1
|
Bader K, Roberts ME, Keller-Hamilton B. An Examination of Dental Health Among Metropolitan and Appalachian Adolescents in Ohio. OHIO JOURNAL OF PUBLIC HEALTH 2019; 2:8-14. [PMID: 34888497 PMCID: PMC8654033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Poor dental health is a common chronic condition among youth. Appalachian versus metropolitan residence, socioeconomic status, and health behaviors contribute to poor dental health. Limited research has directly compared dental health and risk factors for poor dental health among Appalachian and metropolitan youth. We examined the association between dental health and residence among adolescent boys and explored socioeconomic and behavioral factors that may contribute to differences in dental health. METHODS Adolescent males from metropolitan and rural Appalachian Ohio (n = 1220, age 11-16 years) reported their diet and tobacco use. Parents or guardians reported when boys had last visited the dentist and rated their dental health (excellent/very good/good versus fair/poor). Unadjusted logistic regression modeled the association between fair/poor dental health and residence (metropolitan versus Appalachian). Adjusted analyses controlled for race, household income, dental visits, diet, and tobacco use. RESULTS Appalachian (versus metropolitan) boys were more likely to have used tobacco in the past 30 days and consumed fewer fruit and vegetables, more added sugar, and more sugary beverages. The relation between dental health and Appalachian versus metropolitan residence did not reach statistical significance, and adjusting for behavioral factors did little to change the observed association. CONCLUSION Our findings suggest that some of the urban/rural disparities in dental health observed in other studies may be related to behavioral factors like tobacco use and diet, but much remains unexplained. We provide support for behavioral interventions to address these issues in the Appalachian community.
Collapse
Affiliation(s)
- Kyle Bader
- College of Dentistry, The Ohio State University, Columbus, OH
| | - Megan E. Roberts
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH
| | | |
Collapse
|
2
|
Coolidge T, Tangcharoensiri S, Chan DCN, Phillips SL. Dental School Patient Preferences for Receiving and Returning Patient Satisfaction Surveys. J Dent Educ 2019; 83:1323-1331. [PMID: 31285367 DOI: 10.21815/jde.019.129] [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: 07/12/2018] [Accepted: 05/25/2019] [Indexed: 11/20/2022]
Abstract
The aims of this study were to investigate dental school patient, parent, and caregiver preferences for receiving and returning patient satisfaction surveys and to determine how modes of receiving and returning surveys impacted return rates. Two studies were conducted, both of which are reported. In Study 1, adult patients, parents of child patients, and caregivers of patients with special needs were asked to indicate their preferred mode of receiving and returning surveys. In Study 2, patients, parents, and caregivers were randomly assigned to different modes of receiving and returning surveys, and return rates were compared between modes and according to whether the individuals had been assigned to their preferred mode or not. The overall response rates were 90.4% for the first study and 48.1% for the second study. In both studies, the preferred mode was receiving and returning the survey in the clinic (chi-square=84.902 and 32.116; df=3; p<0.001). Younger respondents were more likely to prefer receiving and returning the survey by email (K-W statistics=13.406, 10.241; df=3; p=0.004 and 0.017). In Study 2, respondents were significantly more likely to return surveys in the clinic (chi-square=44.994; df=2; p<0.001) and were also significantly more likely to return surveys if they had received them in their preferred mode (binomial test p<0.001). Although receiving and returning the survey in the clinic was the preferred mode, these respondents' preferences were also related to their age. These results suggest that dental school clinics may be able to expect higher return rates if they can follow patients' preferences for receipt and delivery of surveys.
