An implementation strategy for the adoption of an evidence-based pit-and-fissure sealant guideline by salaried dental providers: Using a framework from organizational development

受薪牙科服务提供者采用基于证据的窝沟封闭指南的实施策略：使用组织发展的框架

• 批准号: 10018478
• 负责人: DEBORAH E POLK
• 金额: $ 51.57万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-05 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10018478
• 关键词: 16 year old; Adopted; Adoption; American Dental Association; Basic Science; Child; Clinic; Clinical Practice Guideline; Clinical Research; Data; Dental; Dental General Practice; Dental caries; Dentists; Development; Dyes; Effectiveness; Evidence based practice; Fissural; Focus Groups; Fostering; Fright; Goals; Guidelines; Interview; Knowledge; Link; Mission; Modeling; Mouth Diseases; National Institute of Dental and Craniofacial Research; Oral health; Organizational Change; Patients; Pit and Fissure Sealants; Plant Roots; Population; Preparation; Prevention; Probability; Process; Provider; Public Health; Research; Running; Science; Site; Surface; Surveys; Testing; Tooth structure; Translational Research; Update; Wages; adherence rate; aged; base; clinical practice; deciduous tooth; design; evidence base; evidence based guidelines; experience; implementation science; implementation strategy; improved; meetings; permanent tooth; prevent; programs; theories; treatment research; uptake

Project Summary/Abstract Targeted implementation strategies are needed to fully realize the benefits of evidence-based practice and the appropriate use of dental sealants by dental providers. The long-term goal of our program of research is to foster the effective implementation of evidence-based guidelines in large, multi-site dental practices. The first step and objective of this proposal is to design an implementation strategy for the American Dental Association’s (ADA) pit-and-fissure sealant guideline targeting root causes of low rates of adherence by dental providers. The central hypothesis is that guiding clinics in selecting their own implementation strategy, based on the EPIS implementation framework and Lewin’s theory for organizational change, will increase dental providers’ uptake of this guideline. The rationale for our proposal is that once we identify an effective implementation process for this guideline, we can adapt the process for other evidence-based guidelines in dental practice. By the completion of the study, we expect to have evaluated the feasibility and acceptability of a process for developing site-specific implementation strategies and the effectiveness of an implementation strategy to increase implementation of the ADA’s pit-and-fissure sealant guideline among providers in a large, multi-site dental practice. Determining the effectiveness of the process and strategies is expected to have an important positive impact, because it is likely that the findings will contribute toward better oral health for patients through the development of implementation strategies for other guidelines. The goal of Aim 1 is to identify the forces and group dynamics influencing Permanente Dental Associates (PDA) providers’ current clinical practices relative to the ADA’s pit and fissure guideline. Our approach will be to conduct interviews, run focus groups, and conduct surveys at each level of four levels of influence. The goal of Aim 2 is to assess the feasibility and acceptability of a process for developing an implementation strategy for the ADA’s guideline. Our approach will be to pilot test the process in one PDA clinic. The goal of Aim 3 is to determine the effectiveness of an implementation strategy for the ADA’s guideline. Our approach will be to compare the percentage of 8 experimental PDA clinics meeting their target implementation goal with the percentage of 8 control PDA clinics meeting the lowest of the experimental clinics’ goals. The immediate contribution of this study is expected to be the development of a process that creates an implementation strategy that is effective in increasing the implementation of the ADA’s pit-and-fissure sealant guideline in a large, multi-site dental practice. This contribution will be significant in a broader manner because it is expected to have broad applicability in facilitating the prevention and treatment of a wide range of oral diseases through enhanced implementation of effective practices.

项目概要/摘要 需要有针对性的实施策略，以充分实现循证实践和 牙科服务提供者正确使用牙科密封剂。我们研究计划的长期目标是 促进在大型多地点牙科诊所中有效实施循证指南。第一个 该提案的步骤和目标是为美国牙科设计实施策略 协会 (ADA) 窝沟封闭剂指南针对牙科依从率低的根本原因 提供商。中心假设是指导诊所选择自己的实施策略，基于 关于 EPIS 实施框架和 Lewin 的组织变革理论，将增加牙科 提供商对本指南的接受程度。我们建议的理由是，一旦我们确定了有效的 本指南的实施过程中，我们可以调整该过程以适应其他循证指南 牙科诊所。在研究完成时，我们希望评估其可行性和可接受性 制定针对具体地点的实施策略和实施有效性的流程 旨在加强大型、大型医疗机构中 ADA 窝沟封闭剂指南实施的策略 多地点牙科诊所。确定流程和策略的有效性预计将有 重要的积极影响，因为这些发现可能有助于改善口腔健康 患者通过制定其他指南的实施策略。目标 1 的目标是 确定影响永久牙科协会 (PDA) 提供商当前的力量和群体动态 与 ADA 凹坑和裂隙指南相关的临床实践。我们的方法是进行采访， 组织焦点小组，并在四个影响力级别的每个级别进行调查。目标 2 的目标是评估 制定 ADA 实施策略的流程的可行性和可接受性 指导方针。我们的方法是在一家 PDA 诊所对这一流程进行试点测试。目标 3 的目标是确定 ADA 指南实施策略的有效性。我们的方法是比较 8 个 PDA 实验诊所达到目标实施目标的百分比为 8 控制 PDA 诊所达到实验诊所最低目标。这的直接贡献 研究预计将制定一个流程，制定有效的实施战略 在大型多部位牙科诊所加强 ADA 窝沟封闭指南的实施 实践。这一贡献将以更广泛的方式发挥重要作用，因为预计它会产生广泛的影响 通过增强的作用，促进预防和治疗多种口腔疾病的适用性 实施有效的做法。