Dentists’ commitment-to-change following a professional development training on dental amalgam phase down: Barriers to implementation of restorative practice changes

Abstract

Objective: To evaluate dentists’ commitment to change towards dental amalgam phase down following implementation of an online  continuous professional development training.

Design: Descriptive cross-sectional survey.

Setting: The 47 counties of Kenya.

Participants: Dentists registered to practice in Kenya

Interventions: Implementation of an online training programme on dental amalgam phase down.

Main outcome measures: Descriptive summaries of self-reported commitment to change statements, level of implementation of the  committed changes and challenges experienced in implementation.

Results: Out of the 216 participants 147 (68.1%) indicated commitment to change (CTC) certain aspects of their practice, and all  responses (100%) were aligned to dental amalgam phase down (DAPD). Overall, the total number of commitment statements were 434,  mean 2.95 and range 1-6. The most committed intended change was “Use alternative restorative materials most of the time”. About a  third 46 (31.3%) reported the status of implementation of the committed practice changes at three months. A total of 130 (30.0%)  commitment reflections were submitted, the most frequent was “partially implemented” 66 (50.8%), whereas the least was “fully implemented” 31 (23.8%). Among those who committed to change, a majority 92 (62.6%) indicated challenges in implementation. Of  these, 38 (41.3%) were hindered by inadequate funding, while a minority 4 (4.3%) faced lack of knowledge.

Conclusion: Majority of the  participants committed to change aspects of their operative practice and all responses were aligned to DAPD. At three months, the most  commitment reflection was partial implementation, while inadequate funding posed the greatest challenge to intended changes.