A major product of the Summit will be the published Consensus Statement on Behavioral and Social Factors in Oral Health. The Consensus Statement will affirm the significant influence of behavioral and social factors on dental, oral, and craniofacial health. In addition, the Consensus Statement will outline the essential research focus areas and critical next steps that experts agree are most likely to maximize the impact of behavioral and social sciences for the promotion of oral health. The Consensus Statement is intended to stimulate future work that will achieve the Summit's vision of promoting oral health globally by advancing the robust application of behavioral and social sciences.

 

A working draft of the Consensus Statement was produced by the Summit's Steering Committee, comprised of the same people who served as session chairs for the Summit. This preliminary draft will be refined through an iterative process that involves an open comment period during which Summit attendees and other are invited to submit feedback. Following careful review of the comments and additional rounds of editing, the final Consensus Statement will be made available for endorsement by Summit attendees, those providing comments, and other relevant parties. The Consensus Statement will be published along with a list of endorsers.

The draft Consensus Statement appears below. You can also download a copy here. Return to this site regularly for updates on the status of Consensus Statement production. For questions, contact Drs. Daniel W. McNeil (dmcneil@wvu.edu) and Cameron L. Randall (CLR333@uw.edu).

You are invited to comment on the draft Consensus Statement!

DRAFT

Consensus Statement on Behavioral and Social Factors in Oral Health

Preamble

 

Behavioral and social factors are critical determinants of oral health status and outcomes and are central to oral healthcare delivery. Individual, family, group, cultural, regional, and national influences all are important in oral health and should be considered in patient care, research, and educational pursuits. Each of the following four areas are emphasized to promote transdisciplinary research, teaching, and practice.

                                                                                            

Behavioral and social theories, models, conceptual frameworks, and mechanisms related to oral health

 

The relevance of behavioral (e.g., knowledge, attitudes, beliefs) and social (e.g., economic, cultural, political, corporate) factors to oral health is widely accepted, but not well understood across the disciplines in oral health and dentistry. The limited set of theories attempting to explain oral health behaviors focus too heavily on individual, rational explanations of behavior, often without attention to the broader determinants of health. Research on the social determinants of health have broad theoretical frameworks that propose complex causal pathways from social factors to oral health and disease but these pathways are difficult to test, and frequently ignore social and political theories of power and inequalities. In order to advance the understanding of how behavioral and social factors shape oral health, more 'middle range' theories are needed that reach beyond the individual, and specify more detailed causal pathways reflecting the complex nature of the social and behavioral determinants of oral health.

 

Methodological issues in social and behavioral science research and practice in relation to oral health

 

As types and sources of data available in oral health research become broader and more complex, so do the methodological opportunities and challenges faced by oral health researchers. In an attempt to reach beyond our current understanding of the multidimensional and multifactorial relationships that impact oral health, our goals include, but are not limited to, developing a theoretically based core of clinically relevant outcomes; engaging with diverse qualitative and quantitative data types; incorporating value-based and patient-reported outcomes; and utilizing causal analyses and complexity sciences to account for individual, environmental, and structural factors that all interact to produce oral health outcomes. Ultimately, we strive to produce high-quality research that is both theoretically sound and clinically relevant with the goal of improving oral health worldwide.

 

Intervention science: Developing and testing behavioral and social science approaches to promote oral health 

 

Oral health intervention science should focus on building theory-based interventions with testable mechanisms in order to increase effectiveness and sustainability of effect sizes upon dissemination.  These interventions should focus not only on those who are motivated to change, but also on building intrinsic motivation among those who are not motivated to change, ambivalent about change, or are unaware that change is needed.  Intervention development should include transdisciplinary members as well as members from the target population in order to build the most engaging and effective interventions.  

 

Research is particularly needed on testable mechanisms and frameworks for oral health interventions. Oral health interventions should consider the individual within the social and environmental context, in addition to cultural practices in order to enhance sustainability and long-term health behavior change and population engagement. Oral health interventions should focus on interventions that are scalable and integrated into existing delivery channels, while also providing customization and tailoring (precision medicine/diagnostics?). Greater attention is needed on interventions focused on at risk groups, such as racial, ethnic, and income minorities, as well as those with physical and mental disabilities.

 

Dissemination and implementation science for oral and craniofacial health

 

Given the complexity and demands of daily life in dental care settings and beyond, rigorous and systematic research on how to implement evidence-based practices will be essential for accelerating the rate at which new scientific developments reach communities, and in some cases, ensuring that the benefits of science are realized at all. Rigorous dissemination and implementation research in dentistry and oral health will rely on contemporary designs, precisely-specified and high-quality methods, and thoughtful consideration of the limitations and contributions of any single study. Innovative research in this area will be characterized by the inclusion of context as a key variable and explicit consideration of how to match evidence-based practices to patients and their care delivery systems to achieve optimal reach and effectiveness. There are significant opportunities to simultaneously: (1) apply recent advances in dissemination and implementation science to improve dental care delivery, the efficacy of oral health programs/initiatives, and the use of robust behavioral approaches for oral health promotion in both clinical and community settings; and (2) advance dissemination and implementation theory, methods, and practice by carrying out such research in the dental and oral health space.