# An implementation strategy for the adoption of an evidence-based pit-and-fissure sealant guideline by salaried dental providers: Using a framework from organizational development

> **NIH NIH U01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $515,746

## Abstract

Project Summary/Abstract
Targeted implementation strategies are needed to fully realize the benefits of evidence-based practice and the
appropriate use of dental sealants by dental providers. The long-term goal of our program of research is to
foster the effective implementation of evidence-based guidelines in large, multi-site dental practices. The first
step and objective of this proposal is to design an implementation strategy for the American Dental
Association’s (ADA) pit-and-fissure sealant guideline targeting root causes of low rates of adherence by dental
providers. The central hypothesis is that guiding clinics in selecting their own implementation strategy, based
on the EPIS implementation framework and Lewin’s theory for organizational change, will increase dental
providers’ uptake of this guideline. The rationale for our proposal is that once we identify an effective
implementation process for this guideline, we can adapt the process for other evidence-based guidelines in
dental practice. By the completion of the study, we expect to have evaluated the feasibility and acceptability of
a process for developing site-specific implementation strategies and the effectiveness of an implementation
strategy to increase implementation of the ADA’s pit-and-fissure sealant guideline among providers in a large,
multi-site dental practice. Determining the effectiveness of the process and strategies is expected to have an
important positive impact, because it is likely that the findings will contribute toward better oral health for
patients through the development of implementation strategies for other guidelines. The goal of Aim 1 is to
identify the forces and group dynamics influencing Permanente Dental Associates (PDA) providers’ current
clinical practices relative to the ADA’s pit and fissure guideline. Our approach will be to conduct interviews,
run focus groups, and conduct surveys at each level of four levels of influence. The goal of Aim 2 is to assess
the feasibility and acceptability of a process for developing an implementation strategy for the ADA’s
guideline. Our approach will be to pilot test the process in one PDA clinic. The goal of Aim 3 is to determine
the effectiveness of an implementation strategy for the ADA’s guideline. Our approach will be to compare the
percentage of 8 experimental PDA clinics meeting their target implementation goal with the percentage of 8
control PDA clinics meeting the lowest of the experimental clinics’ goals. The immediate contribution of this
study is expected to be the development of a process that creates an implementation strategy that is effective in
increasing the implementation of the ADA’s pit-and-fissure sealant guideline in a large, multi-site dental
practice. This contribution will be significant in a broader manner because it is expected to have broad
applicability in facilitating the prevention and treatment of a wide range of oral diseases through enhanced
implementation of effective pract...

## Key facts

- **NIH application ID:** 10018478
- **Project number:** 5U01DE027452-04
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** DEBORAH E POLK
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $515,746
- **Award type:** 5
- **Project period:** 2017-09-05 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10018478

## Citation

> US National Institutes of Health, RePORTER application 10018478, An implementation strategy for the adoption of an evidence-based pit-and-fissure sealant guideline by salaried dental providers: Using a framework from organizational development (5U01DE027452-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10018478. Licensed CC0.

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