Exploring Barriers to Oral-health Prevention to Develop a European Questionnaire

Objectives: To inform development of a web-based questionnaire on stakeholder’s perceptions of the barriers to oral health prevention across 7 EU countries through qualitative interviews.
Methods: This research is part of a multi-centre project: “Added Value for Oral Care” (ADVOCATE) and the qualitative findings from England are described here. One hour, audio-recorded, one-to-one semi-structured interviews were conducted with dental stakeholders and the general public (February-September 2016) and were analysed using thematic analysis.
Results: Twenty-seven participants took part in the research: policy makers (n=11), insurers (n=6), dental team members (n=7) and the general public (n=3). A key barrier to undertaking prevention was identified by both policy makers and insurers as ‘prevention not being a priority’. The dental team highlighted ‘reimbursement and time management’ as the key barrier, whereas policy makers did not view reimbursement as a potential barrier to prevention being undertaken. For the general public, the key barrier was an 'unawareness of what aspects of preventive advice they were entitled to within the dental consultation'. This was the opposite perspective from insurers, policy makers and the dental team; they perceived that the general public often lacked the motivation to be involved in their own oral healthcare (not an unawareness of the prevention option available to them).
Conclusions: This research has identified barriers to oral health prevention from the perspective of dental stakeholders and the general public. This methodological approach has highlighted that each stakeholder group perceives different barriers to providing and receiving oral health prevention. These findings feed into the development of a robust stakeholder-specific tool (web-based questionnaire) which has been derived directly from the stakeholders. The next phase of this research is the implementation of the web-based questionnaire to further unpick each stakeholder group’s perspective across a representative sample within the 7 EU countries in the ADVOCATE project.