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Brushing behavior among young adolescents: does perceived severity matter

Parisa Kasmaei1, Farkhondeh Amin Shokravi1*, Alireza Hidarnia1, Ebrahim Hajizadeh2, Zahra Atrkar-Roushan2, Kambiz Karimzadeh Shirazi3 and Ali Montazeri4

Author Affiliations

1 Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

2 Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

3 Department of Health Education, Faculty of Medical Sciences, Yasuj University, of Medical Sciences, Yasuj, Iran

4 Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran

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BMC Public Health 2014, 14:8  doi:10.1186/1471-2458-14-8

Published: 8 January 2014



Oral health is a basis for general health and well-being and affects physical and psychological aspects of the human life. The aim of this study was to determine the power of the health belief model in general and the role of perceived severity and its components in particular in predicting tooth brushing behavior among young adolescents.


This was a cross sectional study of a sample of female students grade four in Rasht (a metropolitan in north Iran) in 2012. A systematic random sampling method was applied to recruit students. They were asked to respond to a designed questionnaire containing items on brushing behavior based on the health belief model. In this study for the first time perceived severity and perceived barriers were divided into two parts, perceived subjective and objective severity and perceived physical and psychological barriers and were treated as independent variables. Logistic regression analysis was performed in order to identify the variables that predict the desirable behavior (brushing twice a day or more).


In all 265 female students were entered into the study. Of these, only 17.4% reported that they were brushing at least twice a day (desirable behavior). The results obtained from the logistic regression analysis indicated that perceived objective severity (OR = 0.37, 95% CI = 0.21- 0.66, P = 0.001) and feeling less perceived psychological barriers (OR = 2.60, 95% CI = 1.50- 4.52, P = 0.001) were the significant predicting factors for brushing twice a day.


The findings suggest that perceived objective severity and perceived psychological barriers play important role in adapting a desirable health behavior among young adolescents.