title: The information filter: how dentists use diet diary information to give patients clear and simple advice.
abstract: Diet diaries are recommended for dentists to monitor children's sugar consumption. Diaries provide multifaceted dietary information, but patients respond better to simpler advice. We explore how dentists integrate information from diet diaries to deliver useable advice to patients.
  
  
  
  As part of a questionnaire study of general dental practitioners (GDPs) in Northwest England, we asked dentists to specify the advice they would give a hypothetical patient based upon a diet diary case vignette. A sequential mixed method approach was used for data analysis: an initial inductive content analysis (ICA) to develop coding system to capture the complexity of dietary assessment and delivered advice. Using these codes, a quantitative analysis was conducted to examine correspondences between identified dietary problems and advice given. From these correspondences, we inferred how dentists reduced problems to give simple advice.
  
  
  
  A total of 229 dentists' responses were analysed. ICA on 40 questionnaires identified two distinctive approaches of developing diet advice: a summative (summary of issues into an all-encompassing message) and a selective approach (selection of a main message approach). In the quantitative analysis of all responses, raw frequencies indicated that dentists saw more problems than they advised on and provided highly specific advice on a restricted number of problems (e.g. not eating sugars before bedtime 50.7% or harmful items 42.4%, rather than simply reducing the amount of sugar 9.2%). Binary logistic regression models indicate that dentists provided specific advice that was tailored to the key problems that they identified.
  
  
  
  Dentists provided specific recommendations to address what they felt were key problems, whilst not intervening to address other problems that they may have felt less pressing.
authors.affiliation: Department of Health Services Research/School of Dentistry, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK. Arheiam@liverpool.ac.uk.
authors.forename: Arheiam
authors.initials: A
authors.lastname: Arheiam
authors.affiliation: Department of Psychological Sciences/School of Dentistry, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Brown
authors.affiliation: Department of Health Services Research/School of Dentistry, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Higham
authors.affiliation: Department of Health Services Research/School of Dentistry, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Sondos
authors.initials: S
authors.lastname: Albadri
authors.affiliation: Department of Health Services Research/School of Dentistry, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Rebecca V
authors.initials: RV
authors.lastname: Harris
mesh_terms: D002648:Child; D003376:Counseling / Q000379:methods; D003731:Dental Caries / Q000517:prevention & control; D004032:Diet / Q000706:statistics & numerical data; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D010290:Parents / Q000193:education; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D004040:Dietary Carbohydrates
keywords: advice; dentists; diet; diet diaries; prevention