Background
Methods
Ethical considerations
Phase I: development and pilot test of the questionnaire
Phase II: item reduction and questionnaire testing
Phase III: practicability of the questionnaire
Results
Phase II: item reduction and questionnaire testing
EFA results
Factor 1 Self-efficacy | Factor 2 Perceived benefits | Factor 3 Perceived severity | Factor 4 Perceived barriers | Factor 5 Cues to action | Factor 6 Perceived susceptibility | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
EFF37 | 0.92 | BEN5 | 0.83 | SEV27 | 0.79 | BAR14 | 0.84 | CUE22 | 0.88 | SUS1 | 0.77 |
EFF38 | 0.90 | BEN6 | 0.81 | SEV26 | 0.77 | BAR13 | 0.82 | CUE21 | 0.86 | SUS2 | 0.75 |
EFF34 | 0.90 | BEN7 | 0.80 | SEV25 | 0.74 | BAR19 | 0.56 | CUE20 | 0.75 | ||
EFF39 | 0.88 | BEN3 | 0.78 | SEV30 | 0.71 | BAR15 | 0.55 | CUE23 | 0.43 | ||
EFF33 | 0.88 | BEN9 | 0.74 | SEV28 | 0.71 | BAR12 | 0.53 | ||||
EFF42 | 0.87 | BEN8 | 0.70 | SEV24 | 0.68 | BAR16 | 0.51 | ||||
EFF40 | 0.86 | BEN10 | 0.70 | SEV29 | 0.67 | BAR17 | 0.50 | ||||
EFF41 | 0.86 | BEN4 | 0.44 | SEV31 | 0.55 | BAR18 | 0.49 | ||||
EFF35 | 0.83 | SEV32 | 0.55 | BAR11 | 0.32 | ||||||
EFF36 | 0.82 | ||||||||||
Eigenvalue | |||||||||||
10.41 | 5.00 | 3.89 | 3.08 | 2.19 | 1.67 | ||||||
Variance explained | |||||||||||
24.79 | 11.91 | 9.27 | 7.33 | 5.21 | 3.98 |
CFA results
Phase III: practicability of the questionnaire
Reliability and stability
Items of subscale | Mean | SD | Item-total correlation | Cronbach’s α If item deleted (n = 421) | Cronbach’s α of the subscale (n = 421) | Test-retest intra-class correlation (n = 40) | |
---|---|---|---|---|---|---|---|
Subscale of perceived susceptibility | 0.81 | 0.82 | |||||
SUS1 | There is a chance that I will get caries. | 2.73 | 1.00 | 0.69 | – | ||
SUS2 | There is a chance that I will have periodontal disease. | 2.47 | 0.95 | 0.69 | – | ||
Subscale of perceived benefits | 0.90 | 0.80 | |||||
BEN3 | I think brushing and flossing can make teeth healthier. | 4.13 | 0.77 | 0.73 | 0.88 | ||
BEN5 | I think brushing and flossing can prevent oral diseases from happening. | 4.14 | 0.76 | 0.78 | 0.87 | ||
BEN6 | I think brushing and flossing can make teeth look good. | 4.09 | 0.73 | 0.77 | 0.88 | ||
BEN7 | I think brushing and flossing can keep breath fresh. | 4.02 | 0.81 | 0.72 | 0.88 | ||
BEN8 | I think brushing and flossing can prevent inconvenient eating caused by oral diseases. | 4.11 | 0.78 | 0.66 | 0.89 | ||
BEN9 | I think brushing and flossing can help me avoid spending more time on dental treatment in the future. | 3.81 | 0.84 | 0.66 | 0.89 | ||
BEN10 | I think brushing and flossing can help me avoid spending more money on dental treatment in the future. | 3.78 | 0.91 | 0.62 | 0.89 | ||
Subscale of perceived barriers | 0.84 | 0.88 | |||||
BAR11 | I think it is difficult for me to brush twice a day. | 1.83 | 0.92 | 0.47 | 0.83 | ||
BAR15 | I think it’s a waste of time to brush and floss. | 1.99 | 0.90 | 0.59 | 0.81 | ||
BAR16 | I think I do not have enough time to have an annual dental visit. | 2.55 | 1.09 | 0.54 | 0.82 | ||
BAR17 | I am afraid of undergoing tooth treatment, so I don’t have dental visits annually. | 1.93 | 0.89 | 0.68 | 0.79 | ||
BAR18 | I think we have no money at my home, so I don’t have an annual dental visit. | 1.94 | 0.97 | 0.68 | 0.79 | ||
BAR19 | I think the dental clinic is far from my home, so I don’t have an annual dental visit. | 2.06 | 1.01 | 0.71 | 0.78 | ||
Subscale pf cues to action | 0.85 | 0.85 | |||||
CUE20 | Parents often reminds me of brushing and flossing | 2.48 | 1.13 | 0.58 | 0.92 | ||
