Perceptions of community healthcare workers on the use of teledentistry for seniors in Singapore: A qualitative study

Objective: This study aimed to identify barriers and facilitators surrounding the implementation of TDOCS from Community Health Workers (CHW)'s perspective before TDOCS implementation.

Methods: A descriptive qualitative study was conducted through semistructured interviews with a purposive sampling of CHWs from partner nursing homes and home care teams. A French framework outlining barriers to asynchronous oral teleconsultation adoption was used to develop the topic guide for this study. Then, the Consolidated Framework for Implementation research (CFIR 1.0) was used to guide coding and analysis.

Results: A total of 43 CHWs from participating institutions were interviewed prior to receiving teledentistry training. Perceived barriers included low awareness about the importance of dental care, limiting conditions to T-DOCS participation among beneficiaries, limited understanding of T-DOCS, perceived low self-efficacy among CHWs, manpower shortages, perceived low priority of dental care, competition with other nursing duties and restricted access due to COVID-19. Facilitators included existing relationships between CHWs and beneficiaries, receptivity towards participation, CHWs' motivation to upskill and improve dental care for seniors, prior experience with other telemedicine technology, perceived need for change, supportive management, colleagues and existing impediments to access dental care.

Conclusion: This study identified barriers and facilitators to implementing T-DOCS from the CHWs' perspectives. We recommend for targeted CHW training, programme champions, workflow integration and incentivisation schemes. Addressing challenges like manpower strain and resource limitations through efficient scheduling and capacity building is vital for sustainability. Policy-level support, including legal frameworks, funding and regulatory structures, is essential for integrating teledentistry into mainstream healthcare.