RESUMEN
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.
Asunto(s)
Consejo , Obstetricia , Salud Bucal , Mujeres Embarazadas , Atención Prenatal , Rol Profesional , Derivación y Consulta , Femenino , Humanos , Entrevistas como Asunto , Partería , Aceptación de la Atención de Salud , Embarazo , Investigación CualitativaRESUMEN
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.
Asunto(s)
Atención Odontológica , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Salud Bucal , Pobreza , Mujeres Embarazadas , Atención Prenatal , Adulto , Caries Dental/prevención & control , Femenino , Humanos , Maryland , Medicaid , Embarazo , Estados UnidosRESUMEN
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.
Asunto(s)
Actitud del Personal de Salud , Atención Dental para Niños , Caries Dental/prevención & control , Higienistas Dentales/psicología , Odontólogos/psicología , Alfabetización en Salud , Percepción , Preescolar , Enfermedad Crónica , Atención Odontológica , Caries Dental/diagnóstico , Higienistas Dentales/estadística & datos numéricos , Odontólogos/estadística & datos numéricos , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Humanos , Maryland , Salud Bucal , Educación del Paciente como Asunto , Pediatras/psicología , Proyectos Piloto , Pobreza , Odontología Preventiva , Investigación Cualitativa , Servicios de Enfermería Escolar , Encuestas y Cuestionarios , TeléfonoRESUMEN
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.
Asunto(s)
Atención Dental para Niños/estadística & datos numéricos , Caries Dental/etiología , Caries Dental/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Pobreza , Cuidadores , Niño , Preescolar , Femenino , Fluoruros/administración & dosificación , Grupos Focales , Humanos , Lactante , Masculino , Maryland , PadresRESUMEN
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.
Asunto(s)
Clínicas Odontológicas/estadística & datos numéricos , Ambiente de Instituciones de Salud/estadística & datos numéricos , Alfabetización en Salud/estadística & datos numéricos , Odontología Comunitaria/métodos , Odontología Comunitaria/organización & administración , Odontología Comunitaria/estadística & datos numéricos , Caries Dental/prevención & control , Clínicas Odontológicas/métodos , Clínicas Odontológicas/organización & administración , Femenino , Educación en Salud/métodos , Educación en Salud/estadística & datos numéricos , Ambiente de Instituciones de Salud/métