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Guo Y, Woodard J, Zhang Y, Staras SAS, Gordan VV, Gilbert GH, McEdward DL, Shenkman E. Patients' comfort with and receipt of health risk assessments during routine dental visits: Results from the South Atlantic region of the US National Dental Practice-Based Research Network. Community Dent Oral Epidemiol 2023; 51:854-863. [PMID: 35851866 PMCID: PMC10792993 DOI: 10.1111/cdoe.12773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To understand patients' comfort with health risk assessments (HRAs) and patient and dentist factors associated with the provision of HRAs. METHODS In this cross-sectional study, 857 patients seen by 30 dental practitioners in the United States National Dental Practice-Based Research Network reported their comfort receiving HRA for six risk factors (tobacco use, alcohol use, dietary sugar intake, human immunodeficiency virus risks, human papillomavirus risks and existing medical conditions) and whether they discussed any of the risk factors during their visits. Multi-level logistic models were used to examine the impacts of patient, practitioner, practice characteristics on the (1) number of risk factors patients were comfortable discussing and (2) number of risk factors assessed in the current dental visit. RESULTS Only a small percentage (4%) of patients reported being uncomfortable receiving any HRA during their dental visits. However, over half of the patients (53%) reported that they did not receive any HRAs during the current visit. In the regression analyses, patients who were older, male and from the suburban were more likely to be comfortable with more HRAs. Dentists were more likely to provide HRA if they were younger, not non-Hispanic white, less likely to feel that providing HRAs was beyond their scope of practice, yet more likely to feel occasional discomfort in providing HRA. CONCLUSIONS Interventions should focus on reducing dental practitioner perception that conducting HRAs is beyond their scope of practice and standardizing screening assessments for multiple risk factors.
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Affiliation(s)
- Yi Guo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | - Jennifer Woodard
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | - Yahan Zhang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1225 Center Drive, Gainesville, FL, 32610
| | - Stephanie A. S. Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | - Valeria V. Gordan
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, 1395 Center Drive; Gainesville, FL 326010-0415
| | - Gregg H. Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama, 1919 7th Ave S, Birmingham, AL 35294
| | - Deborah L. McEdward
- National Dental Practice-Based Research Network, Restorative Dental Sciences, University of Florida, 1395 Center Drive; Gainesville, FL 326010-0415
| | - Elizabeth Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
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Isett KR, Doshi AM, Rosenblum S, Eller W, Hicks D, Melkers J. Temporal search persistence, certainty, and source preference in dentistry: Results from the National Dental PBRN. PLoS One 2022; 17:e0264913. [PMID: 35580118 PMCID: PMC9113567 DOI: 10.1371/journal.pone.0264913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/21/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives The primary goal of this paper was to investigate an old question in a new way: what are the search patterns that professionals demonstrate when faced with a specific knowledge gap? Methods We examine data from a cascading survey question design that captures details about searching for information to answer a self-nominated clinical question from 1027 dental professionals enrolled in the National Dental Practice Based Research Network. Descriptive and conditional logistical regression analysis techniques were used. Results 61% of professionals in our sample choose informal sources of information, with only about 11% looking to formal peer reviewed evidence. The numbers of professionals turning to general internet searches is more than twice as high as any other information source other than professional colleagues. Dentists with advanced training and specialists are significantly more likely to consult peer-reviewed sources, and women in the sample were more likely than men to continue searching past a first source. Conclusions Speed/availability of information may be just as, or in some cases, more important than credibility for professionals’ search behavior. Additionally, our findings suggest that more insights are needed into how various categories of professionals within a profession seek information differently.
