1
|
Brame JL, Quinonez RB, Ciszek BP, Weintraub JA. Implementing a Prenatal Oral Health Program for Dental Students: Lessons Learned. Health Promot Pract 2023:15248399231207070. [PMID: 37904487 DOI: 10.1177/15248399231207070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
The Prenatal Oral Health Program (pOHP) was developed to educate dental students on prenatal oral health and promote access to dental care for pregnant women. Program advancement has occurred in support of quality improvement. This mixed-methods design combined quantitative data from fourth-year dental students who participated the pOHP (N = 81) and qualitative data from a student-faculty-staff focus group discussion (N = 7). Different clinical structures, appropriate leveling in the curriculum, management with a patient care coordinator, and inclusion of interprofessional learning experiences (IPE) were compared. The survey response rate was 96.4% (N = 81). Trends were noted between students who provided clinical care for a pregnant patient (31%) versus those who did not. Results indicated that an integrated clinic was preferred, though students who had treated a pOHP patient showed greater support for a standalone clinic model. Survey and focus group data agreed that pOHP should occur during the third-year dental school training; however, students with patient experience favored second-year placement. Survey and focus group data emphasize the importance of a patient care coordinator for clinical management and IPE as an essential learning element. Innovating new clinical models requires a period of evolution to determine preferred and sustainable infrastructure. Results reveal the advantages and disadvantages of various program implementation models and demonstrate that student perceptions were influenced by their clinical experiences. Study findings will inform implementation and guide other programs as they create and modify existing curricula to enhance prenatal oral health.
Collapse
Affiliation(s)
- Jennifer L Brame
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rocio B Quinonez
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brittney P Ciszek
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- The University of Utah, Salt Lake City, UT, USA
| | - Jane A Weintraub
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
2
|
Vamos CA, Cayama MR, Mahony H, Griner SB, Quinonez RB, Boggess K, Beckstead J, Daley EM. Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers. BMC Pregnancy Childbirth 2023; 23:721. [PMID: 37821843 PMCID: PMC10566079 DOI: 10.1186/s12884-023-06032-3] [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: 07/02/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Poor oral health during pregnancy has significant implications across the life course, including increased risk for adverse pregnancy, birth outcomes, and the development of early childhood caries. In efforts to improve perinatal oral health in the United States, a set of national interprofessional guidelines were developed that include recommended practice behaviors for both oral health providers and prenatal providers. The purpose of this study was to examine guideline awareness, familiarity, beliefs, and practice behaviors among both provider types. METHODS Prenatal providers and oral health providers in Florida were recruited via random and convenience sampling to complete an online survey guided by the Consolidated Framework for Implementation Research (CFIR) and the Cabana Framework. The present analysis focused on the Individuals Involved domain (CFIR), awareness and familiarity with the guidelines (Cabana Framework), confidence, and practice behaviors as recommended by prenatal oral health guidelines (assess, advise, refer, share/coordinate). Data were analyzed using chi-square tests, independent samples t-tests, Pearson correlation coefficients, and one-way analysis of variance (ANOVA) and analyses were conducted in SPSS. RESULTS Prenatal and oral health providers did not differ significantly in their awareness of the guidelines, but awareness was significantly associated with three of the four practice behaviors for prenatal providers. Familiarity with the guidelines was significantly higher among oral health providers and was associated with all four practice behaviors for both provider types. Five out of ten oral health belief items were significantly associated with practicing the guidelines among prenatal providers, but only two among oral health providers. Confidence in performing the practice behaviors was significantly associated with guideline implementation among both groups. Years in practice was significantly associated with performing practice behaviors for prenatal providers, but not for oral health providers. CONCLUSIONS Our findings highlight the importance of professional organizations and the role of clinical guidelines on practice behaviors. Although provider education is a key implementation strategy, organizational and policy-level system changes could also be critical in supporting practice behaviors.
Collapse
Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA.
| | - Morgan Richardson Cayama
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| | - Helen Mahony
- College of Social Sciences and Public Policy, Florida State University, 113 Collegiate Loop, Tallahassee, FL, 32304, USA
| | - Stacey B Griner
- School of Public Health, The University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd Fort Worth, Fort Worth, TX, 76107, USA
| | - Rocio B Quinonez
- Division of Pediatric Dentistry and Public Health, Department of Pediatrics, Schools of Dentistry and Medicine, University of North Carolina at Chapel Hill, 385 S. Columbia St., Chapel Hill, NC, 27599, USA
| | - Kim Boggess
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, 3009 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA
| | - Jason Beckstead
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd MDC 56, Tampa, FL, 33612, USA
| |
Collapse
|
3
|
Adeniyi A, Donnelly L, Janssen P, Jevitt C, Kardeh B, von Bergmann H, Brondani M. Pregnant women's perspectives on integrating preventive oral health in prenatal care. BMC Pregnancy Childbirth 2021; 21:271. [PMID: 33794806 PMCID: PMC8016156 DOI: 10.1186/s12884-021-03750-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/22/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Oral diseases are considered a silent epidemic including among pregnant women. Given the prevalence of oral conditions among pregnant women and the reported association with adverse pregnancy outcomes, there have been suggestions for the inclusion of preventive oral care in routine prenatal care. However, due to the different administrative and funding structure for oral health and prenatal care in Canada, progress towards this integration has been slow. Our study sought to qualitatively explore the views of pregnant women in British Columbia (BC) on the strategies for integrating preventive oral health care into prenatal care services. METHODS A qualitative approach was utilized involving semi-structured interviews with fourteen (14) purposefully selected pregnant women in Vancouver and Surrey, BC. The interviews were audio-recorded and transcribed. The transcripts were analyzed using an inductive thematic approach. Study validity was ensured via memoing, field-notes, and member checking. RESULTS Interviews ranged from 28 to 65 min producing over 140 pages of transcripts. Analysis resulted in three major themes: oral health experiences during pregnancy, perspectives on integration and integrated prenatal oral care, and strategies for addressing prenatal oral health care. A majority of participants were supportive of integrating preventive oral care in routine prenatal services, with referrals identified as a critical strategy. Oral health education was recognized as important before, during, and after pregnancy; oral health assessments should therefore be included in the prenatal care checklist. Limited funding was acknowledged as a barrier to oral health care access, which may explain why few participants visited their dentists during pregnancy. Interprofessional education surfaced as a bridge to provide prenatal oral health education. CONCLUSION Pregnant women interviewed in this study support the inclusion of educational and preventive oral care during prenatal care, although their views differed on how such inclusion can be achieved in BC. They advocated the establishment of a referral system as an acceptable strategy for providing integrated prenatal oral health care.
Collapse
Affiliation(s)
- A Adeniyi
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada.
| | - L Donnelly
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - P Janssen
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - C Jevitt
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - B Kardeh
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - H von Bergmann
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada
| | - M Brondani
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada
| |
Collapse
|
4
|
Dsouza R, Quinonez R, Hubbell S, Brame J. Promoting oral health in nursing education through interprofessional collaborative practice: A quasi-experimental survey study design. NURSE EDUCATION TODAY 2019; 82:93-98. [PMID: 31446325 DOI: 10.1016/j.nedt.2019.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/24/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Optimal oral health education is limited in nursing curricula and may therefore, not translate as a priority for nurses in clinical practice. OBJECTIVES To evaluate the influence of an educational intervention on knowledge, confidence, practice behaviors, and perceived barriers of nursing students regarding preventive oral health services. DESIGN Quasi-experimental pre-post survey study design. PARTICIPANTS Sixty-four first-year Accelerated Bachelor of Nursing (ASBN) students at the University of North Carolina at Chapel Hill. METHODS Students were asked to complete oral-health-related questionnaires following didactic and clinical simulation on principles of oral health, oral screening, counseling, and referral to a dentist. A post-survey following clinical rotations was completed testing long-term effectiveness. RESULTS Fifty-five (86%) ABSN students completed the pre-survey, 49 (77%) completed the post-survey; 44 (69%) completed both. Participants' showed a significant increase in knowledge from pre-post questionnaires for two of five questions (p = 0.04; p < 0.0001). Confidence scores in performing oral screenings (p < 0.0001) and counseling (p = 0.006) increased; while scores regarding referrals decreased (p = 0.718). Post-intervention, 37% reported performing oral screenings, 45% counseling, and 8% dental referrals. Respondents reported a significant increase in willingness to implement oral health services during clinical visits (p < 0.0001). CONCLUSION Mixed educational methods can successfully influence oral health knowledge and confidence among ABSN students and their willingness to perform in clinical practice.
Collapse
Affiliation(s)
- Roxanne Dsouza
- Division of Comprehensive Oral Health, UNC-Chapel Hill, Adams School of Dentistry, 3270 First Dental Bldg., Chapel Hill, NC 27599-7450, United States of America.
| | - Rocio Quinonez
- Division of Pediatric and Public Health, UNC-Chapel Hill, Adams School of Dentistry, United States of America.
| | - Sara Hubbell
- UNC-Chapel Hill, School of Nursing, United States of America.
| | - Jennifer Brame
- Division of Comprehensive Oral Health, UNC-Chapel Hill, Adams School of Dentistry, United States of America.
| |
Collapse
|
5
|
Weintraub JA, Quinonez RB, Friga PN, Kowlowitz V, Ciarrocca K. Development of a Dental School Strategic Plan to Inform Interprofessional Education. J Dent Educ 2019; 83:1411-1419. [PMID: 31501256 DOI: 10.21815/jde.019.154] [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: 05/29/2019] [Accepted: 08/07/2019] [Indexed: 11/20/2022]
Abstract
Changes in U.S. health care delivery systems and Commission on Dental Accreditation standards provide impetus for interprofessional education (IPE) and collaborative practice, but roadmaps for engaging dental and dental hygiene faculty to incorporate IPE in a systematic manner are limited. The purpose of this report is to describe the process for creating a strategy and gathering a variety of baseline data to use for determining objectives and metrics and the subsequent development of an IPE strategic plan at the University of North Carolina (UNC) at Chapel Hill Adams School of Dentistry (SOD). SOD IPE committee members included representation from the UNC Schools of Dentistry, Medicine, Pharmacy, and Business. A three-phase framework was developed. Phase 1 (IPE assessment) was an internal environmental scan including a 2017 faculty survey, departmental mapping of IPE activities, comparison of UNC with national results on the IPE component of the American Dental Education Association (ADEA) survey of dental school seniors (2016 graduating class), identification of faculty joint/adjunct appointments at other UNC schools, and a strengths, weaknesses, opportunities, threats (SWOT) analysis. Phase 2 (visioning) consisted of development of IPE mission, vision, and priorities. In Phase 3 (implementation), priorities were developed. Data-gathering led to a strategic plan with three objectives: 1) increase faculty engagement and recognition, 2) develop predoctoral dentistry and dental hygiene IPE curricula, and 3) develop an infrastructure that supports IPE. Specific initiatives and activities, supporting metrics, and estimated costs were developed for each objective. The framework guided a systematic, transparent, and organized process for collecting and monitoring the evidence and directing activities. A three-year strategic plan for IPE was developed in 2017, and implementation is ongoing.
Collapse
Affiliation(s)
- Jane A Weintraub
- Jane A. Weintraub, DDS, MPH, is Rozier Douglass Distinguished Professor of Dental Public Health, Division of Pediatric and Public Health, and former Dean, University of North Carolina at Chapel Hill Adams School of Dentistry; Rocio B. Quinonez, DMD, MS, MPH, is Associate Dean for Educational Leadership and Innovation and Professor, Division of Pediatric and Public Health, University of North Carolina at Chapel Hill Adams School of Dentistry; Paul N. Friga, MBA, PhD, is Clinical Associate Professor of Strategy and Entrepreneurship, University of North Carolina at Chapel Hill Kenan-Flagler Business School; Vicki Kowlowitz, PhD, is Evaluation, Teaching, and Learning Consultant, Academic Support Center, University of North Carolina at Chapel Hill Adams School of Dentistry; and Katharine Ciarrocca, DMD, MSEd, is Associate Professor and Director of Interprofessional Education and Practice, Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry.
