Psychology of behaviour change is key to effective oral health promotion

Data sourcesAMED, CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PsycARTICLES, ScienceDirect, SocINDEX, ASSIA, Social Policy and Practice, HMIC (Health Management Information Consortium), The Knowledge Network, Intute, MedNar, Copac, EPPI-Centre, EThOS, OpenGrey and TRIP databases. Searches were limited to publications in the English language published after 1994.Study selectionStudies set in general practice that investigated promoting good oral health in adult or child patients were considered. Study quality was assessed using NICE public health guidance checklists.Data extraction and synthesisStudies were grouped according to the evidence they offered in relation to the research questions and key findings and themes identified. No meta-analysis was conducted. Qualitative studies underwent thematic analysis. The evidence was synthesised after considering the studies' homogeneity, quality and applicability and studying the evidence tables.ResultsForty-four studies reported in 52 papers were considered. Fifteen studies were randomised controlled trials (RCTs), two cluster RCTs and one controlled trial. Five quasi-experimental studies, two before and after studies without controls, three surveys, 11 qualitative studies, three mixed methods studies, one audit and one pilot study were included.The studies were very heterogeneous; the quality of reporting highly variable with many using patient reported behaviours rather than objective measures. Follow-up periods were also short. Narrative summaries of psychological and behavioural models, verbal advice, written advice, other methods of conveying advice, message content, sender characteristics, receiver factors, 'framing' of advice, barriers and facilitators and patient satisfaction were provided.ConclusionsThe results of this review suggest that the psychology of behaviour change is the key to oral health promotion, and greater emphasis on teaching oral health professionals about health psychology would make oral health promotion in the dental surgery more effective.