Research

7 • Understanding Behaviour and Behaviour Change

Background

Understanding behaviour and behaviour change is a critical part of effecting improvements in both the provision of dental services and the approach people adopt towards their oral health and general wellbeing. This multidisciplinary research involves academics, clinicians, students, government and community-based groups and individuals, and takes place in primary and secondary care, as well as in undergraduate and postgraduate training forums.

Progress

The results of the Scottish Dental Clinical Effectiveness Programme (SDCEP) survey into the prevention and management of caries in children suggest that there is great variation in what dentists in Scotland are doing and what they believe they should do, particularly in regard to the SDCEP guidance recommended behaviour of applying fluoride to the teeth of all children. The results of the survey suggest that an intervention will be required to enable the implementation of this evidence based behaviour and this work is at present being linked in with Childsmile, a national initiative.

Research is currently being carried out to identify the barriers and facilitators of the Oral Health Assessment, which involves a consistent and comprehensive method of developing a personal care plan for every patient by recording their social, dental and medical history, oral health status, as well as identifying any factors that might increase the likelihood of developing oral health problems and then assigning an overall risk level to determine a recall interval in line with the NICE guidelines.

An intervention is being developed based on the results of a survey identifying the barriers and facilitators of appropriate dental prescribing of antibiotics. This will take the form of a randomised controlled trial that will take place throughout Scotland.

Understanding Effective Communication in Primary Care Dentistry: the dentally anxious patient, an example of special care dentistry. This study is in the final stages of completion and the results are due early in 2011. This CSO funded project involved an intensive year long field work element, pioneering the use of video recording and analysis of the primary care patient-dentist interaction.

Rural Economy and Land Use Project (RELU): Consumer attitudes and behaviour towards local foods and healthy eating. Collaboration is underway with the University of Reading into improving diet and health behaviours. Results from this work suggest that theoryled, tailored interventions can improve behaviour change outcomes in relation to eating a healthier diet.

Communication, cues and framing MIXed methods research programme to promote motivation and compliance for fluoride toothpaste use (ComMIX) is a joint research programme between the University of Dundee and St Andrews concerned with the development of specific tools to enable detailed and scientific analysis of the observed behaviour of participants in routine dental treatment sessions. The interim report of the feasibility study was presented to the grant funder GlaxoSmithKline in August 2010.

Images below

A figure from the results of a survey of dentists in Scotland on a recommended behaviour from SDCEP guidance on the prevention and management of caries in children and a flowchart showing an overview of the Oral Health Assessment methodology.

Impact Statement

This programme of research will improve patient care by informing service and education policy makers on the design of effective interventions.