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Horowitz AM, Maybury C, Clough SR, Wang MQ, Kleinman DV. Dental Hygiene Students' Knowledge, Understanding and Intended Use of Caries Preventive Regimens and Community Water Fluoridation. J Dent Hyg 2024; 98:68-77. [PMID: 38346898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024]
Abstract
Purpose The purpose of this study was to determine dental hygiene students' perspectives regarding their knowledge and understanding about caries prevention strategies and their intention to use these regimens in clinical practice. Dental hygienists' knowledge and understanding of caries prevention is critical because they are the primary providers of these regimens and the relevant education.Methods This 2019 national cross-sectional online survey was designed by the University of Maryland (UMD), structured by the ADA staff for online administration, distributed and collected by the American Dental Hygienists' Association (ADHA) to 9533 email addresses, and de-identified response data were analyzed by UMD. The survey included questions on three caries preventive regimens: fluoride varnish, dental sealants, and silver diamine fluoride (SDF), and items on community water fluoridation (CWF), respondent's demographics and intent to use the regimens. Statistical analyses included descriptive statistics and analysis of variance. Significance was set at p<0.05.Results Of the 235 surveys returned (response rate 2.5%) the majority were female, White and born in the United States. Over half were in associate degree programs; nearly a third were in baccalaureate programs. Respondents reported greater knowledge/understanding and intention to use fluoride varnish and dental sealants than SDF. Less than half (44.7%) reported knowledge/understanding of SDF and only 22.6% had a high level of confidence regarding applying it. Additionally, only 31.1% indicated they were extremely likely to use SDF upon graduation.Conclusions To reduce the prevalence of caries, dental hygiene graduates must be well-versed with the latest science-based preventive procedures, including non-invasive caries prevention and control therapies. The results of this survey, albeit non representative of the general population of dental hygiene students, suggest a need for a more extensive review of the caries preventive regimen content, especially for silver diamine fluoride, of dental hygiene curricular programs.
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Affiliation(s)
- Alice M Horowitz
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Catherine Maybury
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Sharon R Clough
- Council on Advocacy for Access and Prevention, American Dental Association, Chicago, IL, USA
| | - Min Qi Wang
- School of Public Health, University of Maryland, College Park, MD, USA
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Koo LW, Baur C, Horowitz AM, Wang MQ. Parental Health Literacy, Empowerment, and Advocacy for Food Allergy Safety in Schools: A Cross-Sectional Study. Health Lit Res Pract 2023; 7:e165-e175. [PMID: 37698847 PMCID: PMC10495122 DOI: 10.3928/24748307-20230823-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/10/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Approximately 8% of elementary school-aged children in the United States have food allergies, a complicated health management situation that requires parents to use many types of health literacy, empowerment, and advocacy skills to work with school staff to protect their children. OBJECTIVE This cross-sectional study examined (a) whether the highest versus lowest levels of functional, communicative, and critical health literacy are associated with higher perceived effectiveness of parental advocacy behaviors for safe food allergy management in schools [parental advocacy]; and (b) whether communicative and critical health literacy are more strongly associated with parental advocacy than functional health literacy. METHODS A sample of parents of elementary school-aged children was recruited through 26 food allergy organizations and a research patient registry. Participants completed an anonymous online survey. Self-reported measurements of parental health literacy, empowerment, and advocacy were adapted and refined through pre-testing and pilot-testing. General linear model analyses were conducted to predict parental advocacy. KEY RESULTS Participants (N = 313) were predominantly White, college-educated mothers with moderately high levels of food allergy knowledge, health literacy, empowerment, and parental advocacy skills. Parents who scored at the highest levels in the three dimensions of health literacy reported they engaged in more effective advocacy behaviors than parents who scored at the lowest levels. Parental advocacy was predicted largely by parental empowerment and the quality of the relationship with the school (B = .41 and B = .40, respectively). Functional health literacy and the child's diagnosis of asthma were smaller predictors. While accounting for covariates, functional health literacy was significantly associated with parental advocacy whereas communicative and critical health literacy were not. CONCLUSIONS Interventions to impact parental empowerment and parent-school relationships, including a health-literate universal precautions approach of communicating food allergy school policies, may influence parental advocacy for food allergy safety in schools. Further research could use a performance-based multidimensional measure of health literacy. [HLRP: Health Literacy Research and Practice. 2023;7(3):e165-e175.].
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Affiliation(s)
- Laura W. Koo
- Address correspondence to Laura W. Koo, PhD, MS, FNP-BC, University of Maryland School of Nursing, 655 West Lombard Street, Suite 375D, Baltimore, MD 21201;
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Kitur H, Horowitz AM, Beck K, Wang MQ. HPV Knowledge, Vaccine Status, and Health Literacy Among University Students. J Cancer Educ 2022; 37:1606-1613. [PMID: 33768470 DOI: 10.1007/s13187-021-01997-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to assess university students' knowledge and understanding about HPV and its association with their vaccination status and health literacy. A sample of 383 undergraduate university students between the ages of 18 and 26 were recruited between February 14 and March 22, 2018. An electronic survey was administered to assess knowledge and HPV awareness, vaccination status, and health literacy. Participants had moderate mean knowledge scores of 6.02 of a possible 11 (SD = 3.06). There was a positive association between health literacy and HPV knowledge and a statistically significant difference in knowledge scores between those who are vaccinated and unvaccinated p < 0.001. This study expanded available research on HPV vaccine and its uptake among university students and can be used to develop educational interventions. Continuous examination of HPV knowledge gaps and identifying factors that affect vaccine uptake is pivotal to increasing vaccination rates.
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Affiliation(s)
- Harriet Kitur
- School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Alice M Horowitz
- School of Public Health, University of Maryland, College Park, MD, 20742, USA.
| | - Kenneth Beck
- School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Min Qi Wang
- School of Public Health, University of Maryland, College Park, MD, 20742, USA
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Abstract
Science and technology advances have led to remarkable progress in understanding, managing, and preventing disease and promoting human health. This phenomenon has created new challenges for health literacy and the integration of oral and general health. We adapted the 2004 Institute of Medicine health literacy framework to highlight the intimate connection between oral health literacy and the successful integration of oral and general health. In doing so we acknowledge the roles of culture and society, educational systems and health systems as overlapping intervention points for effecting change. We believe personal and organizational health literacy not only have the power to meet the challenges of an ever- evolving society and environment, but are essential to achieving oral and general health integration. The new “Oral Health Literacy and Health Integration Framework” recognizes the complexity of efforts needed to achieve an equitable health system that includes oral health, while acknowledging that the partnership of health literacy with integration is critical. The Framework was designed to stimulate systems-thinking and systems-oriented approaches. Its interconnected structure is intended to inspire discussion, drive policy and practice actions and guide research and intervention development.