Collapse
Affiliation(s)
- Trilby Coolidge
- Trilby Coolidge, PhD, is Clinical Assistant Professor, Department of Oral Health Sciences, School of Dentistry, University of Washington; Sovipa Tangcharoensiri, BA, is a predental student and Lecturer, Office of the Dean, School of Dentistry, University of Washington; Daniel C.N. Chan, DMD, MS, DDS, is Professor and Chair, Restorative Dentistry, School of Dentistry, University of Washington; and Sandra L. Phillips, MPA, is Director of Quality Improvement and Health and Safety, Office of the Dean, and Senior Lecturer, Restorative Dentistry, School of Dentistry, University of Washington.
| | - Sovipa Tangcharoensiri
- Trilby Coolidge, PhD, is Clinical Assistant Professor, Department of Oral Health Sciences, School of Dentistry, University of Washington; Sovipa Tangcharoensiri, BA, is a predental student and Lecturer, Office of the Dean, School of Dentistry, University of Washington; Daniel C.N. Chan, DMD, MS, DDS, is Professor and Chair, Restorative Dentistry, School of Dentistry, University of Washington; and Sandra L. Phillips, MPA, is Director of Quality Improvement and Health and Safety, Office of the Dean, and Senior Lecturer, Restorative Dentistry, School of Dentistry, University of Washington
| | - Daniel C N Chan
- Trilby Coolidge, PhD, is Clinical Assistant Professor, Department of Oral Health Sciences, School of Dentistry, University of Washington; Sovipa Tangcharoensiri, BA, is a predental student and Lecturer, Office of the Dean, School of Dentistry, University of Washington; Daniel C.N. Chan, DMD, MS, DDS, is Professor and Chair, Restorative Dentistry, School of Dentistry, University of Washington; and Sandra L. Phillips, MPA, is Director of Quality Improvement and Health and Safety, Office of the Dean, and Senior Lecturer, Restorative Dentistry, School of Dentistry, University of Washington
| | - Sandra L Phillips
- Trilby Coolidge, PhD, is Clinical Assistant Professor, Department of Oral Health Sciences, School of Dentistry, University of Washington; Sovipa Tangcharoensiri, BA, is a predental student and Lecturer, Office of the Dean, School of Dentistry, University of Washington; Daniel C.N. Chan, DMD, MS, DDS, is Professor and Chair, Restorative Dentistry, School of Dentistry, University of Washington; and Sandra L. Phillips, MPA, is Director of Quality Improvement and Health and Safety, Office of the Dean, and Senior Lecturer, Restorative Dentistry, School of Dentistry, University of Washington
| |
Collapse
|
3
|
Byrne MJ, Tickle M, Glenny AM, Campbell S, Goodwin T, O'Malley L. A systematic review of quality measures used in primary care dentistry. Int Dent J 2018; 69:252-264. [PMID: 30430563 DOI: 10.1111/idj.12453] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION 'Quality' in primary care dentistry is poorly defined. There are significant international efforts focussed on developing quality measures within dentistry. The aim of this research was to identify measures used to assess quality in primary care dentistry and categorise them according to which dimensions of quality they attempt to measure. METHODS Quality measures were identified from the peer-reviewed and grey literature. Peer-reviewed papers describing the development and validation of measures were identified using a structured literature search. Measures from the grey literature were identified using structured searches and direct contact with dental providers and institutions. Quality measures were categorised according to domains of structure, process and outcome and by disaggregated dimensions of quality. RESULTS From 22 studies, 11 validated measure sets (comprising nine patient satisfaction surveys and two practice assessment instruments) were identified from the peer-reviewed literature. From the grey literature, 24 measure sets, comprising 357 individual measures, were identified. Of these, 96 addressed structure, 174 addressed process and 87 addressed outcome. Only three of these 24 measure sets demonstrated evidence of validity testing. The identified measures failed to address dimensions of quality, such as efficiency and equity. CONCLUSIONS There has been a proliferation in the development of dental quality measures in recent years. However, this development has not been guided by a clear understanding of the meaning of quality. Few existing measures have undergone rigorous validity or reliability testing. A consensus is needed to establish a definition of quality in dentistry. Identification of the important dimension of quality in dentistry will allow for the production of a core quality measurement set.
