Investigating parental attitudes to randomised controlled trials in primary dental care : The IMPACT Study

Abstract

BACKGROUND: Evidence-based practice is of increasing significance within dentistry, with randomised controlled trials (RCTs) regarded as the gold standard. There is however, uncertainty regarding parental understanding of RCTs, and the emotional effects of their child’s participation. AIMS: To quantify whether their child’s participation in a RCT impacted on parents’ dental anxiety (MDAS), oral health related quality-of-life (OHIP-14) and attitudes (dental health beliefs (DHB) and sense of coherence (SOC-13)) to their own dental care and that of their children, and whether these constructs were associated with socio-demographic characteristics. To investigate parents’ views, knowledge and experience around their child participating in dental research. METHODS: A mixed methods approach was adopted. A longitudinal survey (questionnaires at baseline and 18 months) was conducted of parents whose children were FiCTION RCT participants or had been screened for FiCTION but did not participate. Semi-structured face-to-face qualitative interviews were completed with a subsample of these parents. RESULTS: 261 parents completed a baseline questionnaire; of these, 55 were parents of FiCTION RCT participants. 192 parents also completed a follow-up questionnaire and were included in an analysis of change over time. Quantitative analysis showed no difference at baseline in MDAS, OHIP-14, DHB or SOC-13, between FiCTION participant parents (Mean (SD) score 11.8 (6.3), 6.7 (6.1), 9.2 (1.6), and 63.7 (7.8) respectively) and FiCTION non-participant parents (10.9 (4.8), 6.7 (6.5), 9.4 (1.9), and 62.9 (7.0) respectively). Nor was there a difference between groups for the very limited change in scores over 18 months. Socio-demographic variables were not significant predictors of change over time for any outcomes. The 18 parents who participated in qualitative interviews indicated positive attitudes towards research in primary dental care, but there was no noticeable differences in their definitions of good dental health or perception of the facilitators and barriers thereof. CONCLUSION: There was no difference at baseline or over time between FiCTION participant parents and non-participant parents for dental health outcomes. Parents valued dental research in primary care, but perceived it as complex and challenging. Further research should explore the effect of parental education on the perceived importance of primary dental care research.