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Affiliation(s)
- Kimberley R. Isett
- Biden School of Public Policy and Administration, University of Delaware, Newark, Delaware, United States of America
- * E-mail:
| | - Ameet M. Doshi
- Princeton University Library, Princeton, NJ, United States of America
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Simone Rosenblum
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Warren Eller
- John Jay College of Criminal Justice, City University of New York, New York, NY, United States of America
| | - Diana Hicks
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Julia Melkers
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, United States of America
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McCracken BA, VanPutte CL, Hildebolt CF. Nicotine-related misperceptions among faculty and students at a Midwestern dental school. J Dent Educ 2021; 86:161-168. [PMID: 34542179 DOI: 10.1002/jdd.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/10/2021] [Accepted: 09/03/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE/OBJECTIVES To determine the perceptions about the ill-effects of nicotine in students and faculty at a Midwestern dental school. This information will help inform the school and improve teaching on this subject during a time when electronic nicotine delivery systems are increasingly popular. METHODS An online survey of dental students and faculty of a Midwestern dental school was deployed in November, 2020 to determine their level of misperception about the ill effects of nicotine. An online Qualtrics survey was administered to approximately 212 predoctoral students at a dental institution and approximately 100 part- and full-time faculty at the same school. RESULTS The response rate for faculty was 55.1% and that for students was 37.5%. The majority of faculty and students "agreed" or "strongly agreed" that nicotine causes cancer, birth defects, cardiovascular disease, oral inflammation, and Chronic Obstructive Pulmonary Disease. CONCLUSIONS Dental school faculty and students linked the risks of smoking tobacco to nicotine. Based on the results of this study, we feel our institution's curriculum should consider including information specific to nicotine in addition to tobacco in general.
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Affiliation(s)
- Barbara A McCracken
- Department of Growth, Development, and Structure, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Cinnamon L VanPutte
- Department of Growth, Development, and Structure, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Charles F Hildebolt
- Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
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Rosenblum S, Isett KR, Melkers J, Funkhouser E, Hicks D, Gilbert GH, Melkers MJ, McEdward D, Buchberg-Trejo M. The association between professional stratification and use of online sources: Evidence from the National Dental Practice-Based Research Network. J Inf Sci 2021; 47:373-386. [PMID: 34177010 PMCID: PMC8221114 DOI: 10.1177/0165551519890519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of online information sources in most professions is widespread, and well researched. Less understood is how the use of these sources vary across the strata within a single profession, and how question context affects search behaviour. Using the dental profession as a case of a highly stratified discipline, we examine search preferences for sources by professional strata among dentists in a practice-based network. Results show that variation exists in information search behaviour across professional strata of dental clinicians. This study highlights the importance of addressing information literacy across different levels of a profession. Findings also underscore that search behaviour and source preference vary with perceived question relevance.
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Affiliation(s)
- Simone Rosenblum
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Julia Melkers
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ellen Funkhouser
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Diana Hicks
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA
| | - Gregg H Gilbert
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Deborah McEdward
- South Atlantic Region, National Dental Practice-Based Research Network, Gainesville, FL, USA
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Burgette JM, Isett KR, Rosenblum S, Doshi A, Melkers J. Association between predoctoral evidence-based practice training and later use of peer-reviewed journals: National dental PBRN. J Dent Educ 2021; 85:812-820. [PMID: 33598977 PMCID: PMC8197728 DOI: 10.1002/jdd.12564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 01/11/2021] [Accepted: 01/22/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We examined whether evidence-based practice (EBP) during dental school was associated with the increased use of peer-reviewed literature during subsequent clinical practice for National Dental Practice-Based Research Network (PBRN) dentists. We also sought to understand whether this association was moderated by being a dental specialist. METHODS We analyzed cross-sectional data from 1228 dentists participating in the PBRN. We used logistic regression to examine the association between self-reported EBP training during dental school and the use of peer-reviewed journals in clinical practice, controlling for the number of years since dental school graduation and dental practice type. We stratified the data by dental specialists and examined effect modification using the Breslow-Day test for homogeneity of the odds ratio. RESULTS The prevalence of peer-reviewed journal use by PBRN dentists in clinical practice was 87% (n = 1070) with no statistical evidence of effect modification by dental specialists on the EBP peer-reviewed journal use relationship (p > 0.05). After controlling for years since dental school graduation and dental practice type, dentists who self-reported EBP training during dental school had greater odds of using peer-reviewed journals in clinical practice than dentists who did not self-report EBP training during dental school (OR, 1.47; 95%CI = 1.01, 2.15). CONCLUSION The use of peer-reviewed published literature by PBRN dentists who had EBP predoctoral training is one important step in the EBP process by which practicing dentists can implement evidence-based findings, interventions, and policies into routine health care and public health settings. These findings add to the body of support for EBP curricula in dental education.
