Respondents were required to indicate the extent to which each of the beliefs would encourage them to, or prevent them from, brushing their teeth using a very true (5) to very untrue (1) Likert scale. The belief-based measure of control was grounded on the seven beliefs elicited from the focus group discussions, and measured using single items. Again, each normative belief was multiplied by the corresponding motivation to comply, and the summed product served as an indirect measure of subjective norm.

This was followed by a request to indicate the extent to which they were motivated to comply with the wishes of their significant others, across a five-point Likert scale, ranging from strongly agree (5) to strongly disagree (1).

Respondents were first required to indicate the extent to which each of their significant others would endorse their intention to brush their teeth. The belief-based measure of subjective norm was derived from the expectations of six referents: mummy, daddy, other members of my family, dentist, friends and teacher/principal. Much debate surrounds the manner in which the indirect measures are operationalized, exemplified by conflicting opinions as to whether item responses should follow unipolar (1вЂ“5) or bipolar (в€’2 to +2) scaling. Response options Meaning Very good, good, not sure, bad, very bad Strongly agree, agree, not sure, disagree, strongly disagree Very true, true, not sure, untrue, very untrue Once the response formats had been decided upon, the next step was to design items to assess each of the indirect measures of the TPB constructs. Indeed, the questionnaire is often criticized for being long in duration, tiring and repetitive., Of the TPB-based research that has been conducted using child samples aged between 9 and 14 years, most have been applied to a range of health-related behaviours including physical activity, вЂ“ smoking and breastfeeding. It has been suggested that one of the reasons the TPB has not been used to any great extent with children is that it is a difficult model to operationalize.

While much supportive evidence has been obtained for the efficacy of the TPB as a predictor of both intention and behaviour, and for the success of the theory in providing a framework for health behaviour-change interventions, a lack of TPB-based research with children under 13 years exists.

To date, health promotion initiatives have often been reinforced within the school setting not only for the benefit of assessing large numbers of children, but to also ensure that through them their families and wider communities can also be reached. In fact, it has been suggested that providing children with skills to improve knowledge, attitudes and ultimately behaviour to enable them to make healthy decisions, increases the likelihood of establishing healthy lifetime habits., However, in order to promote behaviour change among child populations, there is firstly a need to understand how personal and environmental determinants affect behaviour which then in turn enables effective health-related behaviour-change interventions to be designed and implemented. Introduction Within society, health and the establishment of health-promoting behaviours are essential particularly among children given that behaviours adopted early in life are more likely to be continued throughout adolescence and into adulthood (World Health Organization WHO).

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