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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Carol Kunzel, PhD and Don Sadowsky, DDS, MPH, PhD. School of Dental and Oral Surgery, Columbia University, 630 W. 168th St., New York, NY 10032, 212-304-7176, ck60@columbia.edu
Evidence suggests that dentists have mixed feelings regarding treating HIV+ patients. In this study we investigate the respective utilities of the Theory of Reasoned Action (TRA) and the Theory of Planned Behavior (TPB) for explaining private general practice dentists' (GPDs') willingness to treat HIV+ patients. TRA views behavior as predicted by Behavioral Intention, which, in turn, is predicted by the two constructs, Subjective Norm and Attitude toward the Behavior. TPB expands the TRA model to include Perceived Behavioral Control as an additional predictor. Data collected in 1999-2000 by a mail survey of a representative sample of 392 active private general practitioner dentists (response rater=70%) in New York City are used to create summary measures of the model constructs. These measures are used to test the explanatory power of the two models via the use of multiple regression techniques. Articles identifying predictors of dentists’ willingness to treat HIV+ patients have been, by and large, atheoretical. There has not been a developing and unifying theory that reflects the process by which dentists’ arrive at an intention to treat HIV+ patients. The data presented here begin to address these gaps in the literature. TRA, developed by Fishbein and Ajzen, was developed to explain behaviors that are under full volitional control. For behaviors that are not completely under one’s volitional control, such as those that require skills and opportunities, an additional component is viewed as important: the individual’s beliefs about his/her ability to perform the behavior, termed Behavioral Control. Ajzen therefore expanded TRA to include consideration of perceived behavioral control, calling the model the Theory of Planned Behavior. In this study, the dependent variable, used as a proxy for Intention, is an index constructed of items measuring GPDs' willingness to treat four types of HIV+ patients who differ in severity of disease and length of time as a patient. Contrasting the two models suggests that expanding the original TRA model, R2=.26, by adding Perceived Behavioral Control, helps in the prediction of dentists' willingness to treat HIV+ patients, R2=.43. Fishbein and Ajzen’s work is attractive because it integrates much of what has been learned about the connection between attitudes and behavior into an explanatory model that is explicit, testable and predictive. Understanding the relative importance of the model components can help to shape the content and design of interventions to motivate GPDs' increased willingness to treat HIV+ patients.
Learning Objectives:
Keywords: Access to Care, HIV/AIDS
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.