Collapse
Affiliation(s)
- Matthew J Byrne
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Martin Tickle
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stephen Campbell
- NIHR Patient Safety Translational Research Centre, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tom Goodwin
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lucy O'Malley
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
4
|
Cunha-Cruz J, Huebner CE, Ludwig S, Dysert J, Mitchell M, Allen G, Shirtcliff RM, Scott JM, Milgrom P. Everybody Brush! Consumer Satisfaction with a Tooth Decay Prevention Program. Front Public Health 2017; 5:264. [PMID: 29021979 PMCID: PMC5623708 DOI: 10.3389/fpubh.2017.00264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/14/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Twice-daily caregiver-supervised toothbrushing with fluoridated toothpaste is an effective and widely recommended strategy to prevent tooth decay in children. Qualitative research suggests that low-income caregivers know the recommendation but would benefit from toothbrushing supplies and advice about how to introduce this health behavior especially as the child becomes older and asserts autonomy to do it “myself.” Our objective is to assess consumer satisfaction with the evidence-based theory-informed campaign and usefulness of materials that were home delivered. The focus of the evaluation was families with children <36 months of age because of the high incidence of disease in this population. Methods A dental care organization designed and implemented Everybody Brush! in three counties of Central Oregon. Participants were families of Medicaid-insured children <21 years of age. Participants were randomly assigned to one of the three study groups: test (supplies, voice/printed messages, telephone support), active (supplies), and a waitlist control. Program materials were in English and Spanish. Caregivers of children <36 months were interviewed at the beginning and end of the program. Results A total of 83,148 toothbrushing kits were mailed to 21,743 families. In addition, 93,766 printed messages and 110,367 recorded messages were sent to half of the families. Caregivers were highly satisfied. On a global rating scale from 0 to 10 (worst to best program possible), they rated the program 9.5 on average (median: 10, SD 0.9). On a scale from 0 to 10 (not at all to very useful), mean ratings for usefulness of the toothbrushing supplies was 9.5 (SD = 1.5), for the printed postcard messages was 7.2 (SD 3.6), and for the voice telephone messages was 6.5 (SD 3.9). Discussion A dental care organization carried out a complex community intervention designed to address excess tooth decay among low-income children. Caregivers were highly satisfied with the Everybody Brush! program and toothbrushing supplies were considered the most useful, followed by printed messages. Voice telephone messages were rated least useful. Further evaluation of the impact of the program on toothbrushing behavior and dental-care utilization is underway.
Collapse
Affiliation(s)
- Joana Cunha-Cruz
- Department of Oral Health Sciences, University of Washington, Seattle, WA, United States
| | - Colleen E Huebner
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - Sharity Ludwig
- Advantage Dental Services, LLC, Redmond, OR, United States
| | - Jeanne Dysert
- Advantage Dental Services, LLC, Redmond, OR, United States
| | | | - Gary Allen
- Advantage Dental Services, LLC, Redmond, OR, United States
| | | | - JoAnna M Scott
- Research and Graduate Programs, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Peter Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, WA, United States
| |
Collapse
|
5
|
Nelson TM, Huebner CE, Kim A, Scott JM, Pickrell JE. Parent-reported distress in children under 3 years old during preventive medical and dental care. Eur Arch Paediatr Dent 2014; 16:283-90. [PMID: 25514877 DOI: 10.1007/s40368-014-0161-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/28/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE This study examined factors related to young children's distress during preventive oral health visits. Additionally, associations between parent-reported child behaviour during the dental visit and during previous medical visits were tested. METHODS One hundred twenty-two children under 3 years of age enrolled in a government insurance programme for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. RESULTS The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7 %) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6 % of the children and severe distress was reported for 39.4 %. Intensity of distress during the examination was not associated with the child's age, gender, dental health, or previous experience with dental care. Distress was also unrelated to the caregiver's education level or own dental health. Intensity of distress was associated with the child's pre-dental examination distress and distress during prior medical examinations and injections. CONCLUSIONS Dental professionals can better anticipate child distress by assessing children before a dental examination and enquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit.
