An investigation into the factors influencing tooth brushing behaviour amongst school children living in Northern Ireland: An application of the Theory of Planned Behaviour.

Background: Northern Ireland has the worst oral health in the UK and its children have among the highest levels of tooth decay in Europe (DHSSPS, 2007).
Aim: The aim of this study is to investigate the factors influencing tooth brushing behaviour among Year 6 primary schoolchildren using the Theory of Planned Behaviour (TPB).
Method: Seven semi-structured focus groups involving 56 children were conducted during which children were asked questions about the factors that influence whether or not they brush their teeth. Thematic analysis was used with the purpose of eliciting the belief-based measures for all the TPB constructs.
Results: The findings suggest that children are knowledgeable about their teeth and are aware of the importance of maintaining good oral health; although a number of barriers to consistent tooth brushing exist.
Discussion: The findings will be used to inform stage 2 of the research project; questionnaire development to identify the factors influencing young people’s motivations to improve their tooth brushing behaviour and to assess their relative importance.

The design and psychometric assessment of a TPB-based questionnaire suitable for use with primary school children

Despite the popularity of the Theory of Planned Behaviour (TPB) a lack of research assessing the efficacy of the model in understanding the health behaviour of children exists, with those studies that have been conducted reporting problems with questionnaire formulation and low to moderate internal consistencies for TPB constructs. The aim of this study was to develop and test a TPB-based measure suitable for use with primary school children aged 9 to 10 years. A mixed method sequential design was employed. In Stage 1, 7 semi-structured focus group discussions (N=56) were conducted to elicit the underlying beliefs specific to tooth brushing. Using content thematic analysis the beliefs were identified and a TPB measure was developed. A repeated measures design was employed in Stage 2 using test re-test reliability analysis in order to assess its psychometric properties. In all, 184 children completed the questionnaire. Test-retest reliabilities support the validity and reliability of the TPB measure for assessing the tooth brushing beliefs of children. Pearson’s product moment correlations were calculated for all of the TPB beliefs, achieving substantial to almost perfect agreement levels. Specifically, a significant relationship between all 10 of the direct and indirect TPB constructs at the 0.01 level was achieved. This paper will discuss the design and development of the measure so could serve as a guide to fellow researchers and health psychologists interested in using theoretical models to investigate the health and well-being of children.