The Best of Times at the Worst of Times: How Adults Respond to a Brief Intervention (RETURN) to Increase Planned Dental Visiting

Harris, RV ORCID: 0000-0002-5891-6826, van der Zande, M ORCID: 0000-0002-6117-6531, Hennessy, J, Maitland, R, Exley, C and Lowers, V (2026) The Best of Times at the Worst of Times: How Adults Respond to a Brief Intervention (RETURN) to Increase Planned Dental Visiting COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY. ISSN 0301-5661, 1600-0528

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Abstract

Although acute health crises can disrupt routines and open a window for behaviour change, these teachable moments are rarely harnessed by intervention designs. The RETURN intervention (comprising a dental nurse-led conversation, short peer videos and booklets supporting knowledge, skills and action-planning) aimed to change planned dental visiting behaviour among adults previously reliant on urgent care. The RETURN trial recruited 1179 predominantly socio-economically disadvantaged urgent dental care users. Objectives: This qualitative study explored how RETURN impacted meaning, motivations, and practices related to routine dental visiting. Methods: In-depth interviews were conducted with 55 participants (39 intervention) at 6, 12 and 18-months post-intervention and analysed using reflexive thematic analysis. Results: Urgent dental problems provide a liminal (transitional) space where routines and dental visiting identities are destabilised. RETURN enabled a reflective pause where participants could distance themselves from previous patterns of behaviour, re-evaluate their oral health trajectory and priorities, reduce shame and self-blame, and rework aspects of their self-identity. Intervention components operated synergistically while enabling individually patterned engagement. Four themes generated were: 1. pausing and labelling the problem; 2. reducing ambivalence and energising motivation; 3. normalising struggle, cultivating hope and grit; 4. developing knowledge and skills to enact change. Booklets functioned as a material artefact extending engagement for over 12 months beyond the brief intervention delivery. For some, capabilities developed transferred to other domains of life. Conclusions: Findings position urgent care as an under-utilised site for identity work and sustained behaviour change, with the potential to support disadvantaged groups in service use, thus narrowing health inequalities. Trial Registration: The RETURN trial was registered at isrctn.com (ISRCTN84666712).

Item Type:	Article
Uncontrolled Keywords:	behaviour change, dental care utilisation, health inequalities, intervention, qualitative, teachable moment, urgent care
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health Faculty of Health & Life Sciences > Inst. Population Health > Public Health, Policy & Systems Faculty of Health & Life Sciences > Inst. Population Health > Inst. Population Health (T&R Staff)
Depositing User:	Symplectic Admin
Date Deposited:	14 Jul 2026 15:52
Last Modified:	23 Jul 2026 04:56
DOI:	10.1111/cdoe.70095
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3199412
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