CUE21 | Classmates often reminds me of brushing and flossing. | 1.87 | 1.02 | 0.79 | 0.72 | ||
CUE22 | Teachers often reminds me of brushing and flossing. | 1.95 | 1.04 | 0.79 | 0.72 | ||
Subscale of perceived severity | 0.89 | 0.88 | |||||
SEV24 | If I have caries, for me that is … | 3.36 | 1.05 | 0.61 | 0.88 | ||
SEV25 | If I have periodontal disease, for me that is … | 3.86 | 1.02 | 0.71 | 0.87 | ||
SEV26 | If my teeth do not look good because of oral diseases, for me that is … | 3.60 | 1.02 | 0.72 | 0.87 | ||
SEV27 | If I have bad breath because of oral diseases, for me that is … | 3.80 | 0.98 | 0.79 | 0.86 | ||
SEV28 | If I can’t sleep well because of oral diseases, for me that is … | 1.06 | 1.02 | 0.69 | 0.87 | ||
SEV29 | If I can’t eat my favorite food because of oral diseases, for me that is … | 4.12 | 1.05 | 0.60 | 0.88 | ||
SEV30 | If I get laughed at by classmates because of oral diseases, for me that is … | 3.82 | 1.07 | 0.64 | 0.88 | ||
Subscale of self-efficacy | 0.97 | 0.91 | |||||
EFF | How confident you are that you will brush your teeth for 2 min twice daily on the circumstances below? | ||||||
EFF33 | When you are under a lot of stress | 3.77 | 1.04 | 0.87 | 0.96 | ||
EFF34 | During or after experiencing personal problems | 3.74 | 1.08 | 0.88 | 0.96 | ||
EFF35 | When you are feeling tired | 3.44 | 1.15 | 0.80 | 0.97 | ||
EFF36 | When you don’t feel like it | 3.35 | 1.20 | 0.79 | 0.97 | ||
EFF37 | When you are anxious | 3.78 | 1.05 | 0.91 | 0.96 | ||
EFF38 | After experiencing family problems | 3.72 | 1.11 | 0.88 | 0.96 | ||
EFF39 | When you have other commitments | 3.71 | 1.08 | 0.87 | 0.96 | ||
EFF40 | When you feel you don’t have the time | 3.49 | 1.18 | 0.84 | 0.97 | ||
EFF41 | When you are feeling under pressure from school work | 3.69 | 1.16 | 0.84 | 0.97 | ||
EFF42 | When you have too much work to do at home | 3.80 | 1.05 | 0.86 | 0.96 |
B | SE | Wald statistics | OR (95% CI) | P | |
---|---|---|---|---|---|
Predicting brushing twice daily (N = 412, Cox & Snell R2 = 0.097, Nagelkerke R2 = 0.160) Chi-square = 42.2, df = 6, p < 0.001 | |||||
Perceived susceptibility | −0.16 | 0.17 | 0.91 | 0.85 (0.61–1.19) | 0.34 |
Perceived benefits | 0.14 | 0.25 | 0.31 | 1.14 (0.71–1.86) | 0.58 |
Perceived barriers | −0.10 | 0.25 | 0.16 | 0.91 (0.56–1.47) | 0.69 |
Cues to action | 0.21 | 0.18 | 1.43 | 1.23 (0.88–1.74) | 1.23 |
Perceived severity | 0.14 | 0.20 | 0.48 | 1.15 (0.78–1.69) | 0.49 |
Self-efficacy | 0.86 | 0.17 | 25.98 | 2.36 (1.70–3.28) | < 0.001 |
Predicting weekly flossing behavior (N = 418, Cox & Snell R2 = 0.069, Nagelkerke R2 = 0.106) Chi-square = 30.0, df = 6, p < 0.001 | |||||
Perceived susceptibility | −0.30 | 0.14 | 4.42 | 0.74 (0.56–0.98) | 0.04 |
Perceived benefits | −0.01 | 0.22 | 0.001 | 0.99 (0.65–1.53) | 0.98 |
Perceived barriers | −0.86 | 0.24 | 12.74 | 0.42 (0.26–0.68) | < 0.001 |
Cues to action | 0.31 | 0.14 | 5.26 | 1.36 (1.05–1.77) | 0.02 |
Perceived severity | −0.10 | 0.17 | 0.37 | 0.90 (0.65–1.26) | 0.54 |
Self-efficacy | −0.02 | 1.14 | 0.01 | 0.98 (0.75–1.29) | 0.91 |
Predicting regular dental visit (N = 419, Cox & Snell R2 = 0.070, Nagelkerke R2 = 0.098) Chi-square = 30.6, df = 6, p < 0.001 | |||||
Perceived susceptibility | 0.09 | 0.13 | 0.53 | 1.10 (0.86–1.41) | 0.47 |
Perceived benefits | −0.21 | 0.19 | 1.15 | 0.81 (0.56–1.19) | 0.28 |
Perceived barriers | −1.10 | 0.22 | 26.14 | 0.33 (0.22–0.51) | < 0.001 |
Cues to action | 0.08 | 0.12 | 0.37 | 1.08 (0.85–1.37) | 0.54 |
Perceived severity | −0.23 | 0.15 | 2.25 | 0.80 (0.59–1.07) | 0.13 |
Self-efficacy | −0.16 | 0.12 | 1.71 | 0.85 (0.67–1.08) | 0.19 |