Using Theoretical Domains Framework (TDF) to understand implementation of a pragmatic clinical trial in Public Dental Service in Norway

E A.S Hovden,Rasa Skudutyte-Rysstad

doi:10.1186/s12913-021-06590-2

Abstract

BackgroundMost dental research in Norway has traditionally been conducted by universities, and the involvement of clinicians in research projects has not been a common practice.The aim of the present study was to identify behavioral factors that influence effective implementation of a pragmatic clinical trial in the Public Dental Service (PDS) in Norway and to understand which of these factors result in higher patient recruitment.MethodsDentists, dental hygienists, and dental assistants at nine Public Dental Service clinics in three counties in Norway involved in an ongoing pragmatic clinical trial were asked to complete an electronically distributed questionnaire based on the Theoretical Domains Framework (TDF).ResultsThirty-seven out of 69 dentists and dental hygienists (54 %) and seventeen out of 57 dental assistants (30 %) answered the questionnaire. “Knowledge” was the domain with the highest mean response, suggesting strong confidence in personal knowledge and practical skills among the clinicians. Together with “beliefs about consequences,” “organizational resources,” and “environmental context,” “knowledge” was the one of five domains identified as important behavioral determinants in patient recruitment to clinical trials by dental professionals.ConclusionsThe findings suggest that TDF was useful to understand factors affecting implementation of clinical trials in PDS and that several factors such as clinical relevance of trial to be implemented, organizational resources, and communication with the research team require more attention when planning and implementing clinical trials in PDS.

Highlights

Most dental research in Norway has traditionally been conducted by universities, and the involvement of clinicians in research projects has not been a common practice
Of 37 dentists and dental hygienists who responded to the Theoretical Domains Framework (TDF) questionnaire, 24 (65 %) have recruited patients to the clinical trial
The analysis showed that dentists and dental hygienists previously involved in a research project were 1.75 times more likely to recruit patients into the project than clinicians who were involved in a research project for the first time

Summary

Introduction

Most dental research in Norway has traditionally been conducted by universities, and the involvement of clinicians in research projects has not been a common practice. For just a decade ago most of dental research in Norway has traditionally been conducted by universities and the involvement of clinicians in research projects has not been a common practice [1, 2]. To increase research activities among clinicians and use of clinical data for research, practice-based research networks in dentistry have been established in several countries [5, 6], and an increasing number of studies involving clinicians in primary dental care have been published during the last decade [7, 8]. In order to increase research activity and quality assurre the clinical practice in Public Dental Service (PDS) in Norway, five Oral Health Centers of Expertise (OHCE) were established by the the Norwegian government in 2007 [9]. In 2017 the Norwegian health authorities presented “Research strategy in dentistry” [1], emphasizing again the need for increased research activities in primary dental service and closer collaboration between academic researchers and clinicians [1]

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