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Affiliation(s)
- Jacqueline M Burgette
- Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kimberley R Isett
- Biden School of Public Policy and Administration, the University of Delaware, Newark, Delware, USA
| | - Simone Rosenblum
- School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Ameet Doshi
- School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Julia Melkers
- School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia, USA
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Erku DA, Gartner CE, Morphett K, Steadman KJ. Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis. Nicotine Tob Res 2020; 22:619-629. [PMID: 30938442 DOI: 10.1093/ntr/ntz046] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/20/2019] [Indexed: 12/28/2022]
Abstract
AIMS This review explores the (1) beliefs and attitudes of health care professionals (HCPs) toward electronic nicotine delivery systems (ENDS) including use as a smoking cessation aid and/or harm reduction, safety and regulation, and (2) the extent and content of patient-HCP communication about ENDS. METHODS PubMed, Embase, CINAHL, and PsycINFO were searched to identify articles published since 2003. The Mixed Methods Appraisal Tool and Strengthening the Reporting of Observational Studies in Epidemiology checklists were used to assess the quality of studies. Thematic synthesis was used to analyze qualitative data. RESULTS A total of 45 articles (32 quantitative, 12 qualitative, and 1 mixed) were included. There was wide variation regarding beliefs about the efficacy of ENDS as a cessation aid. Although the majority of HCPs believes that ENDS are safer than combustible cigarettes, they also have concern about the short and long-term safety of ENDS, uptake by adolescents, and the potential for ENDS to act as a "gateway" to smoking cigarettes. Beliefs about ENDS are influenced by media stories and experiences provided by patients. Although most HCPs do not proactively recommend ENDS, they are more likely to support ENDS use among patients with smoking related comorbidities, heavy smokers with previous unsuccessful quit attempts, or patients who express interest in trying them. CONCLUSIONS Overall, HCPs hold diverse views about the efficacy of ENDS and expressed wariness over their potential health effects. HCP endorsement of ENDS use seems to depend largely on patient health status, the presence of other competing risk factors and patient preferences. IMPLICATION Although evidence on safety and efficacy of ENDS is emerging, HCPs should be honest with their clients, stating that the long-term safety is not yet established but what is known is that they appear to be a lower risk alternative to cigarettes. Our review highlights a need for further training and support for HCPs regarding ENDS use, which would enable them to guide their clients in making evidence-based decisions.
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Affiliation(s)
- Daniel A Erku
- School of Pharmacy, University of Queensland, Woolloongabba, Queensland, Australia
| | - Coral E Gartner
- School of Public Health, University of Queensland, Herston, Queensland, Australia.,Queensland Alliance for Environmental Health Sciences, University of Queensland, Woolloongabba, Queensland, Australia
| | - Kylie Morphett
- School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Kathryn J Steadman
- School of Pharmacy, University of Queensland, Woolloongabba, Queensland, Australia
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Patrounova V, Yoon JH, Schmitz JM, Nguyen K, Alaniz J, Yammine L. Combustible and electronic cigarette use among patients at a large academic dental school clinic: A preimplementation needs assessment survey. J Am Dent Assoc 2020; 151:510-518. [PMID: 32593353 DOI: 10.1016/j.adaj.2020.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Tobacco product use is a significant public health concern, particularly with the increasing use of electronic nicotine delivery systems (electronic cigarettes [e-cigarettes]). Dental care providers are well positioned to screen and provide guidance regarding tobacco use, but these services are generally underused. METHODS In preparation for a quality improvement project, patients at a large academic dental school clinic were anonymously surveyed regarding past and current use of combustible cigarettes and e-cigarettes, attitudes about quitting, and health beliefs regarding these products. RESULTS Among 166 surveyed patients, past month use of combustible cigarettes, e-cigarettes, and both combustible cigarettes and e-cigarettes (dual use) was reported by 14.5%, 2.4%, and 5.4% of patients, respectively. Daily combustible cigarette, e-cigarette, and dual use was reported by 12.7%, 1.2%, and 1.8% of patients, respectively. Most current tobacco users expressed thoughts or plans about changing their tobacco use and concerns regarding continued use of these products on their oral health. More than one-half of the current tobacco users expressed interest in receiving additional support to help them quit. CONCLUSIONS Dental care providers see a sizable number of patients who use combustible cigarettes and e-cigarettes, many of whom are concerned about the potential harms of these products on their health and express interest in tobacco-use cessation support. PRACTICAL IMPLICATIONS It is critical that dental care professionals engage in efforts to assess combustible cigarette and e-cigarette use and provide guidance regarding these products to their patients.