Collapse
Affiliation(s)
- T M Nelson
- Department of Pediatric Dentistry, University of Washington, 6222 NE 74th Street, Seattle, WA, 98115, USA,
| | | | | | | | | |
Collapse
|
6
|
Riggs E, Gussy M, Gibbs L, van Gemert C, Waters E, Kilpatrick N. Hard to reach communities or hard to access services? Migrant mothers' experiences of dental services. Aust Dent J 2014; 59:201-7. [PMID: 24861395 DOI: 10.1111/adj.12171] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Good oral health is an important component of overall health which can help migrants settle in a new country. Infant oral health is intimately associated with maternal oral health knowledge and behaviours and therefore, encounters with dental services. This study aimed to explore the experiences of dental service use from the perspective of migrant mothers living in Melbourne, Australia. METHODS A participatory research approach utilizing qualitative methods was adopted. Women from Iraq, Lebanon and Pakistan participated. Semi-structured focus groups and interviews were conducted and thematic analysis of the data was completed. RESULTS Focus groups (n = 11) and interviews (n = 7) were conducted with 115 women. Despite an understanding that visiting the dentist was important for promoting oral health, the first dental contact for both the women and their children was typically for emergency care. Accessibility, cost and waiting lists were identified as significant barriers to attendance. Problematic interpreter encounters often led to negative experiences which were compounded by a perception that public services provided poorer quality of care. CONCLUSIONS Despite evidence of poorer oral health, migrant women face significant barriers in accessing mainstream dental services. Reorientation of such services, to address the accessibility and experience for migrant communities may help reduce oral health inequalities.
Collapse
Affiliation(s)
- E Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria; Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria
| | | | | | | | | | | |
Collapse
|
7
|
Flores G, Lin H. Trends in racial/ethnic disparities in medical and oral health, access to care, and use of services in US children: has anything changed over the years? Int J Equity Health 2013; 12:10. [PMID: 23339566 PMCID: PMC3560223 DOI: 10.1186/1475-9276-12-10] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 12/18/2012] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The 2010 Census revealed the population of Latino and Asian children grew by 5.5 million, while the population of white children declined by 4.3 million from 2000-2010, and minority children will outnumber white children by 2020. No prior analyses, however, have examined time trends in racial/ethnic disparities in children's health and healthcare. The study objectives were to identify racial/ethnic disparities in medical and oral health, access to care, and use of services in US children, and determine whether these disparities have changed over time. METHODS The 2003 and 2007 National Surveys of Children's Health were nationally representative telephone surveys of parents of 193,995 children 0-17 years old (N = 102,353 in 2003 and N = 91,642 in 2007). Thirty-four disparities indicators were examined for white, African-American, Latino, Asian/Pacific-Islander, American Indian/Alaskan Native, and multiracial children. Multivariable analyses were performed to adjust for nine relevant covariates, and Z-scores to examine time trends. RESULTS Eighteen disparities occurred in 2007 for ≥1 minority group. The number of indicators for which at least one racial/ethnic group experienced disparities did not significantly change between 2003-2007, nor did the total number of specific disparities (46 in 2007). The disparities for one subcategory (use of services), however, did decrease (by 82%). Although 15 disparities decreased over time, two worsened, and 10 new disparities arose. CONCLUSIONS Minority children continue to experience multiple disparities in medical and oral health and healthcare. Most disparities persisted over time. Although disparities in use of services decreased, 10 new disparities arose in 2007. Study findings suggest that urgent policy solutions are needed to eliminate these disparities, including collecting racial/ethnic and language data on all patients, monitoring and publicly disclosing disparities data annually, providing health-insurance coverage and medical and dental homes for all children, making disparities part of the national healthcare quality discussion, ensuring all children receive needed pediatric specialty care, and more research and innovative solutions.
Collapse
Affiliation(s)
- Glenn Flores
- Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 5390-9063, USA
- Division of General Pediatrics, Children’s Medical Center, 1935 Medical District Dr, Dallas, TX, 75235, USA
| | - Hua Lin
- Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 5390-9063, USA
| |
Collapse
|
8
|
Carrion IV, Castañeda H, Martinez-Tyson D, Kline N. Barriers impeding access to primary oral health care among farmworker families in Central Florida. SOCIAL WORK IN HEALTH CARE 2011; 50:828-844. [PMID: 22136348 DOI: 10.1080/00981389.2011.594491] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Oral health care is critical for farmworkers' families in Central Florida. There is little research regarding the access to primary oral health care, barriers, and behaviors of Mexican migrant families. Forty semi-structured interviews were conducted with parents who are farmworkers in order to understand the factors that impact dental service utilization. Other factors that were also examined related to parental decisions regarding visits to the dentist with their children. This study highlights the inconsistent and inadequate patterns of dental health care services available for women, men, and children of farmworkers in Central Florida.
