Oral Health Centre of Expertise in Western Norway, Hordaland, Pb. 2354 Møllendal, 5867, Bergen, Norway.
Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Pb. 7807, 5020, Bergen, Norway.
BMC Health Serv Res. 2019 Jul 22;19(1):507. doi: 10.1186/s12913-019-4330-8.
This study provides an empirical test of the reasoned action approach (RAA) socio-cognitive theory with the aim of 1) predicting the intention of public dental health personnel (PDHP) to report suspected child-maltreatment to child welfare services (CWS); 2) estimating the effects of the theoretical constructs of RAA, including experiential and instrumental attitudes, injunctive and descriptive norms, and perceived capacity and autonomy regarding PDHP's behavioural intentions; and 3) exploring whether the RAA operates equivalently (i.e., is invariant) in male and female providers.
This national cross-sectional study was conducted in Norway. An electronic survey was distributed to 1542 dentists and dental hygienists working in the public dental health service. The survey included RAA items constructed in accordance with the recommendations for the RAA model. Structural equation modelling (SEM) was used to identify factors derived from the theory of RAA to predict PDHP reporting intentions.
A total of 77.8% (1200) of those surveyed responded to the survey. The present study provided support for the utility of the RAA across both male and female providers in predicting their intention to report suspected child-maltreatment to the CWS. The final modified SEM model revealed that instrumental attitudes and perceived behavioural control (based on merged capacity and autonomy parameters) were the strongest predictors of intention to report, followed by the reporting of descriptive norms, injunctive norms and experiential attitudes. These factors explained 63.6% of the observed variance in the reporting intention.
The large amount of explained variance suggests that RAA is a well-functioning theory that predicts PDHP's reporting intentions to CWS across gender, and gives an understanding of the socio-cognitive factors involved. To strengthen reporting intention among dental personnel, this study suggests educators should focus on the value and positive consequences of reporting, the resources available and how to overcome obstacles; attention to normative expectations and individuals' feelings about reporting may also be helpful.
本研究通过实证检验理性行为理论（RAA）的社会认知理论，旨在：1）预测公共牙科保健人员（PDHP）向儿童福利服务机构（CWS）报告疑似儿童虐待的意愿；2）评估 RAA 的理论构念，包括体验和工具性态度、规范性和描述性规范，以及 PDHP 行为意向感知能力和自主性的影响；3）探索 RAA 在男性和女性提供者中是否具有同等作用（即不变）。
本研究为全国性横断面研究，在挪威进行。向在公共牙科保健服务机构工作的 1542 名牙医和牙科保健师分发了电子调查问卷。该调查包括根据 RAA 模型建议构建的 RAA 项目。结构方程模型（SEM）用于确定源自 RAA 理论的因素，以预测 PDHP 报告意图。
共有 1200 名（77.8%）调查对象对调查做出了回应。本研究为 RAA 在预测男性和女性提供者向 CWS 报告疑似儿童虐待的意图方面的适用性提供了支持。最终的修正 SEM 模型显示，工具性态度和感知行为控制（基于合并的能力和自主性参数）是报告意图的最强预测因素，其次是描述性规范、规范性规范和体验性态度。这些因素解释了报告意图的 63.6%的可观察方差。
大量的解释方差表明，RAA 是一种运作良好的理论，可预测 PDHP 向 CWS 报告的意图，且有助于理解所涉及的社会认知因素。为了增强牙科人员的报告意愿，本研究建议教育者应关注报告的价值和积极后果、可用资源以及如何克服障碍；对规范性期望和个人对报告的感受的关注也可能有所帮助。
