title: Motivation and compliance with intraoral elastics.
abstract: BACKGROUND
  Intraoral elastics are commonly used in orthodontics and require regular changing to be effective. Unfortunately, poor compliance with elastics is often encountered, especially in adolescents. Intention for an action and its implementation can be improved using "if-then" plans that spell out when, where, and how a set goal, such as elastic wear, can be put into action. Our aim was to determine the effect of if-then plans on compliance with elastics.
  
  
  METHODS
  To identify common barriers to compliance with recommendations concerning elastic wear, semistructured interviews were carried out with 14 adolescent orthodontic patients wearing intraoral elastics full time. Emerging themes were used to develop if-then plans to improve compliance with elastic wear. A prospective pilot study assessed the effectiveness of if-then planning aimed at overcoming the identified barriers on compliance with elastic wear. Twelve participants were randomized equally into study and control groups; the study group received information about if-then planning. The participants were asked to collect used elastics, and counts of these were used to assess compliance.
  
  
  RESULTS
  A wide range of motivational and volitional factors were described by the interviewed participants, including the perceived benefits of elastics, cues to remember, pain, eating, social situations, sports, loss of elastics, and breakages. Compliance with elastic wear was highly variable among patients. The study group returned more used elastics, suggesting increased compliance, but the difference was not significant.
  
  
  CONCLUSIONS
  The use of if-then plans might improve compliance with elastic wear when compared with routine clinical instructions.
authors: Specialty registrar, Orthodontic Department, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire; postgraduate student, University College London Eastman Dental Institute, London, United Kingdom. Electronic address: helenveeroo@hotmail.co.uk.
authors: Helen J
authors: HJ
authors: Veeroo
authors: Professor and program director, Department of Orthodontics, University College London Eastman Dental Institute, London, United Kingdom.
authors: Susan J
authors: SJ
authors: Cunningham
authors: Professor, Unit of Social and Behavioural Sciences, Kings College London Dental Institute, London, United Kingdom.
authors: Jonathon Timothy
authors: JT
authors: Newton
authors: Consultant in orthodontics, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, United Kingdom.
authors: Helen C
authors: HC
authors: Travess
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003463:Cues; D004435:Eating / Q000502:physiology; D004868:Equipment Failure; D005260:Female; D006040:Goals; D006801:Humans; D033182:Intention; D007398:Interpersonal Relations; D008297:Male; D009042:Motivation; D009967:Orthodontic Appliances; D010146:Pain / Q000523:psychology; D010349:Patient Compliance; D010865:Pilot Projects; D011446:Prospective Studies; D036301:Qualitative Research; D013177:Sports; D014836:Volition