Supervised Toothbrushing Programmes: Understanding Barriers and Facilitators to Implementation

Area of Science:

• Implementation Science
• Public Health Interventions
• Child Dental Health

Background:

• Supervised toothbrushing programmes (STPs) are effective for reducing dental caries in children.
• Varied uptake of STPs suggests implementation challenges.
• Understanding stakeholder perspectives is crucial for optimizing STP delivery.

Purpose of the Study:

• To explore barriers and facilitators to supervised toothbrushing programme implementation.
• To utilize an implementation science framework to analyze stakeholder views.
• To identify factors influencing the successful rollout of STPs in England.

Main Methods:

• Qualitative study employing individual interviews and focus groups.
• Purposive sampling of 159 stakeholders across all implementation levels.
• Data collection and analysis guided by the Consolidated Framework for Implementation Research (CFIR).

Main Results:

• Barriers and facilitators identified across 35 CFIR constructs.
• Four key themes emerged: acceptability, external conditions, system engagement, and need for centralized support.
• Stakeholder perspectives revealed critical factors influencing STP implementation.

Conclusions:

• This study provides the first qualitative exploration of STP barriers and facilitators using an implementation science framework.
• Findings inform policymakers on program adaptability, engagement strategies, and the necessity of centralized support.
• Co-design of an implementation toolkit aims to optimize large-scale STP adoption.