Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research
  • Published:

A feasibility and acceptability study of an e-training intervention to facilitate health behaviour change conversations in dental care settings

British Dental Journal (2021)Cite this article

Abstract

Introduction Health behaviours result in oral health problems. Behaviour change techniques, informed by behaviour science, are rarely utilised by dental care professionals (DCPs) within routine care.

Aim To develop a theory-informed intervention to support DCPs' behaviour change conversations and evaluate its feasibility and acceptability.

Intervention A behaviour change toolkit (Toothpicks) comprising 33 behaviour change techniques relevant to dentistry, delivered within an interactive online course.

Design Development and mixed-methods evaluation of the intervention.

Materials and methods Participants' motivation to discuss behaviour change with patients was measured before and after training using a validated questionnaire. Acceptability was assessed through semi-structured interviews.

Results DCPs' (N = 32) motivation increased significantly post-training. Participants found the training acceptable and reported subsequently implementing techniques into their practice. Potential barriers preventing implementation to clinical practice include perceived lack of opportunities to effect change within the constraints of the clinical context.

Conclusions Acceptable theory-informed training that is acceptable and accessible can be developed that increases DCPs' motivation to discuss behaviour change with patients. Further research is necessary to establish the longer-term impact of brief behaviour change training on DCPs' clinical practice and patient health behaviours.

Key points

  • Behaviour change techniques, derived from behaviour science theory, can help individuals improve smoking, alcohol use, diet and exercise habits.

  • Dentists report finding it challenging to initiate and support patients to make health behaviour changes.

  • Dental care practitioners' motivation to engage in behaviour change conversations increased following online training in behaviour change techniques. They found the training acceptable and reported examples of using it within their clinical practice.

  • Theory-informed behaviour change training is feasible and acceptable but changes are needed to the clinical environment to ensure practitioners prioritise preventative conversations.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. World Health Organisation. Global Action Plan for The Prevention and Control of Non-Communicable Diseases 2013-2020. 2014. Available at https://apps.who.int/iris/bitstream/handle/10665/94384/9789241506236_eng.pdf (accessed July 2020).

  2. Marshall J R, Graham S, Haughey B P et al. Smoking, alcohol, dentition and diet in the epidemiology of oral cancer. Eur J Cancer B Oral Oncol 1992; 28: 9-15.

  3. Sheiham A, James W P T. A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake. BMC Public Health 2014; 14: 863.

  4. Newton J T, Asimakopoulou K. Minimally invasive dentistry: Enhancing oral health related behaviour through behaviour change techniques. Br Dent J 2017; 223: 147-150.

  5. Watt RG, D'Cruz L, Rai A, Jones E. Reflections on a training course reorienting dental teams towards prevention. Br Dent J 2015; 218: 25-28.

  6. Michie S, van Stralen M M, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011; 6: 42.

  7. Templeton A R, Young L, Bish A et al. Patient-, organisation-, and system-level barriers and facilitators to preventive oral health care: A convergent mixed-methods study in primary dental care. Implement Sci 2016; 11: 5.

  8. Michie S, Whittington C, Hamoudi Z, Zarnani F, Tober G, West R. Identification of behaviour change techniques to reduce excessive alcohol consumption. Addiction 2012; 107: 1431-1440.

  9. Michie S, Hyder N, Walia A, West R. Development of a taxonomy of behaviour change techniques used in individual behavioural support for smoking cessation. Addict Behav 2012; 36: 315-319.

  10. Michie S, Ashford S, Sniehotta F F, Dombrowski S U, Bishop A, French D P. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health 2011; 26: 1479-1498.

  11. Dixon D, Johnston M. Health Behaviour Change Competency Framework: Competencies to deliver interventions to change lifestyle behaviours that affect health. 2010. Available online at http://www.healthscotland.com/documents/4877.aspx (accessed July 2020).

  12. Newton J T, Asimakopoulou K. Managing oral hygiene is a risk factor for periodontal disease: a systematic review of psychological approaches to behaviour change for improved plaque controlling periodontal management. J Clin Periodontol 2015; 42 Suppl 16: S36-S46.

  13. Renz A, Ide M, Newton T, Robinson P G, Smith D. Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases. Cochrane Database Syst Rev 2007; DOI: 10.1002/14651858.CD005097.pub2.

  14. Al Rawahi S H, Asimakopoulou K, Newton J T. Theory based interventions for caries related sugar intake in adults: systematic review. BMC Psychol 2017; 5: 25.

  15. Public Health England. All Our Health. 2019. Available online at https://www.gov.uk/government/publications/all-our-health-about-the-framework/all-our-health-about-the-framework (accessed July 2020).

  16. Varley E, Murfin M. An implementation guide and toolkit for making every contact count: Using every opportunity to achieve health and wellbeing. 2014. Available at https://www.england.nhs.uk/wp-content/uploads/2014/06/mecc-guid-booklet.pdf (accessed July 2020).

