RESUMO
BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .
Assuntos
Prática Clínica Baseada em Evidências , Odontopediatria , Criança , Humanos , Projetos de Pesquisa , Assistência Odontológica , BrasilRESUMO
Since Oral Health policies in Brazil have been constructed according to circumstances and possibilities, they should be understood within a given context. The present analysis contextualizes several issues of the Brazilian Oral Health Policy, called "Smiling Brazil", and describes its present stage of development. Today it involves re-organizing basic oral health care by deploying Oral Health Teams within the Family Health strategy, setting up Centers of Dental Specialists within an Oral Health network as a secondary care measure, setting up Regional Laboratories of Dental Prosthesis and a more extensive fluoridation of the public water supply.
Assuntos
Serviços de Saúde Bucal/organização & administração , Saúde da Família , Política de Saúde , Promoção da Saúde/organização & administração , Saúde Bucal , Brasil , Centros Comunitários de Saúde/organização & administração , Centros Comunitários de Saúde/estatística & dados numéricos , Índice CPO , Atenção à Saúde/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Fatores Epidemiológicos , Fluoretação , Política de Saúde/história , Promoção da Saúde/história , Promoção da Saúde/legislação & jurisprudência , História do Século XX , História do Século XXI , Humanos , Programas Nacionais de Saúde/história , Administração em Saúde Pública , Odontologia em Saúde Pública , Recursos Humanos , Organização Mundial da SaúdeRESUMO
BACKGROUND: In South American older adults the association between tooth loss and demographic, predisposing and enabling factors has not been determined. The purpose of this study was to evaluate the association between partial and complete tooth loss and demographic, predisposing, enabling and need factors, and quality of life variables in the Brazilian older adults. METHODS: In this cross-sectional study, 5349 subjects aged 65-74 years were evaluated using conglomerate random sampling. Data collection included dental examinations and questionnaires evaluating demographic, predisposing, enabling and need factors, and quality of life variables. Multinomial logistic regression was carried out to evaluate correlates of tooth loss. The number of teeth was set as the outcome and categorized as: edentulous, subjects with 1-19 teeth, and subjects with 20 or more teeth. RESULTS: Predisposing factors including age, female gender and schooling were independently associated with edentulism. Female gender was associated with partial tooth loss. The only enabling factor associated with edentulism was car ownership. Need factors were associated with edentulism and partial tooth loss. Edentulous subjects perceived the need for dental treatment less frequently. Quality of life factors were associated with partial tooth loss and edentulism. Subjects with 1-19 teeth and edentulous subjects were more likely to rate their chewing ability as not good. Edentulous subjects were more likely to rate their speech ability and their dental appearance as good. CONCLUSIONS: The results indicate that tooth loss and edentulism were complex phenomena, with intricate predisposing, demographic, enabling and need factors playing a role.