Collapse
Affiliation(s)
- Iraida V Carrion
- School of Social Work, University of South Florida, Tampa, Florida 33620-6600, USA.
| | | | | | | |
Collapse
|
9
|
Hilton IV, Lester AM. Oral health disparities and the workforce: a framework to guide innovation. J Public Health Dent 2010; 70 Suppl 1:S15-23. [PMID: 20806471 DOI: 10.1111/j.1752-7325.2010.00175.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Oral health disparities currently exist in the United States, and workforce innovations have been proposed as one strategy to address these disparities. A framework is needed to logically assess the possible role of workforce as a contributor to and to analyze workforce strategies addressing the issue of oral health disparities. METHODS Using an existing framework, A Strategic Framework for Improving Racial/Ethnic Minority Health and Eliminating Racial/Ethnic Health Disparities, workforce was sequentially applied across individual, environmental/community, and system levels to identify long-term problems, contributing factors, strategies/innovation, measurable outcomes/impacts, and long-term goals. Examples of current workforce innovations were applied to the framework. RESULTS Contributing factors to oral health disparities included lack of racial/ethnic diversity of the workforce, lack of appropriate training, provider distribution, and a nonuser-centered system. The framework was applied to selected workforce innovation models delineating the potential impact on contributing factors across the individual, environmental/community, and system levels. The framework helps to define expected outcomes from workforce models that would contribute to the goal of reducing oral health disparities and examine impacts across multiple levels. However, the contributing factors to oral health disparities cannot be addressed by workforce innovation alone. CONCLUSION The Strategic Framework is a logical approach to guide workforce innovation, solutions, and identification of other aspects of the oral healthcare delivery system that need innovation in order to reduce oral health disparities.
Collapse
Affiliation(s)
- Irene V Hilton
- San Francisco Department of Public Health, 1525 Silver Avenue, San Francisco, CA 94134, USA.
| | | |
Collapse
|
10
|
Abstract
OBJECTIVES The authors examined whether low-income mothers, who have a regular source of dental care (RSDC), rate the dental health of their young children higher than mothers without an RSDC. METHODS From a population of 108,151 children enrolled in Medicaid aged 3 to 6 years and their low-income mothers in Washington state, a disproportionate stratified random sample of 11,305 children aged 3 to 6 years was selected from enrollment records in four racial/ethnic groups: 3791 Black; 2806 Hispanic; 1902 White; and 2806 other racial/ethnic groups. A mixed-mode survey was conducted to measure mother RSDC and mother ratings of child's dental health and pain. The unadjusted response rate was 44%, yielding the following eligible mothers: 816 Black, 1309 Hispanic, 1379 White, 237 Asian, and 133 American-Indian. Separate regression models for Black, Hispanic, and White mothers estimated associations between the mothers having an RSDC and ratings of child dental health. RESULTS Across racial/ethnic groups, mothers with an RSDC consistently rated their children's dental health 0.15 higher on a 1-to-5 scale (where '1' means 'poor' and '5' means 'excellent') than mothers without an RSDC, controlling for child and mother characteristics and the mothers' propensity to have an RSDC. This difference can be interpreted as a net movement of one level up the scale by 15% of the population. CONCLUSIONS Across racial/ethnic groups, low-income mothers who have a regular source of dental care rate the dental health of their young children higher than mothers without an RSDC.
Collapse
Affiliation(s)
- David Grembowski
- Department of Dental Public Health Sciences, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
- Department of Health Services, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
| | - Charles Spiekerman
- Department of Dental Public Health Sciences, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
| | - Peter Milgrom
- Department of Dental Public Health Sciences, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
- Department of Health Services, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
| |
Collapse
|