Methodology for the development of a national dental PBRN survey on dentist’s beliefs and behaviors concerning antibiotic prophylaxis

Background Dentists are high prescribers of antibiotics for both treatment and prevention of infection, although there are few guidelines to aid clinicians. Given the worldwide concern about unnecessary use of antibiotics, there is a need for a better understanding of dentists’ use of these drugs for antibiotic prophylaxis (AP) to prevent distant site infections, i.e., infective endocarditis and prosthetic joint infection. Objective Our objective was to develop and implement an effective, self-report, crosssectional, survey instrument that optimized the response rate and maximized reliability and validity, for determining the beliefs and behaviors of a large and nationally representative group of generalist and specialist dentists concerning their use of AP. Methods A 15-question survey (58 items) was developed in a structured process by a multidisciplinary team and configured for automated online dissemination to 3,584 National Dental Practice-Based Research Network (network) practitioners. The implementation phase consisted of three waves of more than 1000 network members. Additionally, 47 randomly selected dentists were surveyed twice to assess test-retest reliability. Results Of 3,584 eligible network members, 2,169 (60.5%) completed the survey. The age and geographic distributions of responders was similar to that of dentists in the 2019 American Dental Association census. Furthermore, test-retest weighted kappa values for the survey were acceptable (median 0.56, interquartile range: 0.42-0.64). Conclusion We have developed a highly structured survey with a high response rate and good reliability that will allow us to obtain unique data on dentists AP prescribing beliefs and practices.