Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings

Abstract Background Primary dental care settings are strategically important locations where randomised controlled trials (RCTs) of behaviour change interventions (BCIs) can be tested to tackle oral diseases. Findings have so far produced equivocal results. Improving treatment fidelity is posed as a...

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Main Authors: V. Lowers, R. Kirby, B. Young, R.V. Harris
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Trials
Subjects:
Online Access:https://doi.org/10.1186/s13063-024-08659-9
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author V. Lowers
R. Kirby
B. Young
R.V. Harris
author_facet V. Lowers
R. Kirby
B. Young
R.V. Harris
author_sort V. Lowers
collection DOAJ
description Abstract Background Primary dental care settings are strategically important locations where randomised controlled trials (RCTs) of behaviour change interventions (BCIs) can be tested to tackle oral diseases. Findings have so far produced equivocal results. Improving treatment fidelity is posed as a mechanism to improve scientific rigour, consistency and implementation of BCIs. The National Institutes of Health Behaviour Change Consortium (NIH BCC) developed a tool to assess and evaluate treatment fidelity in health behaviour change interventions, which has yet to be applied to the primary dental care BCI literature. Method We conducted a scoping review of RCTs delivered in primary dental care by dental team members (in real-world settings) between 1980 and 2023. Eligible studies were coded using the NIH BCC checklist to determine the presence of reported fidelity strategies across domains: design, training, delivery, receipt and enactment. Results We included 34 eligible articles, reporting 21 RCTs. Fidelity reporting variations were found both between and within NIH BCC domains: strategy reporting ranged from 9.5 to 85.7% in design, 9.5 to 57.1% in training, 0 to 66.7% in delivery, 14.3 to 36.8% in receipt and 13.3 to 33.3% in enactment. The most reported domain was design (M = 0.45), and the least reported domain was delivery (M = 0.21). Only one study reported over 50% of the recommended strategies in every domain. Conclusions This review revealed inconsistencies in fidelity reporting with no evidence that fidelity guidelines or frameworks were being used within primary dental care trials. This has highlighted issues with interpretability, reliability and reproducibility of research findings. Recommendations are proposed to assist primary dental care trialists with embedding fidelity strategies into future research.
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spelling doaj-art-1be968b08dae4e82ad29abd37156bd132024-12-22T12:46:08ZengBMCTrials1745-62152024-12-0125112510.1186/s13063-024-08659-9Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settingsV. Lowers0R. Kirby1B. Young2R.V. Harris3Department of Public Health, Policy and Systems, Institute of Population Health, University of LiverpoolDepartment of Public Health, Policy and Systems, Institute of Population Health, University of LiverpoolDepartment of Public Health, Policy and Systems, Institute of Population Health, University of LiverpoolDepartment of Public Health, Policy and Systems, Institute of Population Health, University of LiverpoolAbstract Background Primary dental care settings are strategically important locations where randomised controlled trials (RCTs) of behaviour change interventions (BCIs) can be tested to tackle oral diseases. Findings have so far produced equivocal results. Improving treatment fidelity is posed as a mechanism to improve scientific rigour, consistency and implementation of BCIs. The National Institutes of Health Behaviour Change Consortium (NIH BCC) developed a tool to assess and evaluate treatment fidelity in health behaviour change interventions, which has yet to be applied to the primary dental care BCI literature. Method We conducted a scoping review of RCTs delivered in primary dental care by dental team members (in real-world settings) between 1980 and 2023. Eligible studies were coded using the NIH BCC checklist to determine the presence of reported fidelity strategies across domains: design, training, delivery, receipt and enactment. Results We included 34 eligible articles, reporting 21 RCTs. Fidelity reporting variations were found both between and within NIH BCC domains: strategy reporting ranged from 9.5 to 85.7% in design, 9.5 to 57.1% in training, 0 to 66.7% in delivery, 14.3 to 36.8% in receipt and 13.3 to 33.3% in enactment. The most reported domain was design (M = 0.45), and the least reported domain was delivery (M = 0.21). Only one study reported over 50% of the recommended strategies in every domain. Conclusions This review revealed inconsistencies in fidelity reporting with no evidence that fidelity guidelines or frameworks were being used within primary dental care trials. This has highlighted issues with interpretability, reliability and reproducibility of research findings. Recommendations are proposed to assist primary dental care trialists with embedding fidelity strategies into future research.https://doi.org/10.1186/s13063-024-08659-9FidelityBehaviour changePrimary dental careIntervention implementationDental teams
spellingShingle V. Lowers
R. Kirby
B. Young
R.V. Harris
Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
Trials
Fidelity
Behaviour change
Primary dental care
Intervention implementation
Dental teams
title Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
title_full Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
title_fullStr Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
title_full_unstemmed Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
title_short Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
title_sort scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
topic Fidelity
Behaviour change
Primary dental care
Intervention implementation
Dental teams
url https://doi.org/10.1186/s13063-024-08659-9
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