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Shimpi N, Glurich I, Maybury C, Wang MQ, Hashimoto K, Acharya A, Horowitz AM. Knowledge, Attitudes, Behaviors of Women Related to Pregnancy, and Early Childhood Caries Prevention: A Cross-Sectional Pilot Study. J Prim Care Community Health 2021; 12:21501327211013302. [PMID: 33949227 PMCID: PMC8114310 DOI: 10.1177/21501327211013302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Health education interventions during pregnancy can influence maternal oral health (OH), maternal OH-behaviors and children's OH. Interventions that can be delivered at anytime and anywhere, for example mobile-health (mHealth) provides an opportunity to address challenges of health education and support activation of women in underserved and rural communities to modify their health behavior. This pilot study was undertaken as a part of a mHealth initiative to determine knowledge, attitudes, and behaviors related to pregnancy and ECC prevention among women attending obstetrics/gynecology (OB/GYN) practices at a large rurally-based clinic. METHODS A cross-sectional survey study was voluntarily engaged by women (n = 191) aged 18 to 59 years attending OB/GYN visits, over a 3-week period from 12/2019 to 1/2020. Survey results were analyzed applying descriptive statistics, X2 and Fisher's Exact tests. The significance level was set at P < .0001 for all analyses. RESULTS Approximately half of respondents were between 18 and 29 years (53%), had a college degree (55%), and 100% reported cell phone use. Whereas 53% and 31%, respectively, indicated that they were "somewhat" or "very" sure of how to prevent ECC in their children, only 9% recognized evidence of early decay and 30% did not know the purpose of fluoride. Overall, only 27% of participants correctly answered the knowledge-based questions. Further, only 57% reported their provider explained things in a way that was easy to understand. Only 24% reported seeing a dentist during their current pregnancy. CONCLUSIONS Study results suggested potential gaps in knowledge and behaviors related to ECC prevention and provided baseline data to inform future interventions to improve ECC prevention practices. Notably, majority of participants used their cell phones for making medical/dental appointments and reported using their phones to look up health-related information. This demographic represents a potentially receptive target for mHealth approaches to improve understanding of oral health maintenance during pregnancy and ECC prevention.
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Affiliation(s)
- Neel Shimpi
- Marshfield Clinic Research Institute, WI, USA
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Tseng W, Pleasants E, Ivey SL, Sokal-Gutierrez K, Kumar J, Hoeft KS, Horowitz AM, Ramos-Gomez F, Sodhi M, Liu J, Neuhauser L. Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California. Int J Environ Res Public Health 2020; 18:ijerph18010216. [PMID: 33396682 PMCID: PMC7795206 DOI: 10.3390/ijerph18010216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant interview study with 50 participants between November 2019 and March 2020, including 44 dental providers (dentists, hygienists, and assistants) in public or private practice in California and 6 oral health literacy (OHL) experts. We undertook thematic analysis of interview transcripts and descriptive statistics about interviewees from pre-surveys. Dental providers reported frequently speaking slowly, and using simple language and models/radiographs to communicate with patients, while infrequently using interpretation/translation, illustrations, teach-back, or motivational interviewing. Providers reported using only 6 of the 18 American Medical Association's (AMA) recommended communication techniques and only 3 of the 7 AMA's basic communication techniques. A majority of providers indicated using one of five oral health assessment and educational strategies. Key barriers to effective communication included limited time, financial incentives promoting treatment over prevention, lack of OHL training, limited plain-language patient education materials, and patients with low OHL knowledge. Dental organizations should prioritize supporting dental providers in effective patient communication practices. Standardizing OHL continuing education, creating an evidence-based OHL toolkit for dental teams, ensuring accessible interpretation/translation services, and incentivizing dental providers to deliver education could improve oral health literacy and outcomes.
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Affiliation(s)
- Winston Tseng
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
- Correspondence: ; Tel.: +1-925-699-4016
| | - Elizabeth Pleasants
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Susan L. Ivey
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Karen Sokal-Gutierrez
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Jayanth Kumar
- Office of Oral Health, California Department of Public Health, Sacramento, CA 95899, USA;
| | - Kristin S. Hoeft
- Department of Preventive & Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA 94143, USA;
| | - Alice M. Horowitz
- Department of Behavioral Health & Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Francisco Ramos-Gomez
- Division of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, CA 90095, USA;
| | - Miku Sodhi
- Shasta Cascade Health Centers, McCloud, CA 96057, USA;
| | - Jessica Liu
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Linda Neuhauser
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
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Horowitz AM, Kleinman DV, Atchison KA, Weintraub JA, Rozier RG. The Evolving Role of Health Literacy in Improving Oral Health. Stud Health Technol Inform 2020; 269:95-114. [PMID: 32593986 DOI: 10.3233/shti200025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This chapter provides a review of the evolution of oral health literacy including its impact on oral health outcomes, the current status of oral health literacy initiatives and future research needs. Using the Healthy People 2010 definition, the chapter describes opportunities needed to improve oral health literacy among health providers as well as individuals/patients, communities and policy-makers. Studies of the two most prevalent dental diseasesâĂŤdental caries and periodontal diseases - reveal that increasing the oral health literacy of the public and health care providers can play a major role in reducing these diseases. Increasing oral health literacy by creating access to accurate knowledge and supporting use of science-based preventive measures is essential. A major part of the chapter describes oral health literacy's influence in the integration of dental and medical care. The chapter provides an extensive list of research needed to further our understanding of the impact of oral health literacy on health disparities and the health of the population.
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Affiliation(s)
- Alice M Horowitz
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park
| | - Dushanka V Kleinman
- Department of Epidemiology and Biostatistics & School of Public Health, University of Maryland College Park
| | - Kathryn A Atchison
- UCLA School of Dentistry and Fielding School of Public Health, Los Angeles, CA
| | - Jane A Weintraub
- University of North Carolina at Chapel Hill Adams School of Dentistry
| | - R Gary Rozier
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract
Objectives: In this study, we explored what Maryland obstetric (OB) residents and certified nurse-midwives (CNMs) know, understand, and counsel pregnant women about oral health. We also examined the frequency with which they refer patients to dentists and their perspectives on barriers to prenatal dental care. Methods: This qualitative descriptive study used one-on-one phone interviews to identify providers' perspectives about the need for prenatal dental care, reasons low-income pregnant women do not receive care, and recommendations for increasing dental care. We interviewed 32 providers between June 2017 and March 2018. Results: Most providers were unaware of the importance of and need for prenatal dental care. Most did not discuss dental care with their patients and some admitted being inadequately trained to do so. Both provider groups were positive about actions they could take to increase pregnant patients' dental care-seeking. Conclusions: For OB residents and CNMs to play an important role in improving pregnant patients' oral health they must have adequate oral health literacy, receive appropriate training in medical and nursing school, possess oral health educational materials for their patients, and have a list of dental providers who accept their insurance.
