Abreu-Placeres Ninoska, Newton Johnathon Timothy, Pitts Nigel, Garrido Luis Eduardo, Ekstrand Kim R, Avila Viviana, Martignon Stefania
UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia.
Biomaterials and Dentistry Research Center (CIBO-UNIBE), Academic Research Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic.
Community Dent Oral Epidemiol. 2018 Dec;46(6):545-554. doi: 10.1111/cdoe.12388. Epub 2018 Jun 5.
To design and validate a questionnaire to measure caries management based on the Capability, Opportunity, and Motivation Behavior model (COM-B) and the International Caries Classification and Management System (ICCMS™).
A combination of Cariology and Psychology experts developed a 79-item pool that measured the COM-B components according to the ICCMS™ caries management recommended behaviours. After face and content validation and a pilot study, two samples of Colombian dentists participated: clinicians (n = 277) and clinical-practice educators (n = 212).
Using parallel analysis and exploratory structural equation modelling (ESEM), the questionnaire was reduced to a 47-item 5-factor instrument that demonstrated good internal consistency and validity properties, including a robust factor structure, measurement invariance across samples and high predictive validity of ICCMS™ recommended behaviours. Scales' mean scores showed that dentists were conducting recommended behaviours "most-of-the-time" (Behavior), showed high confidence in their ability to conduct these behaviours (Capability) and considered recommendations as highly relevant (Opportunity-Relevance), while their appraisals of the available resources (Opportunity-Resources) and remuneration (Motivation) were notably lower.
Overall, the findings highlight the practical utility of the COM-B ICCMS™ Questionnaire in understanding the potential antecedent variables that may explain dentists' behaviours related to caries diagnosis and management and in suggesting avenues for achieving a positive change in their behaviour.
设计并验证一份基于能力、机会和动机行为模型（COM-B）以及国际龋病分类和管理系统（ICCMS™）来衡量龋病管理的问卷。
龋病学和心理学专家联合开发了一个包含79个条目的题库，该题库根据ICCMS™龋病管理推荐行为来衡量COM-B的各个组成部分。经过表面效度和内容效度验证以及一项预试验研究后，有两组哥伦比亚牙医参与：临床医生（n = 277）和临床实践教育工作者（n = 212）。
通过平行分析和探索性结构方程模型（ESEM），问卷精简为一个包含47个条目的五因素量表，该量表具有良好的内部一致性和效度特性，包括稳健的因素结构、样本间的测量不变性以及ICCMS™推荐行为的高预测效度。量表的平均得分表明，牙医“大多数时候”都在进行推荐行为（行为），对自己进行这些行为的能力表现出高度信心（能力），并认为这些推荐非常相关（机会-相关性），而他们对可用资源（机会-资源）和报酬（动机）的评价则明显较低。
总体而言，研究结果突出了COM-B ICCMS™问卷在理解可能解释牙医与龋病诊断和管理相关行为的潜在前置变量以及为实现其行为的积极改变提供途径方面的实际效用。
