The Application of Structural Equation Modeling in the Investigation of Factors Affecting the Dental Caries Index of Children

Structural equation modeling (SEM) is a class of multivariate statistical methods that combines the dimensions of factor analysis and regression to enable researchers to simultaneously examine the relationships between variables. This method has not been used in dental research until now. In this article, the effect of parents' awareness, attitude and performance on their children's dmft with the mediation of sugary substance consumption has been investigated using the SEM method.

In this research, questionnaires about the knowledge, attitude and performance of parents were completed among 385 people in Tabriz city. These questionnaires are based on previous research and made by researchers. Cronbach's alpha coefficients obtained for them were 0.949, 0.943 and 0.801 respectively, which indicates their good reliability. Also, checking the validity of the questionnaires (content validity with confirmatory factor analysis, convergent validity with average variance criterion and face validity with experts' approval) shows the usefulness of the tool. Structural equation modeling method with partial least squares (PLS) was used to test the research hypotheses.

According to the results of statistical analysis, the effect of "parental awareness", "parental performance" and "children's consumption of sugary substances" on "dmft" and also the effect of "parental awareness", "parental attitude" and "parental performance" on " The consumption of sugary substances by children" is significant at the level of 0.01 (P-value<0.01). Also, the results of the analysis showed that the indirect effect of the variables "awareness", "attitude" and "performance" of the parents on "dmft" through the mediator variable "amount of consumption of sugary substances" is significant at the level of 0.01 (P-value<0.01). But the effect of "parental attitude" on "dmft" was not significant (P-value>0.05).

In this study, it was shown that the knowledge, attitude and performance of parents have a significant effect on "dmft" through the variable of consumption of sugary substances.