Canonical correlation analyses of a previous dental survey suggested that dental checkups, flossing, and tooth brushing could all be predicted from a single equation. Most theories and research about the influence of beliefs on behavior, however, suggest different behaviors will be best predicted by different behavior-specific measures. The current survey investigated influences on brushing, flossing, and dental checkups in a probability sample of adults in the Detroit tri-county area. Both behavior-specific variables, such as perceived benefits and costs of flossing, and general variables, such as gender, were included as predictors. Canonical correlation analysis indicated three equations were needed to predict the three oral health behaviors. Flossing frequency, for example, was best predicted by confidence in flossing ability and beliefs about the benefits of and barriers to flossing. The results suggest that even these closely related behaviors are best predicted using separate equations that include mostly behavior-specific predictors.
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References
1.
American Dental Association: Wake up to prevention for the smile of a lifetime. J Am Dent Assoc116:3g,6g-13g, 1988.
2.
National Institutes of Health.Rx for Sound Teeth (brochure. Washington, DC, U.S. Government Printing Office, 1991. (NIH Pub. No. 91-3245.)
3.
Ronis DL, Lang WP, Farghaly MM, Ekdahl SM: Preventive oral health behaviors among Detroit-area residents. J Dent Hygiene68:123-130, 1994.
4.
American Dental Association: Dental Habits and Opinions of the Public: Results of a 1978 Survey. Chicago, IL, American Dental Association, 1979.
5.
Swank ME, Vernon SW, Lairson DR: Patterns of preventive dental behaviors. Public Health Rep101:175-184, 1986.
6.
Chen M-S, Rubinson L: Preventive dental behavior in families: A national survey. JAm Dent Assoc105:43-46, 1982.
7.
Jack SS, Bloom B: Use of Dental Services and Dental Health: United States, 1986 (Vital and Health Statistics, Series 10, No. 165. Hyattsville, MD , National Center for Health Statistics, 1988. (DHHS Pub. No. [PHS] 88-1593)
8.
Chen M-S, Stone DB: Toothbrushing, flossing, and dental visits in relation to socioeconomic characteristics of White American families. Community Dent Oral Epidemiol11:324-332, 1988.
9.
Reisine S: A path analysis of the utilization of dental services. Community Dent Oral Epidemiol15:119-124, 1987.
10.
Ronis DL, Lang WP, Farghaly MM, Passow E: Tooth brushing, flossing, and preventive dental visits by Detroit-area residents in relation to demographic and socioeconomic factors. J Public Health Dent53:138-145, 1993.
11.
Schuurs AHB, Duivenvoorden HJ, van Velzen SKT, Verhage F: Differentiating regular from irregular dental attenders of either sex by linear discriminant analysis. Community Dent Oral Epidemiol11:43-49, 1983.
12.
Keogh T, Linden GJ: Knowledge, attitudes and behaviour in relation to dental health of adults in Belfast, Northern Ireland. Community Dent Oral Epidemiol19:246-248, 1991.
13.
Corah NL, Gale EL, Illig AJ: Assessment of a dental anxiety scale. J Am Dent Assoc97:816-819, 1978.
14.
Locker D, Liddell A: Correlates of dental anxiety among older adults . J Dent Res70:198-203, 1991.
15.
Ronis DL: Updating a measure of dental anxiety: Reliability, validity, and norms. J Dent Hygiene68:228-233, 1994.
16.
McCaul KD, Glasgow RE, Gustafson C: Predicting levels of preventive dental behaviors. J Am Dent Assoc111:601-605, 1985.
17.
McCaul KD, O'Neill HK, Glasgow RE: Predicting the performance of dental hygiene behaviors: An examination of the Fishbein and Ajzen model and self-efficacy expectations. J Appl Social Psychol18:114-128, 1988.
18.
Chen M-S, Land KC: Testing the health belief model: LISREL analysis of alternative models of causal relationships between health beliefs and preventive dental behavior. Social Psychol Q49:45-60, 1986.
19.
Chen M-S, Tatsuoka M: The relationship between American women's preventive dental behavior and dental health beliefs. Soc Sci Med19:971-978, 1984.
20.
Ronis DL: Conditional health threats: Health beliefs, decisions, and behaviors among adults. Health Psychol11:127-134, 1992.
21.
Janz NK, Becker MH: The health belief model: A decade later. Health Educ Q11:1-47, 1984.
22.
Rosenstock IM, Strecher VJ, Becker MH: Social learning theory and the health belief model. Health Educ Q15:175-183, 1988.
23.
Fishbein M, Ajzen I: Belief, Attitude, and Behavior: An Introduction to Theory and Research. Reading, MA, Addison-Wesley, 1975.
24.
Ajzen I: The theory of planned behavior. Organiz Behav Human Decision Processes50:179-211, 1991.
25.
