Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews
Abstract Background Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach t...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-022-00363-6 |
| _version_ | 1811207764551139328 |
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| author | Cheryl A. Vamos Stacey B. Griner Ellen M. Daley Morgan Richardson Cayama Jason Beckstead Kim Boggess Rocio B. Quinonez Laura Damschroder |
| author_facet | Cheryl A. Vamos Stacey B. Griner Ellen M. Daley Morgan Richardson Cayama Jason Beckstead Kim Boggess Rocio B. Quinonez Laura Damschroder |
| author_sort | Cheryl A. Vamos |
| collection | DOAJ |
| description | Abstract Background Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Implementation Research (CFIR) constructs with the greatest potential to impact prenatal oral health guideline implementation, and to operationalize and pre-test survey items based on the prioritized CFIR constructs. Identifying barriers and facilitators to guideline implementation will inform the development of targeted interventions that address gaps in adherence which can positively impact oral-systemic health. Methods The online survey development process employed three rounds of a modified-Delphi technique with prenatal (i.e., MD/DO, CNM) and oral health (i.e., DMD) Practice Advisory Board Members, cognitive interviews with prenatal and oral health providers, and deliberations among the research team and a Scientific Advisory Board (OBGYN, pediatric dentist, and researchers). High-impact CFIR constructs were identified and translated into survey items that were subsequently piloted and finalized. Results During three modified-Delphi rounds, a total of 39 CFIR constructs were evaluated with final input and deliberations with the Practice Advisory Board, Scientific Advisory Board, and the research team achieving consensus on 19 constructs. The instrument was pre-tested with four prenatal and two oral health providers. Overall, participants reported that the survey items were feasible to respond to, took an appropriate length of time to complete, and were well-organized. Participants identified specific areas of improvement to clarify CFIR items. The final survey instrument included 21 CFIR items across four domains, with five constructs included from the intervention characteristics domain, two from the process domain, two from the outer setting domain, and 12 from the inner setting domain. Conclusions Lessons learned from the survey development process include the importance of soliciting diverse scientific and practice-based input, distinguishing between importance/impact and direction of impact (barrier/facilitator), and the need for additional qualitative methods during interdisciplinary collaborations. Overall, this study illustrated an iterative approach to identifying high-priority CFIR constructs that may influence the implementation of the prenatal oral health guidelines into practice settings. |
| first_indexed | 2024-04-12T04:10:13Z |
| format | Article |
| id | doaj.art-e5a20cc2b27b434d9082dd1f269ca7e1 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-04-12T04:10:13Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-e5a20cc2b27b434d9082dd1f269ca7e12022-12-22T03:48:32ZengBMCImplementation Science Communications2662-22112022-11-01311910.1186/s43058-022-00363-6Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviewsCheryl A. Vamos0Stacey B. Griner1Ellen M. Daley2Morgan Richardson Cayama3Jason Beckstead4Kim Boggess5Rocio B. Quinonez6Laura Damschroder7College of Public Health, University of South FloridaSchool of Public Health, The University of North Texas Health Science Center at Fort WorthCollege of Public Health, University of South FloridaCollege of Public Health, University of South FloridaCollege of Public Health, University of South FloridaDepartment of Obstetrics and Gynecology, School of Medicine, University of North, Carolina at Chapel HillDepartment of Pediatric Dentistry, Schools of Dentistry, Pediatrics and Public Health, University of North Carolina at Chapel HillImplementation PathwaysAbstract Background Pregnancy presents an opportune time for oral health promotion and intervention; however, implementation of the prenatal oral health guidelines remains a challenge among prenatal and oral health providers. The purpose of this study was twofold: To employ a theory-based approach to identify high-priority Consolidated Framework for Implementation Research (CFIR) constructs with the greatest potential to impact prenatal oral health guideline implementation, and to operationalize and pre-test survey items based on the prioritized CFIR constructs. Identifying barriers and facilitators to guideline implementation will inform the development of targeted interventions that address gaps in adherence which can positively impact oral-systemic health. Methods The online survey development process employed three rounds of a modified-Delphi technique with prenatal (i.e., MD/DO, CNM) and oral health (i.e., DMD) Practice Advisory Board Members, cognitive interviews with prenatal and oral health providers, and deliberations among the research team and a Scientific Advisory Board (OBGYN, pediatric dentist, and researchers). High-impact CFIR constructs were identified and translated into survey items that were subsequently piloted and finalized. Results During three modified-Delphi rounds, a total of 39 CFIR constructs were evaluated with final input and deliberations with the Practice Advisory Board, Scientific Advisory Board, and the research team achieving consensus on 19 constructs. The instrument was pre-tested with four prenatal and two oral health providers. Overall, participants reported that the survey items were feasible to respond to, took an appropriate length of time to complete, and were well-organized. Participants identified specific areas of improvement to clarify CFIR items. The final survey instrument included 21 CFIR items across four domains, with five constructs included from the intervention characteristics domain, two from the process domain, two from the outer setting domain, and 12 from the inner setting domain. Conclusions Lessons learned from the survey development process include the importance of soliciting diverse scientific and practice-based input, distinguishing between importance/impact and direction of impact (barrier/facilitator), and the need for additional qualitative methods during interdisciplinary collaborations. Overall, this study illustrated an iterative approach to identifying high-priority CFIR constructs that may influence the implementation of the prenatal oral health guidelines into practice settings.https://doi.org/10.1186/s43058-022-00363-6Consolidated Framework for Implementation ResearchPrenatal oral healthSurvey design |
| spellingShingle | Cheryl A. Vamos Stacey B. Griner Ellen M. Daley Morgan Richardson Cayama Jason Beckstead Kim Boggess Rocio B. Quinonez Laura Damschroder Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews Implementation Science Communications Consolidated Framework for Implementation Research Prenatal oral health Survey design |
| title | Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews |
| title_full | Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews |
| title_fullStr | Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews |
| title_full_unstemmed | Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews |
| title_short | Prenatal oral health guidelines: a theory- and practice-informed approach to survey development using a modified-Delphi technique and cognitive interviews |
| title_sort | prenatal oral health guidelines a theory and practice informed approach to survey development using a modified delphi technique and cognitive interviews |
| topic | Consolidated Framework for Implementation Research Prenatal oral health Survey design |
| url | https://doi.org/10.1186/s43058-022-00363-6 |
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