Determinants of communicable disease risk awareness and protective behaviors among dental students: a path analysis-based cross-sectional study

The present study aimed to investigate the associations of gender and clinical training stage (CTS) with awareness of communicable disease risks and protective behaviors among dental students. This single-center, cross-sectional study included 441 students enrolled at the Faculty of Dentistry, Eskişehir Osmangazi University; the response rate was 75.3%. Students were classified into three groups according to their level of patient contact: (1) preclinical, (2) observer, and (3) clinical. Data were collected with a questionnaire that comprised demographic items and the Communicable Diseases Risk Awareness and Protection Scale. Groups were compared with one-way ANOVA (with Bonferroni-corrected post hoc tests) and the independent-samples t-test, and effect sizes were reported. Multiple linear regression and an observed-variable path analysis were used to examine the associations of gender and CTS with awareness and behavior, the latter both directly and indirectly through awareness. The preclinical group scored lower than both the observer and clinical groups on the behavior and total scores ( p < 0.001), with no difference between the observer and clinical groups. Female students scored higher than male students on all dimensions (all p ≤ 0.01). For the primary outcome (behavior), being female ( p < 0.001) and CTS ( p = 0.004) were the only significant predictors. In the path analysis, gender was associated with behavior both directly ( p < 0.001) and through awareness ( p = 0.003); for CTS the total association was significant ( p = 0.032) although its direct and indirect paths were not. Protective behavior was associated mainly with CTS and gender, whereas risk awareness was only weakly related to CTS. In this cross-sectional design, a strong awareness-mediated pathway to behavior was not supported. Increased risk awareness was not directly reflected in protective behavior, which improved mainly with advancing clinical training stage.