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Affiliation(s)
- Alice M. Horowitz
- Alice M. Horowitz, Research Associate Professor, University of Maryland School of Public Health, College Park, MD;,
| | | | - Catherine Maybury
- Catherine Maybury, Faculty Research Assistant, University of Maryland School of Public Health, College Park, MD
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Thomas SB, Passmore SR, Jackson DN, Horowitz AM, Casper E, Nalls J, Kleinman DV. The 2014 Mid-Maryland Mission of Mercy Dental Clinic: Building Community Capacity and Complementing Public Policy. Am J Public Health 2019; 107:S74-S76. [PMID: 28661815 DOI: 10.2105/ajph.2017.303702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Stephen B Thomas
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
| | - Susan R Passmore
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
| | - Devlon N Jackson
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
| | - Alice M Horowitz
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
| | - Erica Casper
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
| | - James Nalls
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
| | - Dushanka V Kleinman
- Stephen B. Thomas and Susan R. Passmore are with the Department of Health Services Administration and the Center for Health Equity, University of Maryland, College Park. Devlon N. Jackson and Erica Casper are with the Center for Health Equity, University of Maryland. Alice M. Horowitz is with the Department of Behavioral and Community Health, University of Maryland. James Nalls is with Catholic Charities of the Archdiocese of Washington, Washington, DC. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatistics, University of Maryland
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Maybury C, Horowitz AM, La Touche-Howard S, Child W, Battanni K, Qi Wang M. Oral Health Literacy and Dental Care among Low-Income Pregnant Women. Am J Health Behav 2019; 43:556-568. [PMID: 31046886 DOI: 10.5993/ajhb.43.3.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: In this study, we sought to determine the impact of oral health literacy (OHL) on use of prenatal dental care and knowledge, understanding, and practices related to preventing dental caries (tooth decay) among low-income pregnant women in Maryland. Methods: We conducted a mixed methods study using a survey and a structured guide for one-on-one interviews or focus groups. The study included 117 pregnant women and was conducted between July 2016 and April 2018 in Maryland. Results: Respondents had a low level of OHL. Maryland Medicaid covers prenatal dental care, but only 53% of participants reported seeing a dentist during their pregnancy. Most women were unaware of the Medicaid dental program for pregnant women and the importance of prenatal dental care. They could not afford care if there was an associated cost and had difficulty finding a Medicaid dental provider. Importantly, they lacked understanding of how to prevent caries and did not practice behaviors to prevent this disease. Conclusions: To decrease caries rates, policies and programs must be implemented to increase the OHL of low-income pregnant women because the OHL of caregivers is associated with their children's oral health status.
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Bress LE, Horowitz AM, Capobianco DM, Fleming DE, Kleinman DV. Assessing Dental Hygiene Students' and Community Caregivers' Knowledge of Strategies for Caries Prevention. J Dent Educ 2019; 83:351-358. [PMID: 30692188 DOI: 10.21815/jde.019.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/30/2018] [Indexed: 11/20/2022]
Abstract
With dental caries being a common chronic disease in children and adults, oral health literacy is needed to improve oral health and prevent caries. If oral health providers themselves are confused about preventive strategies, they cannot effectively educate the public or other health care providers. The aim of this study was to assess University of Maryland dental hygiene students' understanding of and ability to communicate caries preventive strategies to low-income populations during a community service-learning program in 2013 and 2014. Fifty baccalaureate degree dental hygiene students were asked to complete surveys before and after receiving a presentation on caries preventive strategies and after an outreach event, and 77 low-income caregivers were asked to complete surveys before and after receiving oral health education from the students. The key knowledge question on all surveys asked respondents to select the "single best way to prevent tooth decay" (i.e., provide caries prevention) from a list that included the following items: limit sweets, going to the dentist, brushing teeth, using fluoride toothpaste, flossing, drinking fluoridated water, fluoride varnish, and sealants. Of the 50 students, 41 completed all three surveys, for a response rate of 82%; all 77 caregivers (100%) completed the survey before the counseling session, and 37 (48%) completed the survey afterwards. While the results showed a significant knowledge increase for the students that drinking fluoridated water is the best caries prevention strategy, only 44% of them correctly ranked that option first even on the final survey, and only 8% of the caregivers ranked that option first even after counseling. These results suggested that neither the students nor the caregivers understood the benefits of community water fluoridation (CWF), even after the interventions. In spite of their low knowledge scores, it was encouraging that 86-92% of the caregivers reported that the students demonstrated respect for them and spent an appropriate amount of time with them and that they understood the information the students communicated. In discussions after the surveys, the students reported that they had received inconsistent messages from faculty members regarding the benefits of CWF, which resulted in their confusion. These results led the authors to revise their program's instruction to increase the students' knowledge of caries prevention strategies.
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Affiliation(s)
- Lisa E Bress
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health.
| | - Alice M Horowitz
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
| | - Diana M Capobianco
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
| | - Deborah E Fleming
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
| | - Dushanka V Kleinman
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
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Jackson DN, Passmore S, Fryer CS, Chen J, Kleinman DV, Horowitz AM, Butler J, Garza MA, Quinn SC, Thomas SB. Mission of Mercy emergency dental clinics: an opportunity to promote general and oral health. BMC Public Health 2018; 18:878. [PMID: 30005660 PMCID: PMC6045818 DOI: 10.1186/s12889-018-5792-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 07/04/2018] [Indexed: 12/27/2022] Open
Abstract
Background Mission of Mercy (MOM) emergency dental clinics are a resource for populations lacking access to dental care. We designed a MOM event incorporating health equity components with established community partners who shared a common vision of addressing the oral health, physical health, and social service needs of Maryland and Washington, DC area residents. Although studies have explored associations between oral and chronic health conditions, few studies to our knowledge have examined the relationship between these conditions and receipt of dental services. Therefore, this study explored these associations and the opportunity for better care coordination. Methods Oral health data from the 2014 Mid-Maryland Mission of Mercy and Health Equity Festival event was analyzed. A descriptive analysis assessed frequencies and percentages of participant sociodemographics characteristics, oral health and chronic disease risk(s), and dental services delivered. Chi-square tests and multivariate logistic regression were conducted to determine the associations between 1) oral health and chronic disease risk(s) and dental services; and 2) oral health and chronic disease risk(s) and participant characteristics. Results Approximately 66.2% (n = 666) of the 1007 participants had one or more chronic conditions and/or risk factors (diabetes, high blood pressure, and tobacco use). These individuals had a significantly higher likelihood of receiving an oral surgery procedure (specifically, tooth extraction) (only one condition/risk: OR = 2.40, 95%, CI = 1.48–3.90, p < .001; two conditions/risks: OR = 3.12, 95% CI = 1.78–5.46, p < .001). Conclusion The 2014 Mid-Maryland Mission of Mercy emergency dental clinic attracted people with risk factors for oral and chronic diseases. Those with one or more risk factors were more likely to receive oral surgery (specifically, tooth extraction). These findings strongly suggest that organizers of MOM emergency dental clinics include wrap-around primary care, health promotion and disease prevention services along with provision of dental services. While such events will not solve the general and oral health challenges of participants, we believe they provide an opportunity to provide basic preventive services. These findings also present an opportunity to inform planning for future MOMs and emphasize the importance of using these public health events to create linkages with other services to support follow-up and care coordination.
