title: The facilitating factors and barriers influencing change in dental practice in a sample of English general dental practitioners.
abstract: OBJECTIVE
  The objective of this study was to investigate the barriers and facilitators to change in dental practices among a sample of general dental practitioners (GDPs) from three regions of England.
  
  
  METHODS
  In-depth face-to-face interviews with 60 GDPs were undertaken. The sample was selected from a group of 317 GDPs who had completed a questionnaire in the first phase of this study. The participants were selected to reflect diversity regarding the number and extent of self-reported changes reported in the questionnaire, and personal and practice characteristics. Of the 92 attempted contacts, 60 (65%) of the interviews were successfully completed. The interview schedule formed the basis of the interview. All the interviews and notes were transferred on to NUD*IST QSR version 4, a qualitative analysis package.
  
  
  RESULTS
  No single factor was identified as being more important than another in facilitating change. The main facilitators for change were: financial factors, regular patient attendance, particularly a core patient group, staff loyalty, having regular staff meetings and open communication and having access to peer support. The main barriers to change were the reverse of the facilitators plus not having a financial stakehold in the practice.
  
  
  CONCLUSIONS
  A range of factors were identified as influencing change in general dental practice. These include GDPs' attitudes and experience of change, patient factors, organisational issues, contact with peers and access to appropriate training courses.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. r.watt@ucl.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: Watt
authors.forename: P
authors.initials: P
authors.lastname: McGlone
authors.forename: D
authors.initials: D
authors.lastname: Evans
authors.forename: S
authors.initials: S
authors.lastname: Boulton
authors.forename: J
authors.initials: J
authors.lastname: Jacobs
authors.forename: S
authors.initials: S
authors.lastname: Graham
authors.forename: T
authors.initials: T
authors.lastname: Appleton
authors.forename: S
authors.initials: S
authors.lastname: Perry
authors.forename: A
authors.initials: A
authors.lastname: Sheiham
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004059:Diffusion of Innovation; D004498:Education, Dental, Continuing; D004739:England; D005260:Female; D005792:General Practice, Dental; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010379:Peer Group; D019239:Practice Patterns, Dentists'; D011331:Private Practice; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires