{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:01:45Z","timestamp":1785438105208,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007288","name":"Mahasarakham University","doi-asserted-by":"publisher","award":["No.5 (2567)"],"award-info":[{"award-number":["No.5 (2567)"]}],"id":[{"id":"10.13039\/501100007288","id-type":"DOI","asserted-by":"publisher"}]},{"award":["No.5 (2567)"],"award-info":[{"award-number":["No.5 (2567)"]}],"id":[{"id":"https:\/\/ror.org\/0453j3c58","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiologia"],"abstract":"<jats:p>Background: Early childhood oral health remains a major public health concern in Thailand despite the implementation of preventive oral health programs. Understanding the factors influencing oral health care system effectiveness is essential for improving oral health outcomes among preschool children. This study aimed to assess oral health care system factors and identify determinants associated with the effectiveness of oral health care services for preschool children in child development centres under local administrative organizations in Ubon Ratchathani Province, Thailand. Methods: A cross-sectional analytical study was conducted among 270 stakeholders involved in the preschool oral health care system, including administrators, teachers, health professionals, village health volunteers, and parent representatives. Data were collected using a structured questionnaire developed based on the Input\u2013Process\u2013Output framework. Oral health outcome data were obtained from routine dental examination records of 498 preschool children. Descriptive statistics, Pearson\u2019s correlation analysis, and multiple linear regression were used to analyse the data. Results: Overall oral health care system effectiveness was rated at a high level (mean = 4.01, SD = 0.44). Service delivery processes showed the highest mean score (mean = 4.19, SD = 0.39), while monitoring and evaluation activities demonstrated the lowest performance. The prevalence of dental caries among preschool children was 57.83%. Multiple linear regression analysis identified service delivery processes (\u03b2 = 0.239, p &lt; 0.001) and home visits by public health and dental personnel (\u03b2 = 0.165, p = 0.006) as significant predictors of oral health care system effectiveness. The final model explained 11.1% of the variance in system effectiveness (R2 = 0.111, p &lt; 0.001). Conclusions: The effectiveness of oral health care systems for preschool children was primarily influenced by the quality of service delivery processes and community-based outreach activities. These findings indicate that strengthening service implementation and home-visit programs may enhance oral health system effectiveness in child development centres operating within decentralized local government settings.<\/jats:p>","DOI":"10.3390\/epidemiologia7040098","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:34:44Z","timestamp":1783996484000},"page":"98","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of Oral Health System Effectiveness for Preschool Children in Decentralized Child Development Centres: A Cross-Sectional Study in Northeastern Thailand"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6843-5366","authenticated-orcid":false,"given":"Somporn","family":"Keawtong","sequence":"first","affiliation":[{"name":"Sirindhorn College of Public Health, Ubon Ratchathani 34190, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanwit","family":"Maneenin","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2469-1523","authenticated-orcid":false,"given":"Adisorn","family":"Wongkongdech","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Mahasarakham University, Maha Sarakham 44000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7698-3352","authenticated-orcid":false,"given":"Niruwan","family":"Turnbull","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Mahasarakham University, Maha Sarakham 44000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: A global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"ref_2","first-page":"381","article-title":"Oral health of Indigenous children and the influence of early childhood caries on childhood health and well-being","volume":"14","author":"Schroth","year":"2009","journal-title":"Paediatr. Child Health"},{"key":"ref_3","unstructured":"World Health Organization (2022). Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240061484."},{"key":"ref_4","first-page":"153","article-title":"The contribution of life course determinants to early childhood caries: A 2-year cohort study","volume":"53","author":"Zhou","year":"2019","journal-title":"Caries Res."},{"key":"ref_5","unstructured":"Bureau of Dental Health, Department of Health, Ministry of Public Health (2017). Report on the 8th National Oral Health Survey of Thailand, (In Thai)."},{"key":"ref_6","unstructured":"Bureau of Dental Health, Department of Health, Ministry of Public Health (2022). Guidelines for the Development of Model Early Childhood Development Centres for Oral Health, Volume 1, (In Thai)."},{"key":"ref_7","unstructured":"Department of Local Administration, Ministry of Interior (2016). Standards for Child Development Centre Operations of Local Administrative Organizations, Fiscal Year 2016, (In Thai)."