Testing and Validating Green Dental Laboratory ‘Knowledge, Attitude, and Practice’ (KAP) Scale Developed for Dental Technicians Doing Prosthodontic Work

Abstract

Background: Dental laboratories place a considerable burden on the environment through hazardous materials such as methyl methacrylate and gypsum, intensive energy and water use, waste generation, and transport between clinics and laboratories. Although Knowledge, Attitude and Practice (KAP) models are widely used to analyse professional behaviours, no standardised, psychometrically validated instrument exists for dental laboratory technicians. This study evaluated the preliminary psychometric properties of the newly developed “Green Dental Laboratory KAP Scale”. Methods: A methodological, cross-sectional scale development study was conducted with a convenience sample of 194 dental technology students and graduates. The 49-item instrument covered three domains: knowledge (11 items, formative), attitude (19 items, reflective), and practice (19 items, formative). The attitude construct was examined with Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), and the formative constructs and structural relationships were examined with Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: Most participants had never heard of the “Green Laboratory” concept (84.0%) and had not received formal environmental training (89.7%). The attitude scale showed a unidimensional structure (eigenvalue = 12.326; 82.17% of total variance) with high internal consistency (Cronbach’s α = 0.984, AVE = 0.807). CFA fit indices were mixed: CFI (0.917), TLI (0.903), and SRMR (0.030) met the recommended cut-offs. However, the robust RMSEA (0.130) exceeded the accepted cut-off. All formative indicators showed acceptable collinearity (VIF < 5). Knowledge was positively associated with both attitude (β = 0.308, p = 0.002) and practice (β = 0.553, p < 0.001), and attitude with practice (β = 0.362, p < 0.001), a pattern consistent with partial mediation. The structural model explained 56.0% of the variance in practice (R2 = 0.560). Conclusions: The Green Dental Laboratory KAP Scale is a preliminary psychometric evidence tool for assessing sustainability competencies in dental technology education and professional practice. The findings suggest that, alongside knowledge acquisition, cultivating pro-environmental attitudes is central to the adoption of green laboratory practices.

The authors' abstract, as published at the source. Healthcare, 2026 · DOI ↗