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Patient-, organization-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care

Overview of attention for article published in Implementation Science, January 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (81st percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

14 tweeters


28 Dimensions

Readers on

159 Mendeley
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Patient-, organization-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care
Published in
Implementation Science, January 2016
DOI 10.1186/s13012-015-0366-2
Pubmed ID

Anna R Templeton, Linda Young, Alison Bish, Wendy Gnich, Heather Cassie, Shaun Treweek, Debbie Bonetti, Douglas Stirling, Lorna Macpherson, Sharon McCann, Jan Clarkson, Craig Ramsay, $author.firstName $author.lastName, Templeton, Anna Rose, Young, Linda, Bish, Alison, Gnich, Wendy, Cassie, Heather, Treweek, Shaun, Bonetti, Debbie, Stirling, Douglas, Macpherson, Lorna, McCann, Sharon, Clarkson, Jan, Ramsay, Craig, , , Anna Rose Templeton


Dental caries is the most common chronic disease of adult and childhood, a largely preventable yet widespread, costly public health problem. This study identified patient-, organization-, and system-level factors influencing routine delivery of recommended care for prevention and management of caries in primary dental care. A convergent mixed-methods design assessed six guidance-recommended behaviours to prevent and manage caries (recording risk, risk-based recall intervals, applying fluoride varnish, placing preventive fissure sealants, demonstrating oral health maintenance, taking dental x-rays). A diagnostic questionnaire assessing current practice, beliefs, and practice characteristics was sent to a random sample of 651 dentists in National Health Service (NHS) Scotland. Eight in-depth case studies comprising observation of routine dental visits and dental team member interviews were conducted. Patient feedback was collected from adult patients with recent checkups at case study practices. Key informant interviews were conducted with decision makers in policy, funding, education, and regulation. The Theoretical Domains Framework within the Behaviour Change Wheel was used to identify and describe patient-, organization-, and system-level barriers and facilitators to care. Findings were merged into a matrix describing theoretical domains salient to each behaviour. The matrix and Behaviour Change Wheel were used to prioritize behaviours for change and plan relevant intervention strategies. Theoretical domains associated with best practice were identified from the questionnaire (N-196), case studies (N = 8 practices, 29 interviews), and patient feedback (N = 19). Using the study matrix, key stakeholders identified priority behaviours (use of preventive fissure sealants among 6-12-year-olds) and strategies (audit and feedback, patient informational campaign) to improve guidance implementation. Proposed strategies were assessed as appropriate for immediate implementation and suitable for development with remaining behaviours. Specific, theoretically based, testable interventions to improve caries prevention and management were coproduced by patient-, practice-, and policy-level stakeholders. Findings emphasize duality of behavioural determinants as barriers and facilitators, patient influence on preventive care delivery, and benefits of integrating multi-level interests when planning interventions in a dynamic, resource-constrained environment. Interventions identified in this study are actively being used to support ongoing implementation initiatives including guidance, professional development, and oral health promotion.

Twitter Demographics

The data shown below were collected from the profiles of 14 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 159 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 1%
Unknown 157 99%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 33 21%
Student > Master 27 17%
Student > Bachelor 18 11%
Student > Doctoral Student 14 9%
Researcher 10 6%
Other 23 14%
Unknown 34 21%
Readers by discipline Count As %
Medicine and Dentistry 51 32%
Nursing and Health Professions 25 16%
Psychology 11 7%
Social Sciences 10 6%
Agricultural and Biological Sciences 4 3%
Other 22 14%
Unknown 36 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 January 2016.
All research outputs
of 10,202,788 outputs
Outputs from Implementation Science
of 1,187 outputs
Outputs of similar age
of 331,211 outputs
Outputs of similar age from Implementation Science
of 33 outputs
Altmetric has tracked 10,202,788 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,187 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.8. This one has gotten more attention than average, scoring higher than 58% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 331,211 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 81% of its contemporaries.
We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.