March 2013

Objectives: This study used Q-sort methodology to determine the views of staff involved in a national school-based daily toothbrushing programme. Methods: Q-methodology is a mixed-method approach in which participants are asked to sort a collection of statements according to degree of agreement with them. Factor analysis identified subgroups of like-minded participants and revealed areas of consensus and disagreement. 24 Community Dental Service staff managing or delivering the toothbrushing programme were asked to rank 49 statements derived from previous qualitative interviews. Results: Varimax rotation produced a three-factor solution with five/six participants loading significantly into each group. Groups divided largely according to staff role: Factor 1, mainly Support Workers (assistants with no oral-health background); Factor 2, managers; and Factor 3, Oral Health Educators (dental nurses with teaching qualifications). As staff new to the area of oral-health, the views of Support Workers were of particular interest. Unlike others, this group saw Designed to Smile as a unique health promotion scheme and wanted to involve as many children as possible, regardless of oral-disease risk. Managers’ perceptions of issues affecting the establishment of the programme differed from those staff in day-to-day contact with the 515 schools in which the toothbrushing took place. Conclusions: This study used a long established but little used technique to ascertain the commonality of views of staff. These data may be of value not only in managing the current programme, but for anyone who may be considering developing such a toothbrushing scheme. Key words: oral health; health promotion; toothbrushing; school dentistry; q-sort; workforce