IADR Abstract Archives
Optimisation of a Complex Intervention Reducing Inequalities in Dental Visiting
Objectives: Complex interventions may fail to show an intervention effect due to genuine ineffectiveness, sub-optimal intervention design or implementation failure - or a combination of these. Guidance therefore recommends pre-trial work is undertaken to optimise the intervention and its delivery.
Objective: To refine aspects of an opportunistic intervention delivered to adults attending for urgent dental care which aims to reduce inequalities in planned dental visiting, in order to optimise its intervention design and address potential implementation issues.
Methods: Intervention material was discussed in 7 focus groups with mixed policy makers, dental nurses, dentists and community members (n=43). Embedded in a feasibility study, 58 hours of observation of intervention delivery was undertaken together with interviews with 2 dental nurses (DN) delivering the intervention, and 8 patients receiving the intervention. Stakeholder feedback/observations were captured by fieldnotes, with interviews audio-taped and analysed thematically.
Results: i) Patients strongly related to the brief videos shown, finding them not just engaging, but resonating with their self-identity: “It was like looking in a mirror”. The final intervention design would therefore start with these videos. ii) Patients liked accompanying booklet information in very small chunks, but DNs found it hard to manage the separate resources as well as trial documentation, so the final intervention design had fewer separate materials. iii) The supportive conversation with the nurse was important to patients, although observations showed further training was needed to refocus DN attention away from resources and onto eliciting concerns and listening to patients. iv) Training needed to include building DN confidence and practical sessions with role-play. v) passwords to the online material needed streamlining. vi) Final version booklets and videos needed to include more ethnically diverse characters vii) A booklet for the dentist was scaled back.
Conclusions: Optimisation included emphasising impactful parts of the intervention and amending weaker ones.
Objective: To refine aspects of an opportunistic intervention delivered to adults attending for urgent dental care which aims to reduce inequalities in planned dental visiting, in order to optimise its intervention design and address potential implementation issues.
Methods: Intervention material was discussed in 7 focus groups with mixed policy makers, dental nurses, dentists and community members (n=43). Embedded in a feasibility study, 58 hours of observation of intervention delivery was undertaken together with interviews with 2 dental nurses (DN) delivering the intervention, and 8 patients receiving the intervention. Stakeholder feedback/observations were captured by fieldnotes, with interviews audio-taped and analysed thematically.
Results: i) Patients strongly related to the brief videos shown, finding them not just engaging, but resonating with their self-identity: “It was like looking in a mirror”. The final intervention design would therefore start with these videos. ii) Patients liked accompanying booklet information in very small chunks, but DNs found it hard to manage the separate resources as well as trial documentation, so the final intervention design had fewer separate materials. iii) The supportive conversation with the nurse was important to patients, although observations showed further training was needed to refocus DN attention away from resources and onto eliciting concerns and listening to patients. iv) Training needed to include building DN confidence and practical sessions with role-play. v) passwords to the online material needed streamlining. vi) Final version booklets and videos needed to include more ethnically diverse characters vii) A booklet for the dentist was scaled back.
Conclusions: Optimisation included emphasising impactful parts of the intervention and amending weaker ones.