Maddux JE, Rogers RW: Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. J Exp Soc Psychol19:469-479, 1983.
26.
Rogers RW: A protection motivation theory of fear appeals and attitude change. J Psychol91:93-119, 1975.
27.
Bandura A: Social Foundations of Thought and Action. Englewood Cliffs, NJ, Prentice Hall, 1986.
28.
McCaul KD, Sandgren AK, O'Neill HK, Hinsz VB: The value of the theory of planned behavior, perceived control, and self-efficacy expectations for predicting health-protective behaviors. Basic Appl Soc Psychol14:231-252, 1993.
29.
French BN, Kurczynski TW, Weaver MT, Pituch MJ: Evaluation of the health belief model and decision making regarding amniocentesis in women of advanced maternal age. Health Educ Q19(2):177-186, 1992.
30.
Kelly GR, Manon JA, Scott JE: Utility of the health belief model in examining medication compliance among psychiatric outpatients. Soc Sci Med25(11):1205-1211, 1987.
31.
Wurtele SK, Maddux JE: Relative contributions of protection motivation theory components in predicting exercise intentions and behavior. Health Psychol6:453-466, 1987.
32.
Stanley MA, Maddux JE: Cognitive processes in health enhancement: Investigation of a combined protection motivation and self-efficacy model. Basic Appl Soc Psychol7:101-113, 1986.
33.
Ronis DL, Kaiser MK: Correlates of breast self-examination in a sample of college women: Analyses of linear structural relations. J Appl Soc Psychol19:1068-1084, 1989 .
34.
Stein JA, Fox SA, Murata PJ, Morisky DE: Mammography usage and the health belief model . Health Educ Q19(4):447-462, 1992.
35.
Ajzen I, Driver BL: Application of the theory of planned behavior to leisure choice. J Leisure Res24:207-224, 1992.
36.
Ajzen I, Madden TJ: Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. J Exp Soc Psychol22:453-474, 1986.
37.
Shifter DB, Ajzen I: Intention, perceived control, and weight loss: An application of the theory of planned behavior. J Pers Soc Psychol49:843-851, 1985.
38.
Ajzen I, Fishbein M: Attititude-behavior relations: A theoretical analysis and review of empirical research. Psychol Bull84:888-918, 1977.
39.
Ajzen I, Fishbein M: Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ, Prentice Hall, 1980.
40.
Lusk SL, Ronis DL, Kerr MJ, Atwood JR: Test of the health promotion model as a causal model of workers' use of hearing protection. Nurs Res43:151-157, 1994.
41.
Schlegel RP, DiTecco D: Attitudinal structures and the attitude-behavior relation, in Zanna MP, Higgins ET, Herman CP, (eds.): Consistency in Social Behavior: The Ontario Symposium (Vol. 2). Hillsdale, NJ, Lawrence Erlbaum, 1982, pp. 17-49.
42.
Ajzen I: Attitude structure and behavior, in Pratkanis AR, Breckler SJ, Greewald AG (eds.): Attitude Structure and Function. Hillsdale, NJ, Lawrence Erlbaum, 1989, pp. 241-274.
43.
Langlie JK: Social networks, health beliefs, and preventive health behavior. JHealth Soc Behav18:244-260, 1977.
44.
Walker SN, Sechrist KR, Pender NJ: The health promoting lifestyle profile: Development and psychometric characteristics . Nurs Res36:76-81, 1987.
45.
Chen M-S: A sociodemographic analysis of preventive dental behavior among white American families. Health Educ Q13:105-115, 1986.
46.
Bollen K, Lennox R: Conventional wisdom on measurement: A structural equation perspective. Psycholog Bull110(2):305-314, 1991.
47.
Thompson B: Canonical Correlation Analysis: Uses and Interpretation. Newbury Park, CA, Sage, 1984.
48.
Harris RJ: A Primer of Multivariate Statistics (2nd ed.). Orlando, FL, Academic Press, 1985.
49.
Tatsuoka MM, Lohnes PR: Multivariate Analysis: Techniques for Educational and Psychological Research (2nd ed.). New York, Macmillan, 1988.
50.
Thorndike RM: Correlational Procedures for Research. New York, Gardner, 1978.
51.
Lang WP, Farghaly MM, Ronis DL: The relation of preventive dental behaviors to periodontal health status . J Clin Periodontol21:194-198, 1994.
52.
Lang WP, Ronis DL, Farghaly MM: Preventive behaviors as correlates of periodontal health status. J Public Health Dent55:10-17, 1995.
53.
Ronis DL, Yates JF, Kirscht JP: Attitudes, decisions, and habits as determinants of repeated behavior, in Pratkanis AR, Breckler SJ, Greenwald AG (eds.): Attitude Structure and Function. Hillsdale, NJ , Lawrence Erlbaum, 1989, pp. 213-239.
