Barriers and enablers to implementing teledentistry with dental healthcare professionals: Protocol for a systematic quantitative, qualitative, and mixed studies review (Preprint)

Abstract

There is a growing literature on the potential of digital technologies for improving access, continuity, quality of healthcare and to strengthen health systems. Some authors reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Despite these benefits, the current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies aiming to improve teledentistry adoption require an understanding of the factors, which promote or hinder its successful implementation. Therefore, we will perform a systematic review on the barriers and enablers to implementing teledentistry.

The review purpose aims to synthesize evidence on DHCPs’ perceptions on barriers and enablers to use teledentistry using the Theoretical Domain Framework.

This protocol has been written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A search strategy will be performed through the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase and PsycINFO. We will perform additional searches in Google, Google Scholar, and in Dissertations & Theses Global (ProQuest). We will check references of included studies to capture additional relevant studies. Moreover, we will contact authors of studies if we need more details. We will consider studies using qualitative, quantitative, and mixed methods. There will be no restrictions on the publication date and dental setting. We will include studies published in French and English. Two independent reviewers will carry out the study selection, data extraction, and the assessment of the methodological quality using the checklist of mixed methods appraisal tool (MMAT). We will conduct a descriptive and thematic content analysis. We will synthesize and categorize the barriers and enablers using the theoretical domains framework (TDF). We will present a narrative synthesis of results using tables, figures, and quotes.

By October 2022, the literature search has retrieved 7355 publications. We will identify the range of barriers and enablers to implementing teledentistry through DHCPs’ perspectives. Considering the critical need for theory-based implementation interventions to improve the use of evidence-informed practices, we will synthesize the factors influencing adoption of teledentistry according to the domains of the Theoretical Domains Framework (TDF) and the three essential conditions predicting the behavior change according to Behavior change wheel (BCW) model. We will identify behaviour change techniques (BCTs) related to these determinants. As needed, we will add additional determinants if not included in the TDF. We expect to complete the review by July 2023.

Teledentistry is slow to be adopted by DHCPs. This review will be of interest to patients, families, DHCPs, researchers, academic and professional decision-makers and policy makers. The results of the systematic review could be used to improve the teledentistry implementation in dental settings.

PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/#searchadvanced