Using psychogical theory to design a health promotion intervention delivered by primary care dentists

Background: Little is known about how best to impart oral hygiene advice in primary care. The main objective of this study was to use psychologcal theory to design a health promotion intervention that could be delivered by primary care dentists.Methods: Design – A cluster RCT. Measures were assessed by questionnaire and by clinical examination at baseline and at eight weeks (+-2 weeks). Participants 50 general dental practitioners across Scotland/489 patients attending for a check-up. Outcome measures –Cognitive: Self-efficacy; Behavioural: Toothbrushing; Clinical: Plaque. Procedure – Dentists in the intervention group delivered oral hygiene advice framed using Social Cognitive Theory (Bandura) and action planning (Gollwitzer). Participants in the control group receivedroutine care.Findings: The intervention group had significantly higher self-efficacy (CI=0.01 to 1.8), better timing and method of toothbrushing (CI=1.9 to 4.8; CI¼3.6 to 7.8) and a better clinical outcome (plaque CI=25.7 to 7.7).Discussion: A simple, theory-based intervention delivered within the constraints of a primary care environment was more effective than routine care in influencing oral hygiene cognitions, behaviour and health