Applying multiple models to predict clinicians’ behavioural intention and objective behaviour when managing children's teeth

This study used multiple theoretical approaches simultaneously to predict an objectively measured clinical behaviour. The six theoretical approaches were: The Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Action Planning (AP) and the Precaution Adoption Process (PAP), with knowledge as an additional predictor. Data on variables from these models were collected by postal survey. Data on the outcome behaviour, the evidence-based practice of placing fissure sealants, was collected from clinical records. Participants were 133 dentists (64% male) in Scotland. Variables found to predict the behaviour were: intention, attitude, perceived behavioural control, risk perception, outcome expectancies, self efficacy, habit, anticipated consequences, experienced consequences and action planning. The TPB, SCT, AP, OLT and PAP significantly predicted behaviour but the CS-SRM did not. A combined (Stepwise) regression model included only intention and action planning. Post hoc analyses showed action planning mediated effect of intention on behaviour. Taking a theory-based approach creates a replicable methodology for identifying factors predictive of clinical behaviour and for the design and choice of interventions to modify practice as new evidence emerges, increasing current options for improving health outcomes through influencing the implementation of best practice.