背景:关于数字技术在改善获取,确保医疗保健的连续性和质量,加强卫生系统。一些研究报告了远程医学的成本效益,其远程牙科筛查的可靠性,诊断,协商,和治疗计划。尽管如此,目前的证据表明,远程医疗的实施面临许多挑战,并且尚未被牙科保健提供者(DHCP)采用.制定改善远程技术采用的战略需要了解促进或阻碍其成功实施的因素。
目的:本系统综述旨在确定和综合DHCP在其临床实践中认为的实施远程医学的障碍和促进因素,使用理论域框架(TDF)和容量,机会,和动机行为(COM-B)模型。
方法:本方案遵循PRISMA-P(方案的系统评价和Meta分析扩展的首选报告项目)清单。文献将在以下数据库中搜索:PubMed,科克伦图书馆,WebofScience,CINAHL,Embase,和PsycINFO。我们将在Google上执行其他搜索,谷歌学者,和ProQuest学位论文和论文全球,筛选纳入研究的参考文献,以获取其他相关研究,如果我们需要更多细节,请联系研究作者。我们将考虑使用定性的研究,定量,混合方法。对出版日期和牙科设置没有限制。我们将包括用法语发表的研究,英语,和葡萄牙语。两名独立审核员将选择这项研究,提取数据,并使用混合方法评估工具的检查表评估方法质量。数据分析将包括描述性和主题内容分析。我们将使用TDF和COM-B模型对障碍和推动者进行综合和分类,并使用表格对我们的结果进行叙述性综合,数字,和报价。
结果:到2023年3月,文献检索已检索到7355篇出版物。我们将通过DHCP的观点确定实施远程医学的障碍和促成因素的范围。考虑到迫切需要基于理论的实施干预措施,以改善循证实践的使用,我们将根据COM-B模型,基于TDF域和预测行为变化的3个基本条件,综合影响远程医学采用的因素。根据需要,如果不包括在TDF中,我们将包括其他决定因素。如果研究足够,我们将进行一些亚组分析。我们预计到2024年7月完成审查。
结论:这篇综述将提供一些关于牙科环境中DHCP感知的远程医疗实施的决定因素的见解。这些发现将迎合患者,家庭,DHCP,研究人员,学术和专业决策者,和政策制定者。系统评价的结果可用于开发以理论为主导的干预措施,以改善远程医疗的实施。
背景:PROSPEROCRD42021293376;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=293376。
■PRR1-10.2196/44218。
BACKGROUND: There is growing literature on the potential of digital technologies for improving access to, ensuring continuity and quality of health care, and to strengthen health systems. Some studies have reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Nonetheless, current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies to improve teledentistry adoption requires an understanding of the factors that promote or hinder its successful implementation.
OBJECTIVE: This systematic
review aims to identify and synthetize barriers and enablers to implementing teledentistry as perceived by DHCPs in their clinical practices, using the Theoretical Domains Framework (TDF) and the Capacity, Opportunity, and Motivation Behavior (COM-B) model.
METHODS: This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Protocols) checklist. Literature will be searched in the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase, and PsycINFO. We will perform additional searches on Google, Google Scholar, and ProQuest Dissertations & Theses Global, screen the references of the included studies to capture additional relevant studies, and contact the 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, English, and Portuguese. Two independent reviewers will select the study, extract data, and assess methodological quality using the Mixed Methods Appraisal Tool\'s checklist. Data analysis will include a descriptive and a thematic content analysis. We will synthetize and categorize the barriers and enablers using the TDF and COM-B model and present a narrative synthesis of our results using tables, figures, and quotes.
RESULTS: By March 2023, 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 the adoption of teledentistry based on the TDF domains and the 3 essential conditions predicting behavior change in accordance with the COM-B model. As needed, we will include additional determinants if not included in the TDF. We will conduct some subgroups analyses if studies are sufficient. We expect to complete the
review by July 2024.
CONCLUSIONS: This
review will provide some insights on the determinants of teledentistry implementation as perceived by DHCPs in dental settings. These findings will cater to patients, families, DHCPs, researchers, academic and professional decision-makers, and policy makers. The results of the systematic
review could be used to develop theory-led interventions in improving teledentistry implementation.
BACKGROUND: PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=293376.
UNASSIGNED: PRR1-10.2196/44218.