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Table 1 Summary of the predictive measures used in the PRIME study investigating beliefs associated with the placing of preventive fissure sealants (PFS)

From: Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants

Theory of Planned Behaviour[23]  
Variables (number of items) Example Item(s)
Behavioural intention (3) I intend to place FS as a primary part of managing caries in six to sixteen year old patients.
Direct (2); Indirecta (7) behavioural beliefs (bb) multiplied by 7 outcome evaluations (oe). The score was the mean of the summed multiplicatives.)
D: In general, the possible harm caused by placing PFS is outweighed by its benefits;
I: In general, placing a PFS effectively reduces caries risk x effectively reducing caries risk is (un/important).
Subjective Normb
Indirect (3) normative beliefs (nb) multiplied by 3 motivation to comply items (mtc). The score was the mean of the summed multiplicatives).
I feel under pressure from the Dental Practice Board to place PFS (nb) x How motivated are you to do what the Dental Practice Board thinks you should (mtc: very much/not at all).
Perceived Behavioural Control
Direct (5); Indirect/power (10)c
D: It is entirely up to me whether I place PFSs;
I: I find it difficult to decide in favour of placing a PFS if the patient is a poor attender.
Social Cognitive Theory[25, 26]  
Risk Perception (6) It is highly likely that children with medium to high risk of caries will be worse off if I do not place PFS.
Outcome Expectancies
Self (2 × 2), Behaviour (7 × 7). The score was the mean of the summed multiplicatives.
S: If I place PFS, then I will think of myself as a caring dentist x Thinking of myself as a caring dentist is (Un/Important).
B: See Attitude TPB
Self Efficacy
General: Generalized Self-Efficacy Scale (Schwarzer, 1992) (10: 4-point scale, not at all true/exactly true); Specific (12)
General: I can always manage to solve difficult problems if I try hard enough.
Specific: How confident are you that you can effectively place a PFS in a six to sixteen yr old if the child has poor oral hygiene.
Implementation intentions[27]  
Action planning (1) Currently, my standard method of managing caries does not primarily include placing a PFS.
Operant conditioning[28]  
Anticipated consequences (6) Mean If I routinely place PFS then on balance, my life will be easier in the long run.
Evidence of habit (2) Mean When I see a patient, I automatically consider placing a PFS.
Experienced (rewarding and punishing) consequences (4): more likely to PFS (score = 1); less likely (score = -1); unchanged/not sure/never occurred (score = 0)). Scores were summed. Think about the last time you decided to place a PFS in a six to sixteen year old patient and felt pleased that you had done so. Do you think the result of this episode has made you...
Self-regulation model d[29, 30]  
Perceived identity (3) Caries is a condition with symptoms generally of an intense nature.
Perceived cause (5) Caries is caused by poor oral hygiene.
Perceived controllability (7) What the patient does can determine whether caries reverses or progresses, What I do can determine whether the patient's caries reverses.
Perceived duration (4) Caries is a condition which is likely to be permanent rather than temporary.
Perceived consequences (4) Caries does not have much effect on a patient's life.
Coherence (2) I have a clear picture or understanding of caries.
Emotional response (4) Seeing patients with caries does not worry me.
Stage[31, 32]  
Current stage of change. A single statement is ticked to indicate the behavioural stage Which of these sentences most characterises you at the moment?
Unmotivated (3): I have not yet thought about changing the number of PFS I place.
Motivated (2): I have decided that I will place more/less PFS.
Action (2): I have already done something about increasing/decreasing the number of PFS I place.
Other measures  
Knowledge (5) (True/False/Not Sure) PFS are recommended for routine use with high-risk children.
Demographic gender, time qualified, number of other dentists in practice, trainer status, hours per week, list size, if the practice employs hygienists.
  1. aAll indirect measures consist of specific belief items identified in the preliminary study as salient to placing PFS.
  2. bThese individuals and groups were identified in the preliminary study as influential in the decision to place a PFS
  3. cAn indirect measure of perceived behavioural control usually would be the sum of a set of multiplicatives (control beliefs x power of each belief to inhibit/enhance behaviour). However, the preliminary study demonstrated that it proved problematic to ask clinicians meaningful questions which used the word 'control' as clinicians tended to describe themselves as having complete control over the final decision to perform the behaviour. Support for measuring perceived behavioural control using only questions as to the ease or difficulty of performing the outcome behaviour was derived from a metanalysis which suggested that perceived ease/difficulty items were sensitive predictors of behavioural intention and behaviour [24].
  4. d Illness representation measures were derived from the Revised Illness Perception Questionnaire [30]