2.1

Recruitment of participants

A purposive sample of self-identifying dentally anxious adults was recruited from the University of Leeds either via a poster invitation or using snowballing. The Modified Dental Anxiety Scale (MDAS) was used to quantify the anxiety level of the participants and confirm those who might be dentally phobic were willing to participate discussion ( Table 1 ). Data analysis and collection was concurrent and so recruitment ceased after no additional information was generated and data saturation reached . Ethical approval was obtained from the University Dental Research Ethics Committee (DREC:110416/MCW/199).

2.2

Tool development

A topic guide for the focus groups was developed based on a literature review and moderated by a clinical dentist with qualitative research training (MCW). As studies have shown that most dentally anxious people might be more afraid of root canal treatment (RCT) than other dental treatment we opted to include questions relating to RCT specifically. Additional resources such as pictures of RCT in cartoon, X-rays and pictures of real teeth were used in the focus groups as some participants may not have had RCT experience. The topic guide was piloted with six people who included an experienced qualitative researcher (KVC) to ensure the questions were clear and facilitated discussion.

2.3

Data collection

Two complementary qualitative research methods were adopted in this study. Combining focus group and interview data enabled a more diverse range of the participants’ thoughts to be arrived at . Focus groups are suitable to generate opportunities for participant-led content exploring issues related to anxiety and dental treatment these ideas may have not yet been addressed in the literature before . However, anxiety may make participants feel embarrassment or reluctant to engage in focus groups, and individual interviews may be suitable for such sensitive issues . Besides, participants who were hard to recruit in focus groups could be interviewed to include their ideas .

Two focus groups and three interviews were undertaken with fourteen dentally-anxious adults (11 Women and 3 Men aged 18–49 years) each was audio-recorded, anonymised and transcribed verbatim. Two focus groups took two hours each, and interviews were one hour each. The settings for focus groups and interviews were on university premises and non-clinical to minimize any potential for anxiety .

2.4

Data analysis

All focus group and interview transcripts were analysed using thematic analysis . The codes-to-theory model for qualitative inquiries was used to demonstrate the analysis process from codes to themes and presented as figures and mind maps. Analysis was undertaken in Microsoft Word. The coding was done by first author (MCW) and agreed with a second researcher (KVC). The themes were derived from the data and the synthesis of the thematic map was achieved by all four authors to reduce the interpreter bias from the first author (MCW) . Taking into account the possible bias introduced during analysis by the researchers themselves, member-checking was undertaken with one participant from each focus group. This was done with initial themes emerging from the data rather than the actual transcripts to increase the validity of the analyses .

2.1

Recruitment of participants

A purposive sample of self-identifying dentally anxious adults was recruited from the University of Leeds either via a poster invitation or using snowballing. The Modified Dental Anxiety Scale (MDAS) was used to quantify the anxiety level of the participants and confirm those who might be dentally phobic were willing to participate discussion ( Table 1 ). Data analysis and collection was concurrent and so recruitment ceased after no additional information was generated and data saturation reached . Ethical approval was obtained from the University Dental Research Ethics Committee (DREC:110416/MCW/199).

Table 1

Demographic data of all participants.

	Pseudonym	Session	Sex	Age bracket	Health Professional	Regular dental visit	Last visit	RCT hx.	MDAS score	Anxiety level
1	Fiona	FG 1, MC 1	F	18–29	Y	Emergency	1–2 yrs ago	N	21	High
2	Flo	FG 1	F	30–39	Y	Never	Never	N	19	High
3	Fatima	FG 1	F	18–29	N	Occasional	1–2 yrs ago	N	20	High
4	Febe	FG 1	F	18–29	N	Occasional	< 6 mos ago	N	11	Moderate
5	Frederica	FG 1	F	30–39	Y	Emergency	1–2 yrs ago	Y	14	Moderate
6	Fergal	FG 1	M	40–49	N	Regular	< 6 mos ago	Y	15	Moderate
7	Fifi	FG 2, MC 2	F	18–29	N	Regular	< 6 mos ago	N	16	Moderate
8	Frida	FG 2	F	30–39	Y	Occasional	6–12 mos ago	Y	13	Moderate
9	Fanny	FG 2	F	30–39	N	Emergency	6–12 mos ago	N	22	High
10	Farah	FG 2	F	18–29	N	Regular	< 6 mos ago	N	18	Moderate
11	Fabian	FG 2	M	18–29	N	Regular	6–12 mos ago	N	15	Moderate
12	Ian	I 1	M	18–29	N	Emergency	< 6 mos ago	N	17	Moderate
13	Irena	I 2	F	30–39	N	Emergency	< 6 mos ago	N	14	Moderate
14	Iris	I 3	F	30–39	N	Regular	6–12 mos ago	Y	21	High

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