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Affiliation(s)
- Devlon N Jackson
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.
| | - Susan Passmore
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Health Services Administration, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Craig S Fryer
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Jie Chen
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Health Services Administration, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Dushanka V Kleinman
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Center for Health Literacy, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Alice M Horowitz
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - James Butler
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Mary A Garza
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Sandra C Quinn
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Family Science, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
| | - Stephen B Thomas
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA.,Department of Health Services Administration, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD, USA
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Thompson EL, Daley EM, Vamos CA, Horowitz AM, Catalanotto FA, DeBate RD, Merrell LK, Griner SB, Vazquez-Otero C, Kline NS. Health Literacy Approaches to Improving Communication between Dental Hygienists and Patients for HPV-Related Oral Cancer Prevention. J Dent Hyg 2017; 91:37-45. [PMID: 29118082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/30/2017] [Indexed: 06/07/2023]
Abstract
Purpose: Human Papillomavirus (HPV) has been identified as a causal agent for oropharyngeal cancers, suggesting a new role for dental hygienists in HPV-related cancer prevention strategies. Health literacy assessment is an approach that can be used to understand providers' informational assets and needs for educating and discussing HPV prevention with patients. This study aimed to understand dental hygienists' level of health literacy regarding HPV-related oropharyngeal cancers.Methods: Four focus group sessions with dental hygienists (n=48) were conducted at a national conference. The constant comparison method, with a priori codes for health literacy competencies (i.e., access/understand/appraise/apply), was utilized for this qualitative study.Results: Participants mentioned a variety of modes (e.g., magazines, journals) for accessing HPV-information; however, descriptions of understanding HPV and its relationship to oropharyngeal cancer varied. Participants considered patients' personal characteristics, the dental practice environment, and professional factors to appraise HPV-related information. Additionally, participants self-described themselves as being "prevention specialists." These factors influenced how dental hygienists applied primary and secondary prevention of HPV-related care issues with their patients (e.g., education and oral-cancer screenings).Conclusions: Dental hygienists recognized the importance of HPV and oropharyngeal cancer prevention efforts, including oral-cancer screenings and promotion of the HPV vaccine. The study findings identified opportunities for intervention focusing on primary prevention.
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Horowitz AM, Kleinman DV, Child W, Radice SD, Maybury C. Perceptions of Dental Hygienists and Dentists about Preventing Early Childhood Caries: A Qualitative Study. J Dent Hyg 2017; 91:29-36. [PMID: 29118081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 03/08/2017] [Indexed: 06/07/2023]
Abstract
Purpose: The objective of this qualitative pilot study was to gain an in-depth understanding of dental hygienists and dentists perspectives regarding children's oral health and what needs to be done to prevent early childhood caries (ECC), the most frequent chronic disease of childhood.Methods: A skilled facilitator conducted four focus groups and four phone interviews with 20 dental hygienists and 17 dentists practicing in a variety of locations within the state of Maryland. The interview guide was based on results from previous state-wide surveys of dental hygienists and dentists. Sessions were recorded, transcribed, and reviewed by the PI and facilitator. Qualitative content analysis was used to identify and manually code themes.Results: Focus groups and interviews provided rich and insightful information for strategies to help solve the ECC problem in Maryland, which supplemented the earlier quantitative mail survey data. Three key themes emerged: challenges to preventing ECC among low-income families; necessary educational methods and practices; and, the need for inter-professional collaboration. Discussions focused on issues related to educating parents with low oral health literacy about how to prevent ECC and the value of including non-dental health care providers, such as pediatricians and school nurses, in the caries prevention process.Conclusions: Current approaches to educating low-income adults about caries prevention are insufficient to prevent ECC and dental care providers cannot accomplish this goal alone. Ensuring that all dental care providers have a science-based understanding of caries prevention is critical. Integrating science-based oral health preventive care into medical and nursing undergraduate programs could increase providers' knowledge and confidence towards incorporating oral health into patient care plans; improve the oral health literacy of providers and patients; and improve patient oral health outcomes.
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Allukian M, Carter-Pokras OD, Gooch BF, Horowitz AM, Iida H, Jacob M, Kleinman DV, Kumar J, Maas WR, Pollick H, Rozier RG. Science, Politics, and Communication: The Case of Community Water Fluoridation in the US. Ann Epidemiol 2017. [PMID: 28648551 DOI: 10.1016/j.annepidem.2017.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Community water fluoridation (CWF) and its effect in reducing the burden of dental caries (tooth decay) is considered one of the 10 public health achievements in the 20th century. In the U.S., three-quarters (74.4%) of people on community water supplies have optimally fluoridated water, and each year approximately 90 communities actively consider starting or discontinuing CWF. CWF exists within the policy environment and includes actions taken by local community councils, health and water boards, and groups; state legislatures and health departments; national regulatory and science agencies; independent science entities; and professional and nonprofit organizations. Epidemiologists have been in the forefront of CWF. Experience with the past 70 years reveals that the coming decades will bring additional questions, recommendations, and challenges for CWF. The continued involvement of epidemiologists as part of multidisciplinary teams is needed in research, surveillance, peer review of studies, assessment of systematic review findings, and in the translation and communication of science findings to audiences with limited science/health literacy. This chapter's purpose is to 1) examine how epidemiologic evidence regarding CWF has been translated into practice and policy, 2) examine how recommendations for and challenges to CWF have affected epidemiologic research and community decision-making, and 3) identify lessons learned for epidemiologists.
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Affiliation(s)
- Myron Allukian
- President, Massachusetts Coalition for Oral Health, Boston, MA
| | - Olivia D Carter-Pokras
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
| | | | - Alice M Horowitz
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD
| | - Hiroko Iida
- New York State Oral Health Center of Excellence, Rochester, NY
| | - Matt Jacob
- Children's Dental Health Project, Washington, DC
| | - Dushanka V Kleinman
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD.
| | - Jayanth Kumar
- Oral Health Program, California Department of Public Health, Sacramento, CA
| | - William R Maas
- University of Maryland School of Dentistry, Baltimore, MD
| | - Howard Pollick
- Department of Preventive & Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA
| | - R Gary Rozier
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
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Abstract
A questionnaire was mailed to 800 Maryland general practice dentists to assess their knowledge of risk factors and diagnostic procedures for oral cancer. Two indices were created based on 14 questions on knowledge of oral cancer risk factors and 9 questions on oral cancer diagnostic procedures. Data were analyzed statistically and evaluated with an alpha level of 0.05. Nearly all respondents identified use of tobacco, prior oral cancer lesions, and use of alcohol as risk factors. However, only 36% correctly identified that poor-fitting dentures are not a risk factor and 58% that poor oral hygiene is not a risk factor. Nearly 87% knew how to examine the tongue and surrounding areas, and 32% identified erythroplakia and leukoplakia as conditions associated with oral cancer. Appropriate knowledge about risk factors and diagnostic procedures is essential for dentists to counsel their patients and perform appropriate oral cancer examinations.
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Koo LW, Horowitz AM, Radice SD, Wang MQ, Kleinman DV. Nurse Practitioners' Use of Communication Techniques: Results of a Maryland Oral Health Literacy Survey. PLoS One 2016; 11:e0146545. [PMID: 26766557 PMCID: PMC4713077 DOI: 10.1371/journal.pone.0146545] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/19/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives We examined nurse practitioners’ use and opinions of recommended communication techniques for the promotion of oral health as part of a Maryland state-wide oral health literacy assessment. Use of recommended health-literate and patient-centered communication techniques have demonstrated improved health outcomes. Methods A 27-item self-report survey, containing 17 communication technique items, across 5 domains, was mailed to 1,410 licensed nurse practitioners (NPs) in Maryland in 2010. Use of communication techniques and opinions about their effectiveness were analyzed using descriptive statistics. General linear models explored provider and practice characteristics to predict differences in the total number and the mean number of communication techniques routinely used in a week. Results More than 80% of NPs (N = 194) routinely used 3 of the 7 basic communication techniques: simple language, limiting teaching to 2–3 concepts, and speaking slowly. More than 75% of respondents believed that 6 of the 7 basic communication techniques are effective. Sociodemographic provider characteristics and practice characteristics were not significant predictors of the mean number or the total number of communication techniques routinely used by NPs in a week. Potential predictors for using more of the 7 basic communication techniques, demonstrating significance in one general linear model each, were: assessing the office for user-friendliness and ever taking a communication course in addition to nursing school. Conclusions NPs in Maryland self-reported routinely using some recommended health-literate communication techniques, with belief in their effectiveness. Our findings suggest that NPs who had assessed the office for patient-friendliness or who had taken a communication course beyond their initial education may be predictors for using more of the 7 basic communication techniques. These self-reported findings should be validated with observational studies. Graduate and continuing education for NPs should increase emphasis on health-literate and patient-centered communication techniques to increase patient understanding of dental caries prevention. Non-dental healthcare providers, such as NPs, are uniquely positioned to contribute to preventing early childhood dental caries through health-literate and patient-centered communication.
