Evaluation of Caries Risk Assessment: Analysis of Focus Groups Interview

Background: Caries Risk Assessment (CRA) is one of the tools used at the Indiana University School of Dentistry (IUSD) to evaluate the risk of developing caries and create a caries management plan (CRM). Studies evaluating its use were completed in 2004 and 2009; they suggested that CRA can help to improve patients' caries risk status, help to manage clinical care, and enhance learning opportunities for students. They also showed that there was scope for improvement in the implementation of CRA. The present study focused on those findings and explored how to address them.

Objectives: 1) appraise perceptions and values about the program; 2) identify intervention points to make CRA approaches acceptable for everyone; 3) offer practical strategies to improve adoption of CRA procedures for every patient.

Methods: Focus groups methods were used to allow for understanding of students' and faculties' opinions about utilization of CRA program. The interviews were conducted in separate groups (approximately 10 people in each): students from 2^nd, 3^rd, and 4^th years of dental school and clinical faculty (CRA xclientsx). Open-ended questions were used to promote discussion and reduce inhibition. The interviews had a primary research goal of discovery rather than verification. Interviews were recorded, transcribed verbatim, and then the transcripts were qualitatively analyzed.

Results: Illustrated in Figure 1

Figure 1

Conclusions: Attempts have been made to incorporate the CRA system closer to the restorative care planning and delivery, with partial success. This helps achieve a strategically planned, comprehensive adoption of the CRA program in IUSD. The findings of the focus groups' analyses are summarized as a hierarchy of values, a system of concepts, and discrete points of intervention to increase ownership of the CRA throughout IUSD. Future studies based on hypotheses generated by this research will also provide an opportunity to test the transferability of findings.