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Self-Regulation in Oral Hygiene Behaviors in Adults with Gingivitis: The Mediating Role of Coping Planning and Action Control.

AIM
This study investigates the joint role of volitional predictors of oral hygiene behaviors of flossing and brushing in adults with gingivitis, framed by the Health Action Process Approach model (HAPA).


MATERIALS AND METHODS
In a longitudinal online survey, 201 participants aged 18-75, of which 56.7% were women, completed assessments at baseline(T1), 2 weeks(T2), and 4 months(T3). Oral hygiene behaviors(OH) (brushing and flossing) and social cognitive determinants of behavior in the HAPA: action and maintenance self-efficacy(ASE & MSE), intention(INT), coping planning(CP), and action control(AC) were evaluated. Structural equation modeling was used to test a series of three nested models. In Model 1, action self-efficacy would determine MSE and INT, and INT would determine OH; in Model 2, INT would determine both CP and AC and the two OH behaviors; and in Model 3 CP and AC would be sequential mediators between INT and OH.


RESULTS
Model 3, predicting a mediating process from intention to behavior via coping planning and action control, showed the best fit according to the fit indices and explained more of the variance in dental hygiene. The mediating role of coping planning and action control between intention and oral hygiene behaviors was thus confirmed. Importantly, coping planning did not mediate between intention and oral hygiene behaviors, which means that oral hygiene intention influences action control through coping planning, and both sequentially mediate this influence on behavior.


CONCLUSIONS
For individuals who are not yet following the recommendations for specific oral hygiene behaviors, coping planning and action control represent psychological mechanisms by which intentions are put into practice.