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Health Behavior Change in the Dental Practice

Since the total number of dental practitioners was small, no sampling was done. Addresses of dental practitioners working in government health facilities were obtained from the office of the Chief Dental Officer in the Ministry of Health. As this list had last been updated in , confirmation regarding the names, numbers and working stations of dental practitioners in each region was necessary. Regional dental officers were called and e-mail or short mobile phone messages were used to supply updated information about names, working stations and qualifications.

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The pre-tested questionnaire, introductory letter and a stamped envelope for returning the filled questionnaire were mailed individually to all dental practitioners in mainland Tanzania. After 2 months and, finally after 4 months, a reminder letter, the questionnaire and a stamped envelope were sent to all those who had not yet returned the questionnaire. Statistical Analysis. Data Entry and Processing.

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All data were entered into a computer, using SPSS software, version The test-retest of the items resulted in a correlation coefficient of 0. For the items constituting attitude, subjective norm and intention , Cronbach's alpha was calculated to ascertain their internal consistency. The alpha values were 0.

Variables construction for statistical analysis. These were dichotomized by combining "no" and "not sure" into "no" and retaining the "yes" option. Scores for the 7 items used to measure attitude were summed up to form a total attitude score. Scores for 5 items used to measure subjective norm were combined to form a total subjective norm score. Scores for 3 items used to measure intention formed a total intention score.

The total score for each construct was divided by the number of items used to compute it. Using the following cut-off points: The dependent variables were: attitude negative, neutral and positive ; subjective norm weak, moderate and strong social pressure and intention low, moderate and strong intention. The total scores for the 3 constructs were used in a multiple regression analysis to determine the relative contribution of attitude and subjective norm to the intention to practice ART. Twenty respondents were dental officers. Only working experience had an influence on the subjective norm of the dental practitioners.

Table 3 summarizes the responses to the 4 questions about introducing ART in Tanzania. Seventy-three percent of dental practitioners felt that ART was worth introducing in Tanzania. The percent distribution of practitioners according to degree of attitude, subjective norm and intention to practice ART is presented in Table 4. All dental practitioners had a moderate to strong positive attitude towards practicing ART. The proportion of practitioners who had a positive attitude, strong subjective norm and high intention to practice ART rated The inter-item correlations and Cronbach's alpha were high, indicating high internal consistence and reliability.

Therefore the findings of the analysis were considered reliable.

Health Behavior Change in the Dental Practice

The high percentage Nevertheless, a quarter of these practitioners were of the opinion that ART was not worth practicing in Tanzania. This may be the result of a common fear of change. Fear of change has been shown to be one of the obstacles to a broad uptake of clinical guidelines in Australia In some situations it is described as professional uncertainty and disempowerment 11 or as part of a clinical inertia paradigm It is reasonable to assume that dental practitioners may fear that they might not achieve the same success as they do when using traditional modes of treating dental caries.

They may also fear possible disapproval of the innovation from patients, caused by perceptions that treating dental caries by ART procedures may be inferior to using rotary instruments. Unlike the findings of Freeman and Adams 8 that dentists with stronger attitudes had higher intentions towards treatment of special needs patients than those with weaker attitudes, the present study showed that attitude did not contribute significantly to the intention to practice ART.

Subjective norm, on the other hand, had a significant influence on intentions to practice ART. This suggests that dental practitioners in Tanzania respond more positively to social pressures with regard to treatment choice. The indication is that practitioners will use ART if the people important to them council director, colleagues and patients approve of ART. This may indicate that practicing ART in government dental clinics in Tanzania is not a purely volitional behavior.

An employee will do whatever the employer directs.

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On the other hand, it may reflect the mindset of many Tanzanian workers, who tend to be passive in bringing innovations to their workplaces because the institutions belong to the government, and employees have nothing to lose or gain in relation to the success or failure of these institutions The implication is that for countrywide introduction of ART, oral health authorities need not to bother too much about the attitude of practitioners towards ART.

Instead, they should ensure that decision-makers in the districts and councils support the introduction and adoption of this form of therapy. The study indicated that dental practitioners were willing to have ART introduced in Tanzania and that they had a positive attitude towards practicing this treatment approach.

Health Behavior Change in the Dental Practice

Nevertheless, their intention to practice ART was strongly influenced by social pressures. The authors wish to thank the dental practitioners for their time spent in responding to the questionnaire. Understanding attitude and predicting social behaviour. Behavioural Theory 2. Social Learning Theory 3. Cognitive Theory 4. Humanist Theory 5. Developmental Theory 6. Critical Theory 7.

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Salutogenic Theory 8. Expectancy Value Theory 20 Elyasi M, et. Rotter J. Locus of Control. Knowledge Attitude Behaviour 31 Also health educators effort and resultant behaviour change is influenced by many factors such as: 1. Socio-demographic factors 2. Values, beliefs 3. Readiness to change 4.

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Education 5. Cultural norms 6. Cultural values 7. Needs 8. Expectations Environment Method of education delivery 32 Effectiveness of a cognitive behaviour therapy self-help programme for smokers in London, UK. Health Promot Int. Assumptions 1. People learn by observing others: Modeling 2. Learning is internal. Learning is goal-directed behavior. There are ways to reinforce behaviors: 38 Okada, M.

Int J Paediatr Dent. How much? Swetha HL, et. Theory of Planned Behavior Ajzen 49 Ebrahimipour, Sediqe et al. Stages of Change 6 stages 2. Processes of Change 10 processes 3. The transtheoretical model use for smoking cessation.