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Interviews with policymakers in Australian health policy: Understanding the process of policy development 澳大利亚卫生政策决策者访谈:了解政策制定过程。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-24 DOI: 10.1111/jphd.12606
Kelsey Ingram BOH, Melanie J. Aley BOH, BHSc(Hons), MEd, PhD, Michelle Irving MHSciEd, PhD, Janet Wallace PhD, GCPTT, BOH, Dip DT, Dip BM, Hon FADI, Hon FICD, ADASA

Objective

To determine the barriers and enablers oral health and chronic disease policymakers identify during policy development.

Methods

Semi-structured interview questions were developed utilizing an interview guide and applying a knowledge mobilization framework. Reflective thematic analysis of the data was completed based on the research of Braun and Clarke encompassing a critical realist approach.

Results

Twelve policymakers were interviewed. Policymakers reported barriers to accessing evidence including the sheer volume of information and a lack of: research summaries, comprehensive oral health data sets, open access articles, consistency of reporting, and time. They did find relationships with experts and intermediaries crucial at times to policy development. Co-creation of research was also a key enabler for policymakers.

Conclusions

This study highlights that policymakers find evidence crucial during the development of policy and often use it to advocate for policies. However, the links between poor oral health; and cardiovascular disease, diabetes, and cognitive impairment are not well recognized among chronic disease policymakers. It is important that oral health researchers and policymakers work to close this gap. The treatment of poor oral health is a global population health issue. It is imperative that evidence of these links is implemented into health policy for the treatment and prevention of chronic diseases and improved quality of life for individuals living with chronic diseases.

目的确定口腔健康和慢性病政策制定者在政策制定过程中发现的障碍和促进因素:方法:利用访谈指南和知识动员框架制定了半结构式访谈问题。根据布劳恩(Braun)和克拉克(Clarke)的研究,采用批判现实主义方法对数据进行了反思性专题分析:对 12 位决策者进行了访谈。政策制定者报告了获取证据的障碍,包括信息量太大以及缺乏:研究摘要、全面的口腔健康数据集、开放存取的文章、报告的一致性以及时间。他们确实发现,与专家和中介机构的关系有时对政策制定至关重要。共同创造研究成果也是政策制定者的一个关键因素:本研究强调,政策制定者认为证据在政策制定过程中至关重要,并经常利用证据来宣传政策。然而,慢性病政策制定者并没有充分认识到不良口腔健康与心血管疾病、糖尿病和认知障碍之间的联系。口腔健康研究人员和政策制定者必须努力缩小这一差距。治疗口腔健康不良是一个全球性的人口健康问题。当务之急是将这些联系的证据落实到卫生政策中,以治疗和预防慢性疾病,提高慢性病患者的生活质量。
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引用次数: 0
Adverse childhood experiences, dental insurance, and developmental disability: Association with unmet dental needs in Ohio 不良童年经历、牙科保险和发育障碍:俄亥俄州未满足的牙科需求的关联。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-22 DOI: 10.1111/jphd.12605
Lili Horter BS, Carson Richardson BS, Marika Paul PhD, Beau D. Meyer DDS, MPH

Objective

This study investigated whether insurance status and/or developmental disability moderated the association between adverse childhood experiences (ACE) and unmet dental needs among children aged 0 to 17 in Ohio.

Methods

We utilized cross-sectional data from the 2021 Ohio Medicaid Assessment Survey to assess the dental needs of children. ACE scores, dental insurance status, and developmental disability status were analyzed using multivariable logistic regression to identify their potential association with parental-reported unmet dental needs.

Results

The weighted sample represented 2,752,222 children in Ohio. Over half reported zero ACEs (55.8%) and no dental needs (56.1%). Approximately 1 in 9 lacked dental insurance (11.1%), and 1 in 10 had a developmental disability (9.9%). Children with one to three ACEs had three times the odds of unmet dental needs compared to children with zero ACEs (OR = 3.20; 95%CI [2.10, 4.89]), and children with four or more ACEs had eight times the odds of unmet dental needs (OR = 8.78; 95%CI [5.26, 14.67]). Children lacking dental insurance had over six times higher odds of unmet dental needs compared to children with dental insurance (OR = 6.10; 95%CI [3.92, 9.49]). The presence of developmental disability status did not moderate the presence of unmet dental needs; however, the lack of dental insurance status significantly moderated the association between ACEs and unmet dental needs.

Conclusion

Insurance status, not developmental disability, moderated the association between ACEs and unmet dental needs among children in Ohio. Efforts to ensure continuous access to dental insurance are warranted.

目的本研究调查了保险状况和/或发育障碍是否会调节俄亥俄州0至17岁儿童的不良童年经历(ACE)与未满足的牙科需求之间的关系:我们利用 2021 年俄亥俄州医疗补助评估调查的横截面数据来评估儿童的牙科需求。我们使用多变量逻辑回归分析了ACE评分、牙科保险状况和发育障碍状况,以确定它们与父母报告的未满足牙科需求之间的潜在关联:加权样本代表了俄亥俄州的 2,752,222 名儿童。超过半数的儿童报告说他们没有遭遇过 ACE(55.8%),也没有牙科需求(56.1%)。大约九分之一的儿童没有牙科保险(11.1%),十分一的儿童有发育障碍(9.9%)。有一到三次 ACE 的儿童未满足牙科需求的几率是没有 ACE 儿童的三倍(OR = 3.20;95%CI [2.10,4.89]),有四次或四次以上 ACE 的儿童未满足牙科需求的几率是没有 ACE 儿童的八倍(OR = 8.78;95%CI [5.26,14.67])。与有牙科保险的儿童相比,没有牙科保险的儿童未满足牙科需求的几率要高出六倍多(OR = 6.10;95%CI [3.92,9.49])。发育障碍的存在并不影响未满足的牙科需求的存在;然而,缺乏牙科保险的状况却显著地影响了ACE与未满足的牙科需求之间的关联:保险状况,而非发育障碍,调节了俄亥俄州儿童中的ACE与未满足的牙科需求之间的关系。确保持续获得牙科保险的努力是有必要的。
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引用次数: 0
Do dental anxiety and satisfaction with dental professionals modify the association between affordability and dental service use? A population-based longitudinal study of Australian adults 牙科焦虑和对牙科专业人员的满意度会改变经济承受能力与牙科服务使用之间的关联吗?一项针对澳大利亚成年人的人口纵向研究。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-20 DOI: 10.1111/jphd.12608
Mishel Shahid PhD, Santosh Kumar Tadakamadla PhD, Jeroen Kroon PhD, Marco A. Peres PhD

Objectives

This study aimed to assess the association between affordability in terms of difficulty paying dental bills in Australian dollars and dental service use in the presence of sociodemographic confounders, and to assess the role of dental anxiety and satisfaction with dental professionals as mediators. The second aim was to investigate how dental anxiety and satisfaction with dental professionals modify the association between affordability and use of dental services in Australian adults.

Methods

Longitudinal data from the Australian National Study of Adult Oral Health (2004–06 and 2017–18) was used. Poisson regression and path analysis were conducted to determine the association between affordability and frequency of use of dental services. Effect measure modification (EMM) analysis was performed by stratification of dental anxiety and satisfaction with dental professionals.

Results

The study included 1698 Australian adults and identified that the prevalence of low frequency of dental visits was 20% more for those who had difficulty paying dental bills. Adults with dental anxiety (prevalence ratio [PR] = 1.14) and those who were dissatisfied with dental professionals (PR = 1.17) had a higher prevalence of low frequency of dental visits in the presence of difficulty paying dental bills. This indicated that dental anxiety and dissatisfaction with dental professionals were effect modifiers on this pathway.

Conclusions

Adults who experience dental anxiety and dissatisfaction with dental professionals are more likely to avoid dental visits when faced with difficulty paying dental bills. However, it is important to note that these associations do not necessarily imply a causal relationship.

研究目的本研究旨在评估在存在社会人口混杂因素的情况下,以澳元支付牙科账单的困难程度表示的可负担性与牙科服务使用之间的关联,并评估牙科焦虑和对牙科专业人员的满意度作为中介的作用。第二个目的是调查牙科焦虑和对牙科专业人员的满意度如何改变澳大利亚成年人支付牙科服务费用的能力与使用牙科服务之间的关联:方法:采用澳大利亚全国成人口腔健康研究(2004-06 年和 2017-18 年)的纵向数据。进行泊松回归和路径分析,以确定可负担性与牙科服务使用频率之间的关联。通过对牙科焦虑和对牙科专业人员的满意度进行分层,进行了效应测量修正(EMM)分析:研究包括 1698 名澳大利亚成年人,结果发现,支付牙科账单有困难的人看牙频率低的比例要高出 20%。患有牙科焦虑症(患病率比 [PR] = 1.14)和对牙科专业人员不满意(患病率比 = 1.17)的成年人,在支付牙科账单有困难的情况下,看牙频率低的发生率更高。这表明,牙科焦虑和对牙科专业人员的不满是这一路径的效应修饰因子:结论:有牙科焦虑和对牙科专业人员不满意经历的成年人在面临支付牙科账单困难时更有可能避免看牙医。但需要注意的是,这些关联并不一定意味着因果关系。
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引用次数: 0
Hospital usage for oral and dental conditions in Hawaii: A cross-sectional study using the 2021 Hawaii statewide hospital data 夏威夷因口腔和牙科疾病住院的情况:利用 2021 年夏威夷全州医院数据进行的横断面研究。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-20 DOI: 10.1111/jphd.12610
Masako Matsunaga PhD, MPH, MS, Patrick Donnelly BS, John J. Chen PhD

Objective

To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits.

Methods

This was a cross-sectional study of the 2021 Hawaii Statewide Hospital data. We identified records indicating ED usage and a primary diagnosis of non-traumatic dental conditions (NTDC) and other oral dental conditions (OODC). Descriptive analyses of ED visits for NTDC and OODC were performed to identify vulnerable individuals based on age, sex, race/ethnicity, primary source of payment, county of residence, and total charges per hospital record. A multivariable negative binomial regression model included age, sex, and county of residence was used to obtain adjusted rate ratios (aRR) and 95% confidence intervals (CI) of ED visits for NTDC.

Results

Among hospital records with diagnoses for oral or dental conditions (n = 12,336), 97% indicated ED, of which half had an NTDC diagnosis, and the remaining half had an OODC diagnosis. Distinct differences in the characteristics of ED visits were observed between NTDC and OODC. The median total charges per record indicating ED for NTDC and OODC were $1439 and $2439, respectively. A higher rate of ED visits for NTDC was found for those aged 21–44 (aRR [95%CI] = 3.02 [2.41, 3.80], reference: 0–9 years) and those living in a less populous county (Hawaii: 1.73 [1.43, 2.07]; Kauai: 1.78 [1.45, 2.19], reference: Honolulu).

Conclusions

Continued effort to improve dental health is required to reduce ED visits for oral and dental conditions among Hawaii residents, especially for vulnerable individuals.

目的调查夏威夷主要因口腔/牙科疾病而使用急诊室(ED)的频率,并研究与已确定的急诊室就诊相关的社会人口因素:这是一项针对 2021 年夏威夷全州医院数据的横断面研究。我们确定了显示使用急诊室和主要诊断为非创伤性牙科疾病(NTDC)和其他口腔牙科疾病(OODC)的记录。我们根据年龄、性别、种族/人种、主要付款来源、居住县以及每条医院记录的总费用,对因 NTDC 和 OODC 而就诊的急诊室患者进行了描述性分析,以确定易感人群。使用包括年龄、性别和居住县在内的多变量负二项回归模型得出了非传染性口腔疾病 ED 就诊的调整率比(aRR)和 95% 置信区间(CI):在诊断为口腔或牙科疾病的医院病历中(n = 12336),97%的病历显示为急诊室就诊,其中一半的诊断结果为NTDC,其余一半的诊断结果为OODC。NTDC 和 OODC 在急诊就诊特征方面存在明显差异。NTDC 和 OODC 每条显示 ED 的记录总费用中位数分别为 1439 美元和 2439 美元。年龄在 21-44 岁(aRR [95%CI] = 3.02 [2.41, 3.80],参考值:0-9 岁)和居住在人口较少县(夏威夷:1.73 [1.43, 2.07];可爱岛:1.78 [1.45, 2.19],参考值:檀香山)的人群中,NTDC 的急诊就诊率较高:需要继续努力改善牙齿健康状况,以减少夏威夷居民因口腔和牙科疾病而到急诊室就诊的人数,尤其是弱势人群。
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引用次数: 0
The relationship between oral status and healthy aging in Chinese older adults: A community cohort study 中国老年人口腔状况与健康老龄化的关系:一项社区队列研究。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-15 DOI: 10.1111/jphd.12604
Maitixirepu Jilili PhD, Yan Cheng MD

Objectives

In recent years, there has been a growing academic interest in investigating the determinants of healthy aging. The main objective of this study was to investigate the association between oral status, as defined by tooth loss and denture use, and healthy aging among Chinese older adults over a four-year duration.

Methods

The data were derived from the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Descriptive statistics and multivariate logistic regression analysis were employed for statistical analysis.

Results

The results suggest that older adults with ≥20 natural teeth have a higher likelihood of experiencing healthy aging compared to those with fewer than 20 natural teeth. In the fully adjusted model, only older adults with ≥20 natural teeth demonstrated a higher rate of healthy aging compared to those with 0 natural teeth, with an OR (95% CI): 2.09 (1.54–2.84).

Conclusions

These results highlight the importance of maintaining ≥20 teeth for promoting healthy aging among Chinese older adults. Furthermore, wearing dentures can, to varying degrees, mitigate the adverse effects of tooth loss on healthy aging. Rehabilitative interventions, such as the utilization of dentures and other clinical strategies, play a pivotal role in enhancing the oral health status of older individuals.

目的:近年来,学术界对健康老龄化决定因素的研究兴趣日益浓厚。本研究的主要目的是调查以缺牙和义齿使用为定义的口腔状况与中国老年人四年健康老龄化之间的关系:数据来源于 2014 年和 2018 年的中国健康长寿纵向调查。采用描述性统计和多元逻辑回归分析进行统计分析:结果表明,与天然牙少于20颗的老年人相比,天然牙≥20颗的老年人经历健康老龄化的可能性更高。在完全调整模型中,只有天然牙齿≥20 颗的老年人比天然牙齿为 0 颗的老年人有更高的健康老龄化率,OR 值(95% CI)为 2.09(1.54-2.84):这些结果凸显了保持≥20颗牙齿对促进中国老年人健康老龄化的重要性。此外,佩戴假牙可在不同程度上减轻牙齿缺失对健康老龄化的不利影响。康复干预措施,如使用假牙和其他临床策略,在改善老年人口腔健康状况方面发挥着关键作用。
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引用次数: 0
Parents' perspectives on dental team as advisors to promote HPV vaccination among Spanish adolescents 家长对牙科团队作为顾问促进西班牙青少年接种人乳头瘤病毒疫苗的看法。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-14 DOI: 10.1111/jphd.12609
Alejandro Ismael Lorenzo-Pouso DDS, MSC, MPH, Sergio González-Palanca MD, PhD, Gerardo Palmeiro-Fernández MD, Juan Carlos Dominguez-Salgado MD, Mario Pérez-Sayáns DDS, MDS, FDS, PhD, Ernesto J. González-Veiga MD, Vito Carlo Alberto Caponio DDS, PhD, Ellen M. Daley MPH, PhD

Purpose

Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet little is known about how patients perceive their role in HPV education and prevention.

Methods

Parents of adolescents aged 9 to 17 years (n = 375) were recruited from Valdeorras District Hospital (Galicia, Spain) to investigate parents' attitudes concerning the involvement of dental care providers in discussions related to HPV. A survey was distributed to the participants, and 343 (91.5%) were included in the analysis.

Results

In general, nearly half of the parents reported feeling comfortable regarding discussing HPV with their dentist. Participants described more comfort with dentists than with dental hygienists. Parents' comfort levels were influenced by various social determinants of health, including education level, marital status, geographic origin, and child vaccination status (p > 0.05).

Conclusion

Parents reported varying comfort levels when discussing HPV and its vaccine with dental professionals, displaying a preference for dentists. Dental settings have the potential to promote vaccination, but the existence of ongoing barriers needs to be addressed.

目的:人类乳头瘤病毒(HPV)是一种流行的性传播感染,是许多肛门癌和口咽癌的罪魁祸首。牙科保健提供者有可能影响疫苗的接种率,但对于患者如何看待他们在 HPV 教育和预防中的作用却知之甚少:从 Valdeorras 区医院(西班牙加利西亚)招募了 9 至 17 岁青少年的家长(n = 375),以调查家长对牙科保健提供者参与 HPV 相关讨论的态度。向参与者发放了一份调查问卷,其中 343 人(91.5%)参与了分析:总的来说,近一半的家长表示在与牙医讨论人乳头瘤病毒问题时感觉很舒服。与牙医相比,参与者更愿意与牙科保健师交谈。家长的舒适度受到各种健康社会决定因素的影响,包括教育水平、婚姻状况、地域和儿童疫苗接种情况(P > 0.05):结论:在与牙科专业人员讨论人乳头瘤病毒及其疫苗时,家长们表现出不同的舒适度,并表现出对牙科医生的偏好。牙科机构具有促进疫苗接种的潜力,但需要解决持续存在的障碍。
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引用次数: 0
A scoping review of the economic impact of family oral health: Implications for public health, research, and policy 家庭口腔健康的经济影响范围审查:对公共卫生、研究和政策的影响
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-02 DOI: 10.1111/jphd.12599
Jill Boylston Herndon PhD, Marcie S. Rubin DrPH, MPH, MPA, Colin Reusch MPA, Burton L. Edelstein DDS, MPH

Objectives

To summarize evidence on the impact of oral health on individual and family economic outcomes, describe trends in the literature, and identify areas for additional research to inform public health research and practice.

Methods

Searches were conducted within PubMed, CINAHL, EconLit, Cochrane Library, PsycInfo, and Web of Science databases. Article review, selection, abstraction, and reporting processes were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.

Results

Of 2758 unduplicated records identified, 52 met inclusion criteria. Study outcomes included indicators of employment/employability (n = 9), earnings/earnings potential (n = 26), parent missed work and family financial impacts of child oral health (n = 19), and financial loss (n = 3). Dental caries-related variables were the most common predictors of poorer economic outcomes. Other oral health problems, such as poorer dental functioning or poorer self-reported oral health status, also were associated with adverse economic outcomes. Significant associations with employment were found among studies that assessed interventions designed to improve oral health. Only one study estimated the impact of oral health on earnings. One-third of studies conducted multivariable analyses, and 14% incorporated race and ethnicity variables.

Conclusions

Although existing evidence suggests associations between oral health problems and poorer economic outcomes, there is a substantial need for more rigorous research to better understand the extent of economic impact of oral health problems and which populations are most affected. Additional high-quality research is needed to inform which interventions are most likely to improve oral health, reduce adverse economic impacts, and promote health and economic equity.

总结口腔健康对个人和家庭经济成果影响的证据,描述文献趋势,并确定其他研究领域,为公共卫生研究和实践提供信息。
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引用次数: 0
Sleep disorders, anxiety and obesity associated with untreated dental caries in children eight to ten years of age 八至十岁儿童的睡眠障碍、焦虑和肥胖与未经治疗的龋齿有关。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-06 DOI: 10.1111/jphd.12595
Larissa Chaves Morais de Lima PhD, Veruska Medeiros Martins Bernardino PhD, Tiago Ribeiro Leal MSc, Gélica Lima Granja MSc, Saul Martins Paiva PhD, Ana Flávia Granville-Garcia PhD

Objective

To evaluate the presence of sleep disorders, obesity and anxiety associated with cavitated carious lesions in children aged 8 to 10 years.

Materials and Methods

A cross-sectional study was carried out in the Northeast of Brazil. The sample was comprised of 793 schoolchildren randomly selected from public and private schools. Calibrated examiners (Kappa >0.80) performed the clinical examination of dental caries using the International Caries Detection and Assessment System and applied the Revised Children's Manifest Anxiety Scale and the Sleep Disturbance Scale for Children questionnaires. The anthropometric variables evaluated were weight and height. Negative binomial regressions (α ≤ 0.05) were performed. A Directed Acyclic Graph was prepared using DAGitty software (version 3.0), to select the co-variables for the statistical fits.

Results

The prevalence of tooth decay was 52.8%. The mean number of tooth surfaces with cavitated caries was 2.2(2.8), 58.9% of the schoolchildren had some type of sleep disorder, while 20.2% were anxious and 29.1% were obese. Sleep disturbance (RR = 1.38; 95% CI: 1.05–1.83), general anxiety (RR = 1.71; 95% CI: 1.32–2.21), obesity (RR = 1.48; 95% CI: 1.17–1.86) were associated with dental caries in the final model.

