Original article
Characterizing the orthodontic patient's purchase decision: A novel approach using netnography

https://doi.org/10.1016/j.ajodo.2016.10.036Get rights and content

Highlights

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    Netnography provides unobtrusive and rich data for qualitative analysis.

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    New factors were identified to more thoroughly characterize patient decision making.

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    A conceptual framework was created to describe the decision-making process.

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    Internal and societal influences impact perceptions of benefits and barriers.

Introduction

A deeper and more thorough characterization of why patients do or do not seek orthodontic treatment is needed for effective shared decision making about receiving treatment. Previous orthodontic qualitative research has identified important dimensions that influence treatment decisions, but our understanding of patients’ decisions and how they interpret benefits and barriers of treatment are lacking. The objectives of this study were to expand our current list of decision-making dimensions and to create a conceptual framework to describe the decision-making process.

Methods

Discussion boards, rich in orthodontic decision-making data, were identified and analyzed with qualitative methods. An iterative process of data collection, dimension identification, and dimension refinement were performed to saturation. A conceptual framework was created to describe the decision-making process.

Results

Fifty-four dimensions captured the ideas discussed in regard to a patient's decision to receive orthodontic treatment. Ten domains were identified: function, esthetics, psychosocial benefits, diagnosis, finances, inconveniences, risks of treatment, individual aspects, societal attitudes, and child-specific influences, each containing specific descriptive and conceptual dimensions. A person's desires, self-perceptions, and viewpoints, the public's views on esthetics and orthodontics, and parenting philosophies impacted perceptions of benefits and barriers associated with orthodontic treatment.

Conclusions

We identified an expanded list of dimensions, created a conceptual framework describing the orthodontic patient's decision-making process, and identified dimensions associated with yes and no decisions, giving doctors a better understanding of patient attitudes and expectations.

Section snippets

Material and methods

This study received an institutional review board exemption (number14-1254) from the University of North Carolina Office of Human Research Ethics.

Forums that were rich in decision-making concepts about orthodontics were found on the Web using Google search from November 15, 2014, to July 31, 2015. The following terms and phrases were searched by the primary researcher (J.W.P.): “I think I need braces,” “braces forum,” “not sure about orthodontics forum,” “are braces worth it,” “can't decide if

Results

Data were collected from 15 Web sites. Table I lists the Web sites and the number of comments coded from each Web site. The aggregate data provided new information from the patient's perspective. Fifty-four dimensions were created and organized to reflect all aspects of orthodontic decision making discussed (Table II). Some dimensions have already been identified in the orthodontic literature, and others provide new insights. Table II includes descriptions of each dimension, structured into 10

Discussion

As expected, netnography techniques confirmed previously identified decision-making dimensions and discovered new dimensions not previously identified in qualitative orthodontic research studies. Collecting data unobtrusively on the Internet until saturation was reached provided a wide range of ideas organically shared by people considering orthodontics. The data were purposely not limited to a certain age range or location to capture as many ideas as possible.

The grounded-theory qualitative

Conclusions

The data collected demonstrate the following about orthodontic decision making.

  • 1.

    Ten domains capture the decision-making dimensions: individual aspects, societal attitudes, child-specific influences, diagnosis, function, esthetics, psychosocial benefits, finances, inconveniences, and risks of treatment. Fifty-four specific dimensions were sorted into these domains.

  • 2.

    A patient's desires, self-perceptions, and viewpoints, the public's views on esthetics and orthodontics, and parenting philosophies

References (18)

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All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.

Supported by the University of North Carolina School of Dentistry Masters in Science Research Support Grant.

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