants of dental visits among older adults: findings of a nationally representative longitudinal study. BMC Health Serv Res. 19(1): 590. https://doi.org/10.-1186/s12913-019-4427-0.

Sukhabogi JR, Doshi D, Vaggala B, Billa AL (2024). Development and validation of dental visiting behavior among adults based on health belief model. J Oral Biol Craniofac Res. 14(5): 620–625. https://doi.org/10.¬1016/j.jobc r.-2024.08.004.

Sumita I, Toyama N, Ekuni D, Maruyama T, Yokoi A, Fukuhara D, Uchida-Fukuhara Y, et al. (2022). The impact of oral health behaviors, health belief model, and absolute risk aversion on the willingness of Japanese university students to undergo regular dental check-ups: a cross-sectional study. Int J Environ Res Public Health. 19(21): 13920. https://doi.org/10.3390/ijerp-h192113920.

Ministry of Health of the Republic of Indo-nesia. (2023). Indonesian health survey in figures: accurate data appropriate policy.

Taflinger S, Sattler S. (2024). A situational test of the health belief model: how perceived susceptibility mediates the effects of the environment on beha-vioral intentions. Soc Sci Med. 346. https://doi.org/10.1016/j.socscimed.20 24.116715.

Thongchotchat V, Sutthiboonyapan P, Porntaveetus T, Wiriyakijja P. (2025). Relationship between periodontal health-related knowledge, belief, and behaviors: a structural equation modeling approach. BMC Oral Health. 25(1): 1244. https://doi.org/-10.1186/ s12903-025-06664-1.

Tsai FJ, Hu YJ, Chen CY, Tseng CC, Yeh GL, Cheng JF (2021). Using the health belief model to explore nursing students’ relationships between COVID-19 knowledge, health beliefs, cues to action, self-efficacy, and beha-vioral intention. Medicine (Balti-more). 100(11): e25210. https://doi.-org/10.1097/MD.0000000000025210.

Watt RG, Daly B, Allison P, Macpherson LMD, Venturelli R, et al. (2019). End-ing the neglect of global oral health: time for radical action. Lancet. 394 (10194): 261–272. https://doi.org/10-.1016/S0140-6736(19)31133-X.

World Health Organization. (2021). Track-ing universal health coverage: 2021 global monitoring report. Geneva.

Xiang B, Wong HM, Perfecto AP, McGrath CPJ. (2020). Modelling health belief predictors of oral health and dental anxiety among adolescents based on the health belief model: a cross-sectional study. BMC Public Health. 20(1): 1755. https://doi.org/10.1186/-s12889-020-09784-1.

Yuliani S, Dety M (2023). Literature review: pengaruh pelayanan kesehatan gigi dan mulut terhadap kepuasan pasien di puskesmas. J Multidisiplin Indo¬nes. 2(4): 823–828. https://doi.org/-10.58344/jmi.v2i4.229.

Zardak AN, Amini-Rarani M, Abdollahpour I, Eslamipour F, Tahani B. (2025). Factors associated with dental care utilization among Iranian adult populations based on Anderson model. BMC Public Health. 25(1). https://doi.org/10.1186/s12889-025-21540-x.

Zare Z, Bahrami MA, Bastani P, Kavosi Z. (2024). Oral and dental health utiliza¬tion determinants in special health care needs: a systematic review of reviews. BMC Oral Health. 24(1): 965. https://doi.org/10.1186/s12903-024-04734-4.

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