Using Normalisation Process Theory to investigate the implementation of school-based oral health promotion

Area of Science:

• Public Health
• Pediatric Dentistry
• Health Services Research

Background:

• Despite improvements, dental caries remains a significant issue for specific child populations in the UK.
• Existing oral health promotion interventions (OHPI) require enhanced strategies for greater effectiveness.
• A gap exists in translating clinical evidence of OHPI into community-based practice.

Purpose of the Study:

• To explore the implementation of a community-based OHPI in North East England.
• To utilize Normalisation Process Theory (NPT) to identify factors influencing OHPI effectiveness.
• To provide insights for maximizing the impact of oral health interventions in real-world settings.

Main Methods:

• A qualitative research approach was employed.
• 19 participants, including NHS staff and primary school teachers, were interviewed.
• Focus groups were conducted with reception teachers and teaching assistants, followed by thematic analysis mapped onto NPT constructs.

Main Results:

• Participants recognized the benefits of OHPI but faced challenges in implementing 'best evidence'.
• Lack of synthesized evidence on implementation dynamics hindered the translation of clinical effectiveness to real-life settings.
• This gap impacted decision-making, commitment, collaboration, resource allocation, and evaluation of OHPI.

Conclusions:

• A significant gap persists between research evidence and its application in community-based OHPI.
• Effective OHPI requires synthesized information on change mechanisms and implementation protocols, not solely clinical effectiveness data.
• Addressing these gaps is crucial for improving oral health outcomes in children through community interventions.