This project aims to investigate whether simple behavioural interventions, such as pictorial framing and traffic-light-color-coding, can positively influence pediatric dentists' decision-making in adopting rectangular collimation over round collimation for dental radiographs taken in clinical practice.

1. Introduction Dental radiographs are essential in diagnosing oral conditions in pediatric patients. Despite the availability of rectangular collimation as a recommended radiation safety measure, many pediatric dentists continue to use round collimation, which results in unnecessary radiation exposure. This study explores whether nudging strategies-such as pictorial framing and traffic-light color coding-can influence pediatric dentists' decision-making to encourage the adoption of rectangular collimation.

2. Research Objectives

   This study aims to:

   Educate pediatric dentists on the benefits of rectangular collimation over round collimation.

   Assess current collimation practices among pediatric dentists. Evaluate whether behavioral nudging strategies influence pediatric dentists' willingness to adopt rectangular collimation.

3. Study Hypothesis Null Hypothesis: Nudging strategies (pictorial framing and traffic-light color coding) have no impact on pediatric dentists' willingness to adopt rectangular collimation.

   Alternative Hypothesis: The implementation of nudging strategies positively influences pediatric dentists to use rectangular collimation.

4. Methodology Study Design

   • A randomized, quantitative survey distributed online.
   • Three study groups:

1. Control Group (No nudging intervention) 2. Pictorial Framing Group (Visual aids illustrating collimation benefits) 3. Traffic-Light Color Coding Group (Decision cues using color-based risk indicators)

Participants Target Population: Pediatric dentists who are active members of the American Academy of Pediatric Dentistry (AAPD) in the U.S. and Canada.

Sample Size: As a one of its kind research project, the minimum for comparison is 30 participants in each sample group.

Data Collection A self-administered online survey conducted via REDCap. Survey distribution follows randomization of participants into the three groups.

Three e-mail invitations sent at two-week intervals over a six-week period.

Outcome Measures Primary Outcome: Change in willingness to adopt rectangular collimation. Secondary Outcome: Differences in responses across study groups.

Statistical Analysis Descriptive and comparative statistics using SPSS. Statistical significance set at p < 0.05.

5. Ethical Considerations Study approved by the University of Toronto Health Sciences Research Ethics Board.

Participants' responses are anonymous, and data security measures are in place.

6. Expected Impact This study will provide valuable insights into behavioral interventions for pediatric dentistry. If effective, nudging strategies could be incorporated into clinical guidelines to enhance radiation safety practices.

Inclusion Criteria:

• active members of American Academy of Pediatric Dentistry

Exclusion Criteria:

• pre and post doctoral students and affiliated members

It does not abide by the requirements laid out by American Academy of Pedaitric Dentistry, which provided the participant list. Individual partipants are not consenting to sharing of individual data.