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Use of the consolidated framework for implementation research to assess determinants of silver diamine fluoride implementation in safety net dental clinics.

Abstract：

OBJECTIVES:In the United States, silver diamine fluoride (SDF) is a relatively new, quick, and low-cost method for arresting dental caries. This study's purpose was to identify determinants of the implementation of an SDF protocol for pediatric patients in three safety net clinics to inform future efforts to implement the protocol. METHODS:We familiarized dental personnel with the SDF protocol through on-site education and feedback sessions. Two months after the educational sessions, we conducted focus groups with a total of eight dentists and 21 staff across three North Carolina safety net dental clinics: a private nonprofit healthcare network, a community health center, and a county health department. We used the Consolidated Framework for Implementation Research (CFIR) to understand determinants of implementation of the protocol. RESULTS:Determinants of SDF protocol implementation included SDF protocol characteristics (e.g., source of protocol and its ease of use and adaptability, relative advantage compared to alternatives, low cost), characteristics of the outer setting or the dental clinic's environment (e.g., patient needs), inner setting or dental clinics' characteristics (e.g., culture of safety net clinic, leadership engagement), characteristics of dental personnel (e.g., concerns were alleviated by the training and having the protocol), and process characteristics (e.g., training and technical assistance from a reliable source). Overall, implementation was less successful in clinics with less leadership engagement and turnover of dental personnel who did not receive the training. CONCLUSIONS:The determinants of SDF protocol implementation identified in this study will be useful to guide future efforts to implement the SDF protocol.

journal_name

J Public Health Dent

journal_title

Journal of public health dentistry

authors

Weintraub JA,Birken SA,Burgette JM,Lewis TA,White BA

doi

10.1111/jphd.12324

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

298-306

issue

eissn

0022-4006

issn

1752-7325

journal_volume

pub_type

杂志文章

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Use of the consolidated framework for implementation research to assess determinants of silver diamine fluoride implementation in safety net dental clinics.