| | - Rocio B Quinonez
- Jane A. Weintraub, DDS, MPH, is Rozier Douglass Distinguished Professor of Dental Public Health, Division of Pediatric and Public Health, and former Dean, University of North Carolina at Chapel Hill Adams School of Dentistry; Rocio B. Quinonez, DMD, MS, MPH, is Associate Dean for Educational Leadership and Innovation and Professor, Division of Pediatric and Public Health, University of North Carolina at Chapel Hill Adams School of Dentistry; Paul N. Friga, MBA, PhD, is Clinical Associate Professor of Strategy and Entrepreneurship, University of North Carolina at Chapel Hill Kenan-Flagler Business School; Vicki Kowlowitz, PhD, is Evaluation, Teaching, and Learning Consultant, Academic Support Center, University of North Carolina at Chapel Hill Adams School of Dentistry; and Katharine Ciarrocca, DMD, MSEd, is Associate Professor and Director of Interprofessional Education and Practice, Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry
| | - Paul N Friga
- Jane A. Weintraub, DDS, MPH, is Rozier Douglass Distinguished Professor of Dental Public Health, Division of Pediatric and Public Health, and former Dean, University of North Carolina at Chapel Hill Adams School of Dentistry; Rocio B. Quinonez, DMD, MS, MPH, is Associate Dean for Educational Leadership and Innovation and Professor, Division of Pediatric and Public Health, University of North Carolina at Chapel Hill Adams School of Dentistry; Paul N. Friga, MBA, PhD, is Clinical Associate Professor of Strategy and Entrepreneurship, University of North Carolina at Chapel Hill Kenan-Flagler Business School; Vicki Kowlowitz, PhD, is Evaluation, Teaching, and Learning Consultant, Academic Support Center, University of North Carolina at Chapel Hill Adams School of Dentistry; and Katharine Ciarrocca, DMD, MSEd, is Associate Professor and Director of Interprofessional Education and Practice, Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry
| | - Vicki Kowlowitz
- Jane A. Weintraub, DDS, MPH, is Rozier Douglass Distinguished Professor of Dental Public Health, Division of Pediatric and Public Health, and former Dean, University of North Carolina at Chapel Hill Adams School of Dentistry; Rocio B. Quinonez, DMD, MS, MPH, is Associate Dean for Educational Leadership and Innovation and Professor, Division of Pediatric and Public Health, University of North Carolina at Chapel Hill Adams School of Dentistry; Paul N. Friga, MBA, PhD, is Clinical Associate Professor of Strategy and Entrepreneurship, University of North Carolina at Chapel Hill Kenan-Flagler Business School; Vicki Kowlowitz, PhD, is Evaluation, Teaching, and Learning Consultant, Academic Support Center, University of North Carolina at Chapel Hill Adams School of Dentistry; and Katharine Ciarrocca, DMD, MSEd, is Associate Professor and Director of Interprofessional Education and Practice, Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry
| | - Katharine Ciarrocca
- Jane A. Weintraub, DDS, MPH, is Rozier Douglass Distinguished Professor of Dental Public Health, Division of Pediatric and Public Health, and former Dean, University of North Carolina at Chapel Hill Adams School of Dentistry; Rocio B. Quinonez, DMD, MS, MPH, is Associate Dean for Educational Leadership and Innovation and Professor, Division of Pediatric and Public Health, University of North Carolina at Chapel Hill Adams School of Dentistry; Paul N. Friga, MBA, PhD, is Clinical Associate Professor of Strategy and Entrepreneurship, University of North Carolina at Chapel Hill Kenan-Flagler Business School; Vicki Kowlowitz, PhD, is Evaluation, Teaching, and Learning Consultant, Academic Support Center, University of North Carolina at Chapel Hill Adams School of Dentistry; and Katharine Ciarrocca, DMD, MSEd, is Associate Professor and Director of Interprofessional Education and Practice, Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry
| |
Collapse
|