Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial

Harris, Rebecca; Lowers, Victoria; Hulme, Claire; Burnside, Girvan; Best, Ashley; Clarkson, Jan E; Cooke, Richard; Zande, Marieke Van Der; Maitland, R.

doi:10.1186/s13063-022-06418-2

Cited by 3 publications

(4 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…So, while this feasibility study suggested that progression of the RETURN intervention to a main trial was advisable, the use of an internal pilot to assess recruitment rates in a non-pandemic context reduces risk. The main trial protocol for the intervention is now published [ 9 ] and has progressed with the inclusion of an internal pilot milestone relating to recruitment rate [ 12 ]. Exclusion criteria to the main trial includes exclusion of people who had previously participated in the feasibility study reported here.…”

Section: Discussionmentioning

confidence: 99%

“…The RETURN intervention is described in detail elsewhere [ 6 , 9 ]. Participants were shown a pack of resources which included 6 booklets outlining different barriers or reasons people often gave for not taking up planned dental care (‘I don’t have time’; ‘I don’t think to go when I’m not in pain; ‘I don’t have trust in dentists’; cost; embarrassment; anxiety).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial

Harris,

Lowers,

Best

et al. 2024

BMC Oral Health

Self Cite

View full text Add to dashboard Cite

Background Urgent dental care may be the only place where many people, especially vulnerable groups, access care. This presents an opportunity for delivery of a behavioural intervention promoting planned dental visiting, which may help address one of the factors contributing to a socio-economic gradient in oral health. Although we know that cueing events such as having a cancer diagnosis may create a ‘teachable moment’ stimulating positive changes in health behaviour, we do not know whether delivering an opportunistic intervention in urgent dental care is feasible and acceptable to patients. Methods The feasibility study aimed to recruit 60 patients in a Dental Hospital and dental practices delivering urgent care within and outside working hours. Follow-up was by telephone, e mail and post over 4 months. Results Although the recruitment window was shortened because of COVID-19, of 47 patients assessed for eligibility, 28 were enrolled (70.1% of screened patients provided consent). A relatively high proportion were from disadvantaged backgrounds (46.4%, 13/28 receiving State benefits). Retention was 82.1% (23/28), which was also the rate of completion of the Oral Health Impact Profile co-primary outcome. The other primary outcome involved linking participant details at recruitment, with centrally-held data on services provided, with 84.6% (22/26) records partly or fully successfully matched. All intervention participants received at least some of the intervention, although we identified aspects of dental nurse training which would improve intervention fidelity. Conclusions Despite recruitment being impacted by the pandemic, when the majority of clinical trials experienced reduced rates of recruitment, we found a high recruitment and consenting rate, even though patients were approached opportunistically to be enrolled in the trial and potentially receive an intervention. Retention rates were also high even though a relatively high proportion had a low socio-economic background. Therefore, even though patients may be in pain, and had not anticipated involvement before their urgent care visit, the study indicated that this was a feasible and acceptable setting in which to position an opportunistic intervention. This has the potential to harness the potential of the ‘teachable moment’ in people’s lives, and provide support to help address health inequalities. Trial registration ISRCTN 10,853,330 07/10/2019.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial

Harris,

Lowers,

Best

et al. 2024

BMC Oral Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…The RETURN intervention is described in detail elsewhere [9]. Participants were shown a pack of resources which included 6 booklets outlining different barriers or reasons people often gave for not taking up planned dental care ('I don't have time'; 'I don't think to go when I'm not in pain; 'I don't have trust in dentists'; cost; embarrassment; anxiety).…”

Section: Interventionmentioning

confidence: 99%

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial

Harris

Lowers

Best

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Urgent dental care may be the only place where many people, especially vulnerable groups, access care. This presents an opportunity for delivery of a behavioural intervention promoting planned dental visiting, which may help address one of the factors contributing to a socio-economic gradient in oral health. Although we know that cueing events such as having a cancer diagnosis may create a ‘teachable moment’ stimulating positive changes in health behaviour, we do not know whether delivering an opportunistic intervention in urgent dental care is feasible and acceptable to patients. Methods The feasibility study aimed to recruit 60 patients in a Dental Hospital and dental practices delivering urgent care within and outside working hours. Follow-up was by telephone, e mail and post over 4 months. Results Although the recruitment window was shortened because of COVID-19, of 47 patients assessed for eligibility, 28 were enrolled (70.1% of screened patients provided consent). A relatively high proportion were from disadvantaged backgrounds (46.4%, 13/28 receiving State benefits). Retention was 82.1% (23/28), which was also the rate of completion of the Oral Health Impact Profile co-primary outcome. The other primary outcome involved linking participant details at recruitment, with centrally-held data on services provided, with 84.6% (22/26) records partly or fully successfully matched. All intervention participants received at least some of the intervention, although we identified aspects of dental nurse training which would improve intervention fidelity. Conclusions Despite recruitment being impacted by the pandemic, when the majority of clinical trials experienced reduced rates of recruitment, we found a high recruitment and consenting rate, even though patients were approached opportunistically to be enrolled in the trial and potentially receive an intervention. Retention rates were also high even though a relatively high proportion had a low socio-economic background. Therefore, even though patients may be in pain, and have not anticipated involvement before their urgent care visit, the study indicated that this was a feasible and acceptable setting in which to position an opportunistic intervention. This has the potential to harness the potential of the ‘teachable moment’ in people’s lives, and provide support to help address health inequalities. Trial registration: ISRCTN 10853330 07/10/2019

show abstract

“…[5] As a result, patients experience disparities in their oral health measured by clinical outcomes, and often this results from infrequent and inaccessible dental care use. [6,7] Dentists create preventive re-care plans with appointments for regular evaluation based on patient risk factors. The evaluation interval can range from 3 months for high-risk patients, to 1 year in healthy individuals.…”

mentioning

confidence: 99%

Associations between utilization of dental care and oral health outcomes in the U.S. using the National Health and Nutrition Examination Survey (2017-2020)

Archer

Kennedy

et al. 2023

Preprint

View full text Add to dashboard Cite

Background This analysis aims to evaluate the association between the time since and reason for a patient's last dental appointment across clinical oral health outcomes. Methods We used data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES), a cross-sectional nationally-representative of US noninstitutionalized adults. The predictors were the time since last dental appointment and the reason for the last dental appointment (routine vs. urgent). We examined the presence and number of missing teeth and teeth with untreated coronal and root caries. Multivariable regression models were used to assess the interaction between time since last dental appointment and reason of the appointment on clinical oral health outcomes. Results Two-thirds of the US population had a dental appointment within a year, while 53 million individuals did not visit a dentist for the last three years. The odds of having teeth with untreated coronal or root caries increased with the length of time since the last routine appointment. Compared to those who had a dental appointment within a year, individuals who had their last dental appointment more than 3 years ago had 0.44 times the odds of having missing teeth among routine users (95%CI = 0.33, 0.59) and 0.67 times the odds among urgent users (95%CI = 0.45, 0.98). Conclusions Recent routine dental appointments are associated with improved oral health outcomes. Disparities exist in access to care for low-income and/or members of racial/ethnic minorities. The outcomes reiterate how social determinants of health impact access to oral health care and subsequent oral health outcomes.

show abstract

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial

Cited by 3 publications

References 44 publications

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial

Associations between utilization of dental care and oral health outcomes in the U.S. using the National Health and Nutrition Examination Survey (2017-2020)

Contact Info

Product

Resources

About