Explaining the intention of dental health personnel to report suspected child maltreatment using a reasoned action approach

Ingfrid Vaksdal Brattabø,Ragnhild Bjørknes,Anne Nordrehaug Åstrøm,Kyrre Breivik

doi:10.1186/s12913-019-4330-8

Abstract

BackgroundThis 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.MethodsThis 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.ResultsA 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.ConclusionsThe 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.

Highlights

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 in male and female providers
In regard to PDHP’s reporting frequency throughout career, adjusted analysis revealed no significant differences in incidence rate ratio between dentists and dental hygienists or across age groups, while females were less likely to report to CWS than males
This study provides an empirical test of the RAA with the aim of 1) predicting the intention of PDHP to report suspected child maltreatment to 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 reporting intentions; and 3) exploring whether the RAA operates equivalently in male and female providers

Summary

Introduction

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. In Norway, public dental health personnel (PDHP) are mandated through the Norwegian Health Personnel Act, § 33, to report to the child welfare service (CWS) when there is reason to believe that a child is or will be abused, subjected to serious deficiencies in daily care or other serious neglect. This obligation goes above and beyond health personnel’s duty of confidentiality §21.

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