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Affiliation(s)
- Laura W. Koo
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States of America
- * E-mail:
| | - Alice M. Horowitz
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, MD, United States of America
| | - Sarah D. Radice
- Office of the Dean, School of Public Health, University of Maryland College Park, College Park, MD, United States of America
| | - Min Q. Wang
- Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, MD, United States of America
| | - Dushanka V. Kleinman
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland College Park, College Park, MD, United States of America
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Weatherspoon DJ, Horowitz AM, Kleinman DV. Maryland Physicians' Knowledge, Opinions, and Practices Related to Dental Caries Etiology and Prevention in Children. Pediatr Dent 2016; 38:61-67. [PMID: 26892217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE The purpose of this study was to assess Maryland physicians' knowledge and understanding of dental caries etiology and prevention, opinions related to prevention effectiveness, and their prevention practices. METHODS In 2010, a 30-item, self-administered survey questionnaire was mailed to a random sample of 1,472 Maryland family physicians and pediatricians, with 294 surveys being returned and usable, yielding a 20 percent return rate. Statistical analyses in this descriptive study included distributions and cross-tabulations for the survey responses. RESULTS Thirty-five percent of family physicians and 45 percent of pediatricians indicated they provide caries prevention education to their patients. Approximately half of the physicians reported performing some type of caries risk assessment. Out of 10 dental caries knowledge questions, there was not a single question that the majority of physicians answered correctly with certainty. Nine percent of family physicians and 12 percent of pediatricians reported they provided fluoride varnish treatment to their three- to six-year-old patients at the time of this survey. CONCLUSIONS This study identified specific areas, related to Maryland physicians' dental caries etiology and prevention knowledge, that continuing education and training programs could enhance.
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Affiliation(s)
- Darien J Weatherspoon
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill., USA.
| | - Alice M Horowitz
- School of Public Health, University of Maryland, College Park, Md., USA
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Weatherspoon DJ, Horowitz AM, Kleinman DV, Wang MQ. The use of recommended communication techniques by Maryland family physicians and pediatricians. PLoS One 2015; 10:e0119855. [PMID: 25856371 PMCID: PMC4391842 DOI: 10.1371/journal.pone.0119855] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/16/2015] [Indexed: 11/21/2022] Open
Abstract
Background Health literacy experts and the American Medical Association have developed recommended communication techniques for healthcare providers given that effective communication has been shown to greatly improve health outcomes. The purpose of this study was to determine the number and types of communication techniques routinely used by Maryland physicians. Methods In 2010, a 30-item survey was mailed to a random sample of 1,472 Maryland family physicians and pediatricians, with 294 surveys being returned and usable. The survey contained questions about provider and practice characteristics, and 17 items related to communication techniques, including seven basic communication techniques. Physicians’ use of recommended communication techniques was analyzed using descriptive statistics, analysis of variance, and ordinary least squares regression. Results Family physicians routinely used an average of 6.6 of the 17 total techniques and 3.3 of the seven basic techniques, whereas pediatricians routinely used 6.4 and 3.2 techniques, respectively. The use of simple language was the only technique that nearly all physicians routinely utilized (Family physicians, 91%; Pediatricians, 93%). Physicians who had taken a communications course used significantly more techniques than those who had not. Physicians with a low percentage of patients on Medicaid were significantly less likely to use the recommended communication techniques compared to those providers who had high proportion of their patient population on Medicaid. Conclusions Overall, the use of recommended communication techniques was low. Additionally, many physicians were unsure of the effectiveness of several of the recommended techniques, which could suggest that physicians are unaware of valuable skills that could enhance their communication. The findings of this study suggest that communications training should be given a higher priority in the medical training process in the United States.
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Affiliation(s)
- Darien J. Weatherspoon
- University of Illinois at Chicago, College of Dentistry, Department of Pediatric Dentistry, Chicago, Illinois, United States of America
- * E-mail:
| | - Alice M. Horowitz
- University of Maryland, School of Public Health, College Park, Maryland, United States of America
| | - Dushanka V. Kleinman
- University of Maryland, School of Public Health, College Park, Maryland, United States of America
| | - Min Qi Wang
- University of Maryland, School of Public Health, College Park, Maryland, United States of America
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Abstract
OBJECTIVES We obtained in-depth information from low-income parents and caregivers of young children about their knowledge and understanding of and practices related to the prevention and control of dental caries (tooth decay). METHODS In 2010, we conducted 4 focus groups in Maryland communities with low-income, English-speaking parents and caregivers who had at least 1 child aged 6 years or younger or who were pregnant. We developed a focus group guide based on findings of a previous statewide random telephone survey of adults with young children. RESULTS Most participants had limited understanding of and extensive misinformation about how to prevent dental caries. They were confused about the use of juice and its impact on their child's teeth and had limited understanding of the use of fluorides to prevent caries. Most did not drink tap water and did not give it to their children; rather, they used bottled water. CONCLUSIONS These results and those of the statewide telephone survey strongly suggest the need for educational interventions designed for those with limited levels of education.
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Affiliation(s)
- Alice M Horowitz
- Alice M. Horowitz is with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatics, School of Public Health, University of Maryland. Wendy Child is an independent consultant, College Park, Maryland. Catherine Maybury is with the Office of the Dean, School of Public Health, University of Maryland
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Smith W, Brach C, Horowitz AM. Poor oral health literacy: why nobody understands you. J Dent Hyg 2015; 89 Suppl 1:36-38. [PMID: 25691025 PMCID: PMC5102013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Horowitz AM, Robinson LA, Ng MW, Archarya A. After Visit Summaries: A Tool Whose Time Has Come for Use in Dentistry. NAM Perspect 2014. [DOI: 10.31478/201407b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Horowitz AM, Maybury C, Kleinman DV, Radice SD, Wang MQ, Child W, Rudd RE. Health literacy environmental scans of community-based dental clinics in Maryland. Am J Public Health 2014; 104:e85-93. [PMID: 24922128 DOI: 10.2105/ajph.2014.302036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We conducted health literacy environmental scans in 26 Maryland community-based dental clinics to identify institutional characteristics and provider practices that affect dental services access and dental caries education. METHODS In 2011-2012 we assessed user friendliness of the clinics including accessibility, signage, facility navigation, educational materials, and patient forms. We interviewed patients and surveyed dental providers about their knowledge and use of communication techniques. RESULTS Of 32 clinics, 26 participated. Implementation of the health literacy environmental scan tools was acceptable to the dental directors and provided clinic directors with information to enhance care and outreach. We found considerable variation among clinic facilities, operations, and content of educational materials. There was less variation in types of insurance accepted, no-show rates, methods of communicating with patients, and electronic health records use. Providers who had taken a communication skills course were more likely than those who had not to use recommended communication techniques. CONCLUSIONS Our findings provide insight into the use of health literacy environmental scan tools to identify clinic and provider characteristics and practices that can be used to make dental environments more user friendly and health literate.
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Affiliation(s)
- Alice M Horowitz
- Alice M. Horowitz and Min Qi Wang are with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatics, School of Public Health, University of Maryland, College Park. Catherine Maybury and Sarah D. Radice are with the Office of the Dean, School of Public Health, University of Maryland, College Park. Wendy Child is an independent consultant, College Park, MD. Rima E. Rudd is with the Department of Social and Behavioral Science, Harvard School of Public Health, Harvard University, Boston, MA
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Horowitz AM, Clovis JC, Wang MQ, Kleinman DV. Use of recommended communication techniques by Maryland dental hygienists. J Dent Hyg 2013; 87:212-223. [PMID: 23986414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The purpose of this study was to determine dental hygienists' use of recommended techniques to communicate science-based information for intervention and prevention of oral disease. METHODS A 30-item survey containing 18 communication techniques representing 5 domains including 7 basic skills were mailed to a random sample of 1,258 Maryland dental hygienists to determine their use of recommended communication techniques. RESULTS The response rate was 43% (n = 540). Nearly all were females (98%) and 58% practiced in solo settings. About half of respondents used 6 of the 18 techniques routinely. Approximately three-quarters of respondents reported they rarely or never used 3 of the 7 basic recommended techniques. Only one basic technique (use of simple language) was used by over 90%. Respondents who had taken a communications course other than in dental hygiene school were significantly more likely to use communication techniques on a routine basis than those who had not (p < 0.01). CONCLUSION Dental hygienists and their patients would benefit from using the recommended communication tools and techniques to address individual patient needs. To improve oral health outcomes, dental hygiene education must strengthen health literacy knowledge and communication skills in dental hygiene education programs and through continuing education courses for practicing hygienists.
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Abstract
OBJECTIVES We sought to determine Maryland adults' knowledge, understanding, opinions, and practices with respect to prevention and early detection of dental caries. METHODS We conducted a statewide random-digit-dialing, computer-assisted telephone survey in 2010 among 770 adults who had a child aged 6 years or younger living in their home. A traditional random-digit sample and a targeted low-income sample were included. Analyses included frequencies, percentages, the χ(2) test, and multivariate logistic regression. RESULTS Respondents' overall level of knowledge about preventing dental caries was low. Those with higher levels of education were more likely to have correct information regarding prevention and early detection of dental caries. Nearly all respondents (97.9%) reported that they were aware of fluoride, but only 57.8% knew its purpose. More than one third (35.1%) of the respondents were not aware of dental sealants. Those with lower levels of education were significantly less likely to drink tap water, as were their children, and significantly less likely to have had a dental appointment in the preceding past 12 months. CONCLUSIONS Our results demonstrate the need to increase oral health literacy regarding caries prevention and early detection.
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Affiliation(s)
- Alice M Horowitz
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA.
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Clovis JB, Horowitz AM, Kleinman DV, Wang MQ, Massey M. Maryland dental hygienists' knowledge, opinions and practices regarding dental caries prevention and early detection. J Dent Hyg 2012; 86:292-305. [PMID: 23168104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of this study was to assess Maryland dental hygienists' knowledge, practices and opinions regarding dental caries prevention and early detection. METHODS A 30 item survey was mailed to 1,258 Maryland dental hygienists. Two follow-up mailings and email reminders were sent. RESULTS The response rate was 43% (n=540). Nearly all respondents were female (98%), and 58% practiced in solo settings. Knowledge and certainty of knowledge were moderate: sealants are needed regardless of topical fluoride use (55% certain, 40% less certain), newly erupted permanent molars are the best candidates for sealants (54%, 36%) and professionally applied fluorides are desirable in areas without fluoridated water (55%, 36%). Fewer were certain that incipient lesions can be remineralized before cavitation (23%, 69%), and dilute, frequently administered fluorides are more effective in caries prevention than concentrated, less frequently administered fluorides (6%, 24%). Opinions regarding effectiveness of protocols for 2 age groups from 6 months to 6 years, the challenges of early childhood caries (ECC), prevention practices regarding sealant and topical fluoride applications varied widely. Eighty-nine percent reported routinely assessing dental caries risk factors of child patients and 90% were interested in continuing education courses. There were no significant differences between different types of practice settings, year of graduation, race/ethnicity or gender. CONCLUSION Knowledge of recommended guidelines for fluoride and sealant application support clinical decision-making and self-care counseling. Misinformation and lack of understanding of current research and recommendations identify a need for educational interventions in undergraduate dental hygiene programs and through continuing education for practicing hygienists.
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Affiliation(s)
- Joanne B Clovis
- School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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Abstract
Communication practices of dental care providers are especially important to provider-patient and provider-caregiver communication because most patients report that they obtain oral health information from their dentist. The purpose of this study was to determine the perceptions of English-speaking Maryland adults who had a child 6 years and younger in the home about the communication practices of their dentists and staff. Five questions from the Consumer Assessment of Healthcare Providers and Systems survey were included in a random digit dial telephone survey administered in March and April 2010. A total of 803 surveys were completed with adults 18-65 years of age who had a child in their home 6 years of age and younger. Land and cell phones were used. The analysis included frequencies, percentages, chi-square tests, and multivariate logistic regression. The response rate was 24%. Overall, those with higher levels of education and women were more likely to respond favorably about the communication practices of their dentist and staff. Respondents whose child was insured with Medicaid/State Children's Health Insurance Program (SCHIP) were less likely to respond favorably. Medicaid/SCHIP recipients are the individuals with the greatest dental disease and in need of preventive information and regimens for themselves and for their children. Spending time with patients and providing them with accurate information in a manner that patients feel respected and listened to contributes to the patient's ability to understand and act upon this information. Thus, these communication practices are pivotal to increasing oral health literacy and decreasing dental disparities.
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Affiliation(s)
- Alice M Horowitz
- School of Public Health, University of Maryland, College Park, Maryland 20742, USA.
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Parker EJ, Misan G, Chong A, Mills H, Roberts-Thomson K, Horowitz AM, Jamieson LM. An oral health literacy intervention for Indigenous adults in a rural setting in Australia. BMC Public Health 2012; 12:461. [PMID: 22716205 PMCID: PMC3416720 DOI: 10.1186/1471-2458-12-461] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 06/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous Australians suffer substantially poorer oral health than their non-Indigenous counterparts and new approaches are needed to address these disparities. Previous work in Port Augusta, South Australia, a regional town with a large Indigenous community, revealed associations between low oral health literacy scores and self-reported oral health outcomes. This study aims to determine if implementation of a functional, context-specific oral health literacy intervention improves oral health literacy-related outcomes measured by use of dental services, and assessment of oral health knowledge, oral health self-care and oral health- related self-efficacy. METHODS/DESIGN This is a randomised controlled trial (RCT) that utilises a delayed intervention design. Participants are Indigenous adults, aged 18 years and older, who plan to reside in Port Augusta or a nearby community for the next two years. The intervention group will receive the intervention from the outset of the study while the control group will be offered the intervention 12 months following their enrollment in the study. The intervention consists of a series of five culturally sensitive, oral health education workshops delivered over a 12 month period by Indigenous project officers. Workshops consist of presentations, hands-on activities, interactive displays, group discussions and role plays. The themes addressed in the workshops are underpinned by oral health literacy concepts, and incorporate oral health-related self-efficacy, oral health-related fatalism, oral health knowledge, access to dental care and rights and entitlements as a patient. Data will be collected through a self-report questionnaire at baseline, at 12 months and at 24 months. The primary outcome measure is oral health literacy. Secondary outcome measures include oral health knowledge, oral health self-care, use of dental services, oral health-related self-efficacy and oral health-related fatalism. DISCUSSION This study uses a functional, context-specific oral health literacy intervention to improve oral health literacy-related outcomes amongst rural-dwelling Indigenous adults. Outcomes of this study will have implications for policy and planning by providing evidence for the effectiveness of such interventions as well as provide a model for working with Indigenous communities.
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Affiliation(s)
- Eleanor J Parker
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia, 5005
| | - Gary Misan
- University of South Australia, Whyalla campus, Whyalla, Australia
| | - Alwin Chong
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Helen Mills
- University of South Australia, Whyalla campus, Whyalla, Australia
| | - Kaye Roberts-Thomson
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia, 5005
| | - Alice M Horowitz
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia, 5005
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Horowitz AM. Rubber Cup Dental Prophylaxis is Not Needed Prior to the Topical Application of Fluorides and Rubber Cup Dental Prophylaxis at Recall is Not Effective in the Prevention of Gingivitis. J Evid Based Dent Pract 2012; 12:77-8. [DOI: 10.1016/j.jebdp.2012.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Oral health literacy is a relatively new but critical concept in our efforts to decrease disparities and increase oral health for all Marylanders. Oral health literacy is important because low health literacy contributes to disease which results in increased costs for all of us. Those with low health literacy are usually at highest risk for oral diseases and problems. These individuals include the poor, those with low levels of education, minorities, and the elderly. Prompted by the untimely demise of Deamonte Driver, Maryland has taken the lead in developing a statewide approach to improving oral health literacy with the ultimate objective of reducing disparities.
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Affiliation(s)
- Alice M Horowitz
- School of Public Health, University of Maryland, College Park, MD, USA.
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Abstract
A high oral cancer mortality rate and a moderately high oral cancer incidence rate prompted Maryland to develop a statewide approach to oral cancer early detection and prevention. This approach can serve as a model for other states. Key lessons learned include the need to: develop a comprehensive plan that focuses on actions to increase awareness, education and training for the public, dental and non-dental providers and policy makers; include oral cancer in the state's comprehensive cancer control plan to keep attention focused on this disease; and maintain high vigilance among stakeholders to keep oral cancer prevention and early detection a high priority within the state. Future efforts will focus on: requiring all dental and dental hygiene students to perform a set number of supervised oral cancer examinations for licensure to ensure a dental workforce that is competent and predisposed to providing routine oral cancer examinations; training health care providers such as doctors, nurse practitioners, and physician assistants to perform oral cancer examinations as part of a comprehensive cancer screening exam to expand the number of individuals that receive oral cancer examinations; and continuing to educate the public about oral cancer risk factors, its symptoms, and ways to prevent it.
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Horowitz AM, Kleinman DV. Creating a health literacy-based practice. J Calif Dent Assoc 2012; 40:331-340. [PMID: 22679673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The California Dental Association has taken the lead to improve the oral health literacy of its residents, and dental practices play an essential role toward this end. The communication skills of the dental team are essential to increasing oral health skills of Californians. The purpose of this article is to provide suggestions and recommendations for creating and maintaining health literacy-based practices in private practice, public clinics, and dental schools.
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Affiliation(s)
- Alice M Horowitz
- Herschel S. Horowitz Center for Health Literacy, School of Public Health, University of Maryland, College Park, MD 20742, USA
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Braun B, Horowitz AM, Kleinman DV, Gold RS, Radice SD, Maybury C. Oral health literacy: at the intersection of K-12 education and public health. J Calif Dent Assoc 2012; 40:323-330. [PMID: 22679672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The link between a student's health and their ability to learn is well-established. Schools are the intersection of public health programs, dental care, and self-care. This position affords them a unique role and opportunity to enhance health literacy, including oral health literacy. This paper explores the potential of K-12 school programs and the dental profession to address oral health literacy, and, in so doing, provide future participants with essential skills to promote their oral health.
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Affiliation(s)
- Bonnie Braun
- Department of Family Science and Faculty Scholar, Herschel S. Horowitz Centerfor Health Literacy, School of Public Health, University of Maryland College Park, MD 20742, USA
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Maybury C, Horowitz AM, Yan AF, Green KM, Wang MQ. Maryland dentists' knowledge of oral cancer prevention and early detection. J Calif Dent Assoc 2012; 40:341-350. [PMID: 22679674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
To reduce the morbidity and mortality associated with oral cancers, dentists must have accurate knowledge and skills to detect and diagnose oral cancers at early stages. The authors' study found gaps in dentists' knowledge of risk factors and procedures for diagnosing oral cancers. Increasing health literacy for oral cancers among dental professionals may lead to increased health literacy for oral cancers among the public because dental professionals are a key source of oral health information for the public.
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Affiliation(s)
- Catherine Maybury
- Herschel S. Horowitz Center for Health Literacy, School of Public Health, University of Maryland, College Park, MD 20742, USA
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Horowitz AM, Child WL. Design considerations for qualitative research: getting at strawberry milk. J Dent Hyg 2012; 86:30-31. [PMID: 22309929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Buerlein JK, Horowitz AM, Child WL. Perspectives of Maryland women regarding oral health during pregnancy and early childhood. J Public Health Dent 2011; 71:131-5. [DOI: 10.1111/j.1752-7325.2010.00211.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Horowitz AM. The role of health literacy in reducing health disparities. J Dent Hyg 2009; 83:182-183. [PMID: 19909638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Davis JR, Horowitz AM. Response of the rabbit isolated testicular capsule at hypothermic and hyperthermic temperatures to norepinephrine, acetylcholine and prostaglandin F2 alpha. Andrologia 2009; 11:453-60. [PMID: 532985 DOI: 10.1111/j.1439-0272.1979.tb02238.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Spontaneous contractions of the adult rabbit isolated testicular capsule were found to be influenced by moderate hyperthermic and hypothermic temperature changes. The decrease in testicular capsular spontaneous contractions resulting from an exposure to 32, 40 and 42 degrees C have been shown to be influenced by the addition of NE, ACh and PGF2 alpha. Of the three neurohumoral agents studied, NE was found to cause the greatest increase and re-initiation of testicular capsular tone during both hypothermia and hyperthermia. These data indicate that endogenous levels of neurohumoral agents may play an important role in the maintenance of testicular capsular tone during exposure to hyperthermic or hypothermic conditions.
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Abstract
Effective communication with patients is the cornerstone of quality dental care and oral health outcomes. Oral health literacy skills are critical to empowering individuals' ability to improve their oral health. A large part of the American public has low health literacy skills. Low health literacy contributes to disease and is costly. Being able to understand health information and how to obtain services is critical to oral health management. The communication skills of the dental team are pivotal to increasing oral health literacy skills of Americans.
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Affiliation(s)
- Alice M Horowitz
- School of Public Health, University of Maryland, College Park, MD 20742, USA.
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Cannick GF, Horowitz AM, Garr DR, Reed SG, Neville BW, Day TA, Woolson RF, Lackland DT. Use of the OSCE to evaluate brief communication skills training for dental students. J Dent Educ 2007; 71:1203-9. [PMID: 17761627 PMCID: PMC2712283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Although communications competency is recommended by the American Dental Education Association, only a few (n=5) dental schools report evaluating students' skills using a competency examination for communication. This study used an objective structured clinical examination (OSCE) to evaluate dental students' competency in interpersonal and tobacco cessation communication skills. All students were evaluated on their interpersonal communication skills at baseline and at six months post-OSCE by standardized patients and on their tobacco cessation communication skills by two independent raters. First- and second-year dental students (n=104) were randomized to a control or intervention group. One month after the baseline OSCE, students in the intervention group participated in a two-hour training session in which faculty members communicated with a standardized patient during a head and neck examination and counseled the patient about tobacco cessation. There were no statistically significant differences from baseline to post-test between the intervention and control group students as measured by the OSCE. However, among first-year students, both the intervention (n=23) and control (n=21) groups significantly increased in tobacco cessation communication scores. Second-year students in both intervention (n=24) and control (n=28) groups declined in interpersonal communication skills from baseline to post-test. Overall, this one-shot intervention was not successful, and results suggest that a comprehensive communication skills training course may be more beneficial than a single, brief training session for improving dental students' communication skills.
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Cannick GF, Horowitz AM, Garr DR, Reed SG, Neville BW, Day TA, Woolson RF, Lackland DT. Use of the OSCE to Evaluate Brief Communication Skills Training for Dental Students. J Dent Educ 2007. [DOI: 10.1002/j.0022-0337.2007.71.9.tb04385.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Alice M. Horowitz
- College of Health and Human Performance; University of Maryland; College Park
| | - David R. Garr
- Department of Family Medicine; Medical University of South Carolina
| | - Susan G. Reed
- Division of Dental Public Health and Oral Epidemiology, Department of Stomatology; Medical University of South Carolina
| | - Brad W. Neville
- Division of Oral Pathology, Department of Stomatology; Medical University of South Carolina
| | - Terry A. Day
- Department of Otolaryngology; Medical University of South Carolina
| | - Robert F. Woolson
- Department of Biostatistics, Bioinformatics, and Epidemiology; Medical University of South Carolina
| | - Daniel T. Lackland
- Department of Biostatistics, Bioinformatics, and Epidemiology; Medical University of South Carolina
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Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, Eke PI, Beltrán-Aguilar ED, Horowitz AM, Li CH. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital Health Stat 11 2007:1-92. [PMID: 17633507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE This report presents national estimates and trends for a variety of oral health status measures for persons aged 2 years and older by sociodemographic and smoking status since the late 1980s in the United States. METHODS Data from the third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 and from the NHANES 1999-2004 were used. These data sources were designed to provide information on the health and nutritional status of the civilian noninstitutionalized population in the United States. Information from oral health examination methods common to both survey periods were used to present prevalence estimates and for trend analyses. Statistical significance of differences between common estimates from each survey period was evaluated using two-sided t-tests. RESULTS This report provides mean, percentile values, and standard errors for dental caries, dental sealants, incisal trauma, periodontal health, dental visits, perception of oral health status, tooth retention, and edentulism. Additional estimates for monitoring progress toward the Healthy People 2010 oral health objectives using NHANES source data are presented as well. CONCLUSIONS For most Americans, oral health status has improved between 1988-1994 and 1999-2004. For seniors, edentulism and periodontitis has declined; for adults, improvements were seen in dental caries prevalence, tooth retention, and periodontal health; for adolescents and youths, dental sealant prevalence has increased and dental caries have decreased; however, for youths aged 2-5 years, dental caries in primary teeth has increased.
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Affiliation(s)
- Bruce A Dye
- National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland 20782, USA
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Cannick GF, Horowitz AM, Garr DR, Reed SG, Neville BW, Day TA, Woolson RF, Lackland DT. Oral cancer prevention and early detection: using the PRECEDE-PROCEED framework to guide the training of health professional students. J Cancer Educ 2007; 22:250-253. [PMID: 18067438 DOI: 10.1007/bf03174125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Teaching cancer prevention and detection is important in health professional education. It is desirable to select a comprehensive framework for teaching oral cancer (OC) prevention and detection skills. METHODS The PRECEDE-PROCEED model was used to design a randomized pretest and posttest study of the OC prevention and detection skills of dental students (n = 104). OC knowledge, opinions, and competencies were evaluated. RESULTS Second year students in the intervention group were more competent than those in the control group. CONCLUSIONS The novel use of PRECEDE-PROCEED sets a precedent for designing a standardized OC curriculum for a wide range of health professional disciplines.
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Cannick GF, Lackland DT, Horowitz AM, Neville B, Garr DR, Woolson RF, Reed SG, Day TA. Use of Precede-Proceed to Develop a Cancer Prevention and Detection Curriculum. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s138-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVES Tobacco use accounts for 75 percent of oral cancer deaths in the United States. One objective of Healthy People 2010 is to increase the percentage of dentists who provide smoking cessation counseling. However, studies of dentists have shown that the majority feel inadequately prepared to do so. The objective of this study was to determine the opinions of dental students at the Medical University of South Carolina (MUSC) regarding the provision of tobacco use interventions for patients. METHODS In 2002, 163 students were administered a written questionnaire which included questions about tobacco use interventions (response rate=80 percent). Opinion items were analyzed using factor analysis, Fisher's Exact Test, and ANOVA (a < or = 0.025). RESULTS While 89 percent of students agreed that dentists should be trained to provide tobacco cessation education, only 39 percent thought that they themselves were adequately trained. Students' opinions toward the role and training of dentists in providing tobacco use interventions differed by academic year. Only 14.1 percent of dental students were quite or very confident in their ability to help patients to stop smoking. CONCLUSIONS This study indicates that although MUSC dental students support tobacco cessation training for dentists, the majority responded that they are not adequately trained and are not comfortable providing tobacco cessation education to patients. A comprehensive tobacco prevention and cessation program is indicated for the objective of Healthy People 2010 to be met.
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Affiliation(s)
- Gabrielle F Cannick
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892-6401, USA
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Affiliation(s)
- Rima E Rudd
- Department of Society, Human Development and Health, Harvard School of Public Health, USA
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Campbell D, Pollick HF, Lituri KM, Horowitz AM, Brown J, Janssen JA, Yoder K, Garcia RI, Deinard A, Hemphill S, de la Torre MA, Shrestha B, Vargas CM. Improving the oral health of Alaska natives. Am J Public Health 2005; 95:1880; author reply 1881. [PMID: 16195503 PMCID: PMC1449447 DOI: 10.2105/ajph.2005.074666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- Rima Rudd
- Human Development, and Health at the Harvard School of Public Health
| | - Alice M. Horowitz
- Population Research and Health Promotion Branch; Division of Clinical Research and Health Promotion; National Institute of Dental and Craniofacial Research; National Institutes of Health
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