A framework for implementing sustainable oral health promotion interventions

Simpson, D. Dwayne

doi:10.1111/j.1752-7325.2011.00234.x

Cited by 34 publications

(46 citation statements)

References 45 publications

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“…45-51 Importantly, this work can serve as the foundation for developing and testing strategies to facilitate the systematic implementation of published evidence into clinical dental practice in order to improve the profession and public oral health. 52-55 …”

Section: Discussionmentioning

confidence: 99%

Concordance between clinical practice and published evidence

Norton¹,

Funkhouser²,

Makhija³

et al. 2014

The Journal of the American Dental Association

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Background. Documenting the gap between what is occurring in clinical practice and what published research suggests is an important step toward improving care. This study quantified concordance between clinical practice and published evidence across preventive, diagnostic and treatment procedures among a sample of dentists in the National Dental Practice-Based Research Network. Methods. Network dentists completed one questionnaire about their demographic characteristics and another about how they treat patients across 12 scenarios/clinical practice behaviors. Responses to each clinical practice were coded as consistent (i.e., ‘1’) or inconsistent (i.e., ‘0’) with published evidence, summed, and divided by the number of all non-missing to create an overall ‘concordance’ score, calculated as the mean percent of responses that were consistent with published evidence. Results. Analyses were limited to participants in the United States (N = 591). Mean concordance at the practitioner level was 62% (SD = 18); procedure-specific concordance ranged from 8-100%. Affiliation with a large group practice, being a female practitioner, and receiving a dental degree before 1990 were independently associated with high concordance (≥75%). Conclusions. Dentists reported a medium-range concordance between practice and evidence. Clinical Implications. Efforts to bring research findings into routine practice are needed.

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Section: Discussionmentioning

confidence: 99%

Concordance between clinical practice and published evidence

Norton¹,

Funkhouser²,

Makhija³

et al. 2014

The Journal of the American Dental Association

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“…A related challenge is that there is little guidance on how to assess the sustainability of KT interventions. There are frameworks for implementing sustainability interventions and for measuring sustainability [ 22 , 27 , 42 , 43 ], but a recent scoping review by Tricco et al to determine the uptake of such frameworks found no studies that used a framework to consider sustainability of a KT intervention in the context of chronic disease management [ 29 ]. Furthermore, very little attention has been paid to studying the sustainability and scale-up and spread of specific health care innovations [ 44 ] even though these are the investigations that are needed to inform practice and policy decision making.…”

Section: Discussionmentioning

confidence: 99%

Sustainability and scalability of a volunteer-based primary care intervention (Health TAPESTRY): a mixed-methods analysis

Kastner

Sayal

Oliver

et al. 2017

BMC Health Serv Res

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BackgroundChronic diseases are a significant public health concern, particularly in older adults. To address the delivery of health care services to optimally meet the needs of older adults with multiple chronic diseases, Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) uses a novel approach that involves patient home visits by trained volunteers to collect and transmit relevant health information using e-health technology to inform appropriate care from an inter-professional healthcare team. Health TAPESTRY was implemented, pilot tested, and evaluated in a randomized controlled trial (analysis underway). Knowledge translation (KT) interventions such as Health TAPESTRY should involve an investigation of their sustainability and scalability determinants to inform further implementation. However, this is seldom considered in research or considered early enough, so the objectives of this study were to assess the sustainability and scalability potential of Health TAPESTRY from the perspective of the team who developed and pilot-tested it.MethodsOur objectives were addressed using a sequential mixed-methods approach involving the administration of a validated, sustainability survey developed by the National Health Service (NHS) to all members of the Health TAPESTRY team who were actively involved in the development, implementation and pilot evaluation of the intervention (Phase 1: n = 38). Mean sustainability scores were calculated to identify the best potential for improvement across sustainability factors. Phase 2 was a qualitative study of interviews with purposively selected Health TAPESTRY team members to gain a more in-depth understanding of the factors that influence the sustainability and scalability Health TAPESTRY. Two independent reviewers coded transcribed interviews and completed a multi-step thematic analysis. Outcomes were participant perceptions of the determinants influencing the sustainability and scalability of Health TAPESTRY.ResultsTwenty Health TAPESTRY team members (53% response rate) completed the NHS sustainability survey. The overall mean sustainability score was 64.6 (range 22.8–96.8). Important opportunities for improving sustainability were better staff involvement and training, clinical leadership engagement, and infrastructure for sustainability. Interviews with 25 participants (response rate 60%) showed that factors influencing the sustainability and scalability of Health TAPESTRY emerged across two dimensions: I) Health TAPESTRY operations (development and implementation activities undertaken by the central team); and II) the Health TAPESTRY intervention (factors specific to the intervention and its elements). Resource capacity appears to be an important factor to consider for Health TAPESTRY operations as it was identified across both sustainability and scalability factors; and perceived lack of interprofessional team and volunteer resource capacity and the need for stakeholder buy-in are important considerations for the Health TAPESTRY intervention. We used...

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“…This has been shown to be true in other studies where the lack of insurance coverage contributed to underuse of proven services, such as secondary prevention programs in cardiac rehabilitation ( 26 ). Other researchers studying implementation and sustainability have noted that fiscal support is a critical external factor in some or all stages of adoption, implementation, and sustainability ( 6 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

Factors Supporting Implementation among CDSMP Organizations

Paone¹

2015

Front. Public Health

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Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP – citing the alignment between the program and their organizations’ mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption – particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program.

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A framework for implementing sustainable oral health promotion interventions

Cited by 34 publications

References 45 publications

Concordance between clinical practice and published evidence

Concordance between clinical practice and published evidence

Sustainability and scalability of a volunteer-based primary care intervention (Health TAPESTRY): a mixed-methods analysis

Factors Supporting Implementation among CDSMP Organizations

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