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Chaffee B, Urata J, Couch E, Silverstein S. Dental Professionals' Engagement in Tobacco, Electronic Cigarette, and Cannabis Patient Counseling. JDR Clin Trans Res 2020; 5:133-145. [PMID: 31323182 PMCID: PMC7079330 DOI: 10.1177/2380084419861384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES California features low smoking prevalence, cautionary electronic cigarette (e-cigarette) public messaging, and legal recreational cannabis: a unique landscape for dental professionals to navigate tobacco cessation promotion. This cross-sectional study assessed California dental professionals' self-reported tobacco patient counseling behaviors and the correlates of providing such assistance. METHODS Statewide surveys of dental hygienists (n = 701) and dentists (n = 725) were distributed electronically. The dentist survey was weighted for sampling and nonresponse. Prevalence of asking patients about use was compared for cigarette and noncigarette products (e.g., e-cigarettes, cannabis). Multivariable models identified independent correlates of providing cessation assistance to tobacco-using patients. RESULTS Respondents reported frequently (often/always) documenting patient tobacco use (hygienists: 80%; dentists: 73%) but less commonly provided forms of assistance (hygienists: 27%-49%; dentists: 10%-31%). Most respondents asked patients about cigarette smoking, but noncigarette product use (cigar, hookah, pipe, e-cigarette, or cannabis) was not commonly assessed. Greater confidence and willingness to assist were positively associated with providing assistance in multivariable models, but perceived barriers (e.g., lack of time and remuneration) were not. Results were robust to model specifications. CONCLUSIONS California dental professionals often ask about smoking but lag in providing cessation assistance and inquiring about noncigarette products. Successful efforts to encourage dental professionals' engagement in tobacco prevention and cessation must enhance providers' self-efficacy and motivation and likely will require system and organizational change. KNOWLEDGE TRANSFER STATEMENT Study findings identify substantial gaps in dental professionals' engagement in patient tobacco cessation. The results identify correlates of providing assistance and of dental professionals' willingness and confidence to do so, which could serve to inform interventions to support and enhance engagement.
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Affiliation(s)
- B.W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
| | - J. Urata
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
| | - E.T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
| | - S. Silverstein
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
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Chaffee BW, Urata J, Silverstein S, Couch ET. Dental Hygienists' and Dentists' Tobacco Cessation Continuing Education Preferences: Application of a Discrete Choice Method. J Dent Educ 2020; 84:72-80. [PMID: 31977090 DOI: 10.21815/jde.019.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022]
Abstract
Despite ample opportunity, dental professionals frequently fall short of connecting tobacco-using patients with effective cessation support, often citing lack of training as a barrier. To inform development of training options, the aim of this study was to quantify the preferences of practicing dental hygienists and dentists in California for continuing dental education (CDE) offerings related to tobacco and patient tobacco cessation. Two statewide surveys of California dental hygienists and dentists were conducted. In addition to providing their own and their practice characteristics, in a discrete choice experiment, participants indicated their preferences between pairs of randomly generated hypothetical tobacco cessation CDE offerings that differed in topic, cost, delivery modality, and duration. Ultimately, 641 dental hygienists (20.5% of the total invited minus those with undeliverable emails, n=3,129) and 654 dentists (8.5% of the total invited minus those with undeliverable emails, n=7,669) responded to at least one of the discrete choice items, and their responses were analyzed. The results showed that each CDE attribute was independently associated with preference. Cost and topic were more strongly associated with preference than were delivery modality and duration. Lower cost, shorter duration courses were generally favored. Alternative tobacco products and patient communication were the most popular topics for participating dental hygienists and dentists, respectively. CDE preferences differed according to participant characteristics: live webinars were the least preferred modality for more experienced dental professionals, and shorter courses were not preferred by dentists in non-urban locations. These findings showed that these dental professionals considered multiple attributes in selecting CDE courses. To reach the broadest audience, CDE providers should offer low-cost options across a range of delivery modalities, such as full-day workshops in rural areas and online webinars for earlier career professionals.
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