Stimulating dental attendance in the Netherlands: comparison of three conceptual frameworks

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Abstract
A field-experiment was done to study the differential effectiveness of three conceptual approaches to stimulate the demand for dental care. Persuasive messages were based on Ajzen & Fishbein's theory of reasoned action, on the health-belief model, and on the notion that knowledge of rights and obligations is a prerequisite for seeking dental care. All messages included an application form and a return envelope. Subjects were 269 members of Amsterdam health insurance companies. They had not received regular dental treatment and/or a certificate of dental fitness for at least 21/2 yr. Subjects received one of the three messages, an application form only (with a return envelope), or no message at all. Applying for treatment and acquiring a dental certificate were the behavioral measures. In all, 47.4% of insured who received message and/or application form applied for treatment. No control subjects applied. Fifteen months later 70% of the applicants had obtained a dental certificate. A differential effectiveness of the three messages was absent. Contrary to our expectations the condition of no message, application form only proved as effective as the message conditions. Results furthermore indicate that the main reason for not applying concerns fear of dental treatment. Whether or not the subject applied did not correlate with his knowledge of rights and obligations, sex, age, level of education, and occupational status.

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