Oral Health Service Utilisation Behaviour and Its Influencing Factors Among Older Adults: An Empirical Study Based on the Composite Health Behaviour Model.

BACKGROUND: China's aging population faces significant unmet oral health care needs, with delayed service utilisation exacerbating disease burden. Currently, there is a lack of empirical research applying composite health models and analysing pathway relationships among influencing factors in this population. METHODS: A cross-sectional study was conducted from July to September 2023 among 356 older adults in Foshan and Guangzhou using a theory-driven questionnaire. Group comparisons used independent t tests/analysis of variance for sociodemographic variables. Structural equation modelling (SEM) with maximum likelihood estimation was employed to validate pathways. RESULTS: Significant differences were observed: sex and age affected individual model variables; education, residence location, and economic status influenced multiple variables; and living arrangement showed no significant effects. Only 34.04% of older adults proactively sought oral health knowledge, while 65.03% did not receive regular dental checkups. Just 51.84% sought treatment (scaling, fillings, extractions, dentures, implants). When acute oral pain disrupted daily life, 25.15% still delayed medical care. SEM revealed that behavioural intention/control had the strongest total effect on utilisation behaviour (β = 0.593) followed by perceived benefits (β = 0.404), subjective norms exerted only indirect effects (β = 0.216), and both subjective norms (β = 0.365) and perceived benefits (β = 0.282) directly influenced behavioural intention and control. CONCLUSION: Oral health service utilisation among older adults remains passive. The present authors' model identifies three key modifiable factors: behavioural intention and control, perceived benefits, and subjective norms. Strategies to enhance service utilisation should focus on strengthening social support and modifying unrealistic health perceptions.