  17. Dyer T A, Robinson P G. General health promotion in general dental practice-the involvement of the dental team Part 2: A qualitative and quantitative investigation of the views of practice principals in South Yorkshire. Br Dent J 2006; 201: 45.

  18. Peters S, Joseph S, Goldthorpe J et al. Initiating and holding useful conversations about lifestyle behaviours in dental settings. Porto, Portugal: European Association of Communication in Healthcare, 2018.

  19. Witton R V, Moles D R. Barriers and facilitators that influence the delivery of prevention guidance in health service dental practice: a questionnaire study of practising dentists in Southwest England. Community Dent Health 2013; 30: 71-76.

  20. Lawson P J, Flocke S A, Teachable moments for health behaviour change: a concept analysis. Patient Educ Couns 2009; 76: 25-30.

  21. Chan E A, Jones A, Fung S, Wu S C. Nurses' perception of time availability in patient communication in Hong Kong. J Clin Nurs 2012; 21: 1168-1177.

  22. Curry-Chiu M E, Catley D, Voelker M A, Bray K K. Dental hygienists' experiences with motivational interviewing: A qualitative study. J Dent Educ 2015; 79: 897-906.

  23. Chisholm A, Hart J, Mann K, Peters S. Development of a behaviour change communication tool for medical students: The 'Tent Pegs' booklet. Patient Educ Couns 2014; 94: 50-60.

  24. Hart J, Furber C, Chisholm A et al. A mixed methods investigation of an online intervention to facilitate student midwifes' engagement in effective conversations about weight-related behaviour change with pregnant women. Midwifery 2018; 63: 52-59.

  25. Chisholm A, Byrne-Davies L, Peters S, Benstock J, Suzanne G, Hart J. Online behaviour change technique training to support health professionals 'Make Every Contact Count'. BMC Health Serv Res 2020; 20: 390.

  26. Eysenbach G. What is e-health? J Med Internet Res 2001; DOI: 10.2196/jmir.3.2.e20.

  27. Farquhar M C, Ewing G, Booth S. Using mixed methods to develop and evaluate complex interventions in palliative care research. Palliat Med 2011; 25: 748-757.

  28. Ajzen I. The theory of planned behaviour. Organis Behav Human Decision Proc 1991; 50: 179-211.

  29. Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals' intentions and behaviours: A systematic review of studies based on social cognitive theories. Implement Sci 2008; 3: 36.

  30. Fylan F. Semi structured interviewing. In Miles J, Gilbert P (eds) A Handbook of Research Methods for Clinical and Health Psychology. pp 65-78. New York: Oxford University Press, 2005.

  31. Peters S. Qualitative research methods in mental health. Evid Based Ment Health 2010; 3: 35-40.

  32. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77-101.

  33. Steele J, Rooney E, Clarke J, Wilson T. NHS dental services in England: an independent review led by Professor Jimmy Steele. 2009. Available at http://www.sigwales.org/wp-content/uploads/dh_101180.pdf (accessed February 2021).

  34. Sheeran P, Webb T L. The intention-behaviour gap. Soc Personal Psychol Compass 2016; 10: 503-518.

  35. Chisholm A, Ang-Chen P, Peters S, Hart J, Beenstock J. Public health practitioners' views of the 'making every contact count' initiative and standards for its evaluation. J Public Health (Oxf) 2018; DOI: 10.1093/pubmed/fdy094.

  36. Lin J H, Huang Y K, Lin K D, Hsu Y J, Huang W F, Huang H L. Randomized controlled trial on effects of a brief clinical-based intervention involving planning strategy on self-care behaviours in periodontal patients in dental practice. Int J Environ Res Public Health 2019; 16: 3838.

  37. Neville P, Zahra J, Pilch K, Jayawardena D, Waylen A. The behavioural and social sciences as hidden curriculum in UK dental education: a qualitative study. Eur J Dent Educ 2019; 23: 461-470.

Download references

Acknowledgements

We are grateful to the dental practices and staff who generously agreed to participate in the development and evaluation of the intervention in this study. We would also like to thank staff from the University of Manchester who contributed to the development of the intervention, and for their invaluable suggestions and feedback throughout this project. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK

    Sophia Joseph, Joanna Goldthorpe & Sarah Peters

  2. School of Medical Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK

    Jo Hart & Sarah Robinson

  3. Department of Psychological Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 7ZX, UK

    Anna Chisholm

Authors
  1. Sophia Joseph
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jo Hart
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Chisholm
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarah Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joanna Goldthorpe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sarah Peters
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah Peters.

Ethics declarations

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Joseph, S., Hart, J., Chisholm, A. et al. A feasibility and acceptability study of an e-training intervention to facilitate health behaviour change conversations in dental care settings. Br Dent J (2021). https://doi.org/10.1038/s41415-021-2722-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41415-021-2722-8

This article is cited by

Search

Advanced search

Quick links