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Khan, I.M., Mani, S.A., Doss, J.G., Danaee, M., and Kong, L.Y.L. (2021). pre-schoolers\u2019 tooth brushing behaviour and association with their oral health: A cross-sectional study. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01643-8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"436","DOI":"10.18053\/jctres.07.202104.007","article-title":"Determination of the oral health status and behaviours, treatment needs, and guardians\u2019 perception of oral health among preschool children attending Integrated Child Developmental Scheme Anganwadi centres of Belagavi, South India: A cross-sectional study","volume":"7","author":"Kumar","year":"2021","journal-title":"J. Clin. Transl. Res."},{"key":"ref_10","first-page":"56","article-title":"Factors related to oral health care behaviours among parents of preschool children in child development centres, Warin Chamrap District, Ubon Ratchathani Province","volume":"7","author":"Kaewthong","year":"2022","journal-title":"J. Allied Health Sci. Suan Sunandha Rajabhat Univ."},{"key":"ref_11","first-page":"11","article-title":"Factors related to oral health status in pre-school children at day care centres, Wichianburi District, Phetchabun Province","volume":"12","author":"Supak","year":"2018","journal-title":"Kasalongkham Res. J. Chiangrai Rajabhat Univ."},{"key":"ref_12","first-page":"1","article-title":"Oral health status and oral health promotion for preschool children in Phra Bu Subdistrict child development centre, Phra Yuen District, Khon Kaen Province","volume":"4","author":"Ravadee","year":"2022","journal-title":"J. Khon Kaen Prov. Health Off."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Anopa, Y., McMahon, A.D., Conway, D.I., Ball, G.E., McIntosh, E., and Macpherson, L.M.D. (2015). Improving Child Oral Health: Cost Analysis of a National Nursery Toothbrushing Programme. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0136211"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/cdoe.12790","article-title":"Evaluating Childsmile, Scotland\u2019s National Oral Health Improvement Programme for Children","volume":"51","author":"Ross","year":"2023","journal-title":"Community Dent. Oral. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1177\/0022034515599979","article-title":"Ten Years of a National Oral Health Policy in Brazil: Innovation, Boldness, and Numerous Challenges","volume":"94","author":"Pucca","year":"2015","journal-title":"J. Dent. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.11606\/S1518-8787.2019053000540","article-title":"Dental care for early childhood in Brazil: From the public policy to evidence","volume":"53","author":"Essvein","year":"2019","journal-title":"Rev. Saude Publica"},{"key":"ref_17","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences, Lawrence Erlbaum Associates. [2nd ed.]."},{"key":"ref_18","unstructured":"Checkland, P. (1981). Systems Thinking, Systems Practice, John Wiley & Sons."},{"key":"ref_19","unstructured":"Sawangsuk, C. (2002). Theory and Practice in Educational Institution Administration, Book Point. (In Thai)."},{"key":"ref_20","unstructured":"Bloom, B.S., Hastings, J.T., and Madaus, G. (1971). Handbook on Formative and Summative Evaluation of Student Learning, McGraw-Hill."},{"key":"ref_21","first-page":"49","article-title":"On the use of content specialists in the assessment of criterion-referenced test item validity","volume":"2","author":"Rovinelli","year":"1977","journal-title":"Dutch J. Educ. Res."},{"key":"ref_22","unstructured":"Nunnally, J.C., and Bernstein, I.H. (1994). Psychometric Theory, McGraw-Hill. [3rd ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/BF02310555","article-title":"Coefficient alpha and the internal structure of tests","volume":"16","author":"Cronbach","year":"1951","journal-title":"Psychometrika"},{"key":"ref_24","unstructured":"American Academy of Pediatric Dentistry (2020). Policy on early childhood caries (ECC): Classifications, consequences, and preventive strategies. Pediatr. Dent., 42, 49\u201353."},{"key":"ref_25","first-page":"103","article-title":"Development of an oral health promotion model for preschool children through community participation in a child development centre under a sub-district administrative organization, Nakhon Ratchasima Province","volume":"30","author":"Sonpanao","year":"2019","journal-title":"Thai Dent. Nurse J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0140-6736(19)31133-X","article-title":"Ending the neglect of global oral health: Time for radical action","volume":"394","author":"Watt","year":"2019","journal-title":"Lancet"},{"key":"ref_27","first-page":"117","article-title":"Development of an oral health promotion model for preschool children through family and community participation in Kham Pom Subdistrict Child Development Centre, Phra Yuen District, Khon Kaen Province","volume":"3","author":"Wiangdindham","year":"2021","journal-title":"J. Khon Kaen Prov. Health Off."}],"container-title":["Epidemiologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-3986\/7\/4\/98\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:16:16Z","timestamp":1783998976000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-3986\/7\/4\/98"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["epidemiologia7040098"],"URL":"https:\/\/doi.org\/10.3390\/epidemiologia7040098","relation":{},"ISSN":["2673-3986"],"issn-type":[{"value":"2673-3986","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,11]]}}}