Predictors of patient intent to comply with dental student recommendations

Objectives: To determine if race, sex, student demeanor, patient understanding, or locus of control predict patients' intent to comply with recommendations following sessions with dental students. Methods: Dental student-patient sessions, videotaped for class, were rated by trained coders on scales of student dominance, anxiety, anger, friendliness and involvement. One point was given for each outlying negative demeanor rating, and points were added to obtain a total unfavorable demeanor score. Patients responded to surveys asking them to list the dental students' recommendations, rate their understanding of them, and rate their intention to comply with them. For each session, an average patient understanding score and an average patient intent to comply score were produced. Patients also responded to oral health locus of control questions. Results: 125 sessions were eligible, 31 (22%) subjects refused, and 22 patients could not be reached for consent. Of the remaining 72, 54 rated intent to comply and were the subjects of the following analyses. 71% of patients in the initial interviews reported they intended to comply, compared to 56% in treatment planning sessions, 50% in preparation for surgery, and 13% in the behavioral change sessions (Chi Square p<.01). Patients' ratings of ability to understand the recommendations correlated with their ratings of intent to comply (r=.40, p<.005). Racial congruence also predicted intent to comply (Mann Whitney U, p<.01). However, these relationships disappeared when other variables were considered. The final logistic regression model predicting intent to comply revealed the important variables to be the type of session (p<.001) and the student's unfavorable demeanor score (p<.05). Conclusions: A dental student's unfavorable demeanor may affect a patient's intent to comply with recommendations, which may indicate a source of disparities if cultural differences affect demeanor. Funded by NIDCR grant no. R21 DE014991-01, and by a UIC College of Dentistry Wach Grant.