September 2017

Volume 34, Issue 3

Using Normalisation Process Theory to investigate the implementation of school-based oral health promotion

Authors: O.J. Olajide J. Shucksmith A. Maguire F.V. Zohoori
doi: 10.1922/CDH_4040Olajide06

Abstract

Despite the considerable improvement in oral health of children in the UK over the last forty years, a significant burden of dental caries remains prevalent in some groups of children, indicating the need for more effective oral health promotion intervention (OHPI) strategies in this population. Objective: To explore the implementation process of a community-based OHPI, in the North East of England, using Normalisation Process Theory (NPT) to provide insights on how effectiveness could be maximised. Methods: Utilising a generic qualitative research approach, 19 participants were recruited into the study. In-depth interviews were conducted with relevant National Health Service(NHS) staff and primary school teachers while focus group discussions were conducted with reception teachers and teaching assistants. Analyses were conducted using thematic analysis with emergent themes mapped onto NPT constructs. Results: Participants highlighted the benefits of OHPI and the need for evidence in practice. However, implementation of ‘best evidence’ was hampered by lack of adequate synthesis of evidence from available clinical studies on effectiveness of OHPI as these generally have insufficient information on the dynamics of implementation and how effectiveness obtained in clinical studies could be achieved in ‘real life’. This impacted on the decision-making process, levels of commitment, collaboration among OHP teams, resource allocation and evaluation of OHPI. Conclusions: A large gap exists between available research evidence and translation of evidence in OHPI in community settings. Effectiveness of OHPI requires not only an awareness of evidence of clinical effectiveness but also synthesised information about change mechanisms and implementation protocols. Key words: oral health, dental caries, evidence-based dentistry, normalisation process theory, health promotion, health plan implementation

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Other articles in this issue

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BDEF Writers page 130-130 Download
A scoping review of the uses of the care index in children 131-136 Download
Using Normalisation Process Theory to investigate the implementation of school-based oral health promotion 137-142 Download
The oral health condition and treatment needs of nursing home residents in Flanders (Belgium). 143-151 Download
Prevalence, severity and extent of chronic periodontitis among Sri Lankan adults 152-156 Download
The caries experience of 5 year-old children in Scotland in 2013-2014, and in England and Wales in 2014-2015. Reports of cross-sectional dental surveys using BASCD criteria 157-162 Download
Preferences for dental decisional control and associations with quality of life among third molar patients attending public dental services 163-168 Download
Type 2 diabetes as a risk indicator for dental caries in Korean adults: the 2011-2012 Korea national health and nutrition examination survey 169-175 Download
Development and validation of the Child Oral Health Impact Profile – Preschool version 176-182 Download
Association between excessive Internet use and oral health behaviors of Korean adolescents: A 2015 national survey 183-189 Download

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