Conclusion

The presence of carious lesions was higher in children with sleep disorders, anxiety, obesity, and those who experienced dry mouth.

摘要评估 8 至 10 岁儿童是否存在与龋齿相关的睡眠障碍、肥胖和焦虑:在巴西东北部开展了一项横断面研究。样本由从公立和私立学校随机抽取的 793 名学童组成。校准检查员(Kappa >0.80)使用国际龋齿检测和评估系统对龋齿进行临床检查,并使用修订版儿童焦虑量表和儿童睡眠障碍量表进行问卷调查。评估的人体测量变量为体重和身高。进行了负二项回归(α ≤ 0.05)。使用 DAGitty 软件(3.0 版)绘制了有向无环图,以选择用于统计拟合的共变量:蛀牙发生率为 52.8%。58.9%的学童有某种睡眠障碍,20.2%的学童焦虑,29.1%的学童肥胖。在最终模型中,睡眠障碍(RR=1.38;95% CI:1.05-1.83)、普遍焦虑(RR=1.71;95% CI:1.32-2.21)、肥胖(RR=1.48;95% CI:1.17-1.86)与龋齿相关:结论:患有睡眠障碍、焦虑症、肥胖症和口干的儿童龋齿率较高。
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引用次数: 0
Association between dental visits during pregnancy and setting for prenatal care 孕期牙科就诊与产前护理环境之间的关系。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-03 DOI: 10.1111/jphd.12596
Divesh Byrappagari BDS, MSD, Lisa Cohn MS, Lindsay Sailor BA, Sarah Clark MPH

Objectives

Federally Qualified Health Centers (FQHCs) may be well positioned to facilitate dental visits during pregnancy for low-income women. We sought to compare receipt of dental visits during pregnancy for women who received prenatal care at an FQHC versus a non-FQHC setting.

Methods

We analyzed Michigan Medicaid administrative data for all live birth deliveries between April 2018 and December 2020. We used billing data to categorize the predominant setting for prenatal care as occurring at a FQHC or a non-FQHC and claims data to identify dental visits during pregnancy (in the 9 months prior to delivery). We employed bivariate and multivariate analyses to explore the relationship between setting for prenatal care and dental visits during pregnancy.

Results

Women who received prenatal care at an FQHC versus non-FQHC had a higher proportion of dental visits during pregnancy (31.85% vs. 19.37%, p < 0.0001). In multivariate analyses, the strongest predictors of having a dental visit during pregnancy were FQHC prenatal care setting, having a dental emergency visit, having ≥3 prenatal visits, and having Medicaid coverage throughout pregnancy. Hispanic or Black race/ethnicity and 2020 delivery year were predictors of a lower likelihood of a dental visit. These predictors were consistent for the overall population and for the subset who had no dental visits pre-pregnancy.

Conclusion

Medicaid-enrolled women who receive prenatal care at an FQHC are more likely to have a dental visit during pregnancy than their counterparts who receive prenatal care in a non-FQHC setting.

目的:联邦合格医疗中心(FQHC)在促进低收入妇女孕期牙科就诊方面可能处于有利地位。我们试图比较在联邦合格保健中心和非联邦合格保健中心接受产前保健的妇女在怀孕期间接受牙科检查的情况:我们分析了 2018 年 4 月至 2020 年 12 月期间密歇根州医疗补助计划(Medicaid)管理的所有活产分娩数据。我们利用账单数据将产前检查的主要地点分为在 FQHC 或非 FQHC 进行,并利用索赔数据确定孕期(分娩前 9 个月)的牙科就诊情况。我们采用双变量和多变量分析来探讨产前护理环境与孕期牙科就诊之间的关系:与在非 FQHC 环境中接受产前护理的妇女相比,在 FQHC 接受产前护理的医疗补助参保妇女更有可能在怀孕期间接受牙科就诊。
{"title":"Association between dental visits during pregnancy and setting for prenatal care","authors":"Divesh Byrappagari BDS, MSD,&nbsp;Lisa Cohn MS,&nbsp;Lindsay Sailor BA,&nbsp;Sarah Clark MPH","doi":"10.1111/jphd.12596","DOIUrl":"10.1111/jphd.12596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Federally Qualified Health Centers (FQHCs) may be well positioned to facilitate dental visits during pregnancy for low-income women. We sought to compare receipt of dental visits during pregnancy for women who received prenatal care at an FQHC versus a non-FQHC setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed Michigan Medicaid administrative data for all live birth deliveries between April 2018 and December 2020. We used billing data to categorize the predominant setting for prenatal care as occurring at a FQHC or a non-FQHC and claims data to identify dental visits during pregnancy (in the 9 months prior to delivery). We employed bivariate and multivariate analyses to explore the relationship between setting for prenatal care and dental visits during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women who received prenatal care at an FQHC versus non-FQHC had a higher proportion of dental visits during pregnancy (31.85% vs. 19.37%, <i>p</i> &lt; 0.0001). In multivariate analyses, the strongest predictors of having a dental visit during pregnancy were FQHC prenatal care setting, having a dental emergency visit, having ≥3 prenatal visits, and having Medicaid coverage throughout pregnancy. Hispanic or Black race/ethnicity and 2020 delivery year were predictors of a lower likelihood of a dental visit. These predictors were consistent for the overall population and for the subset who had no dental visits pre-pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Medicaid-enrolled women who receive prenatal care at an FQHC are more likely to have a dental visit during pregnancy than their counterparts who receive prenatal care in a non-FQHC setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"84 1","pages":"21-27"},"PeriodicalIF":2.3,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jphd.12596","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leveraging technology to increase the disseminability of evidence-based treatment of dental fear: An uncontrolled pilot study 利用技术提高以证据为基础的牙科恐惧治疗的可传播性:一项非对照试点研究。
IF 2.3 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-19 DOI: 10.1111/jphd.12598
Richard E. Heyman PhD, Kelly A. Daly PhD, Amy M. Smith Slep PhD, Mark S. Wolff DDS, PhD

Objectives

U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in-chair time, delivered only in person at a few sites). We developed a disseminable CBT-DF stepped-care treatment comprising (Step 1) a mobile-health application and, for those who remain fearful, (Step 2) a 1-h, one-on-one psychological treatment session that allows practice during exposure to the patient's most-feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0–3 “no/low fear” zone) and statistically significant changes in global dental fear.

Method

Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2.

Results

As hypothesized, users found the stepped-care treatment highly usable, credible, and helpful. Critically, this stepped-care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11).

Conclusions

This usable, credible, stepped-care approach to dental fear treatment holds promise for liberating evidence-based CBT-DF from specialty clinics, allowing broad dissemination.

目标:据美国和全球估计,超过 30% 的成年人害怕接受牙科治疗,其中超过 20% 的人在过去一年中看过牙医,这导致了他们对牙科治疗的回避以及口腔和全身健康状况的下降。虽然已有针对牙科恐惧的循证认知行为疗法(CBT-DF),但它们对每年数百万寻求牙科治疗的人影响甚微,因为它们不具有可传播性(6 个小时的椅上时间,只能在少数几个地点亲自提供)。我们开发了一种可推广的CBT-DF阶梯式护理疗法,包括(第一步)移动医疗应用程序,以及(第二步)1小时的一对一心理治疗,让患者在接触最恐惧的刺激时进行练习。我们假设该治疗方法将(a)在可用性和可信度方面得到高度评价;(b)在临床上产生效果(即将恐惧感降至 0-3 级 "无/低恐惧 "区),并在统计学上显著改变总体牙科恐惧感:方法:招募了不同种族/族裔的中度至重度牙科恐惧患者(48 人);所有患者都完成了步骤 1,16 人完成了步骤 2:结果:正如假设的那样,使用者认为阶梯式护理疗法非常实用、可信且有帮助。重要的是,这种阶梯式护理方法减轻了患者的牙科恐惧,既有临床效果(半数患者不再恐惧),又有显著的统计学意义(d = 1.11):结论:这种可用、可信、阶梯式的牙科恐惧治疗方法有望将循证 CBT-DF 从专科门诊中解放出来,并得到广泛传播。
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引用次数: 0
期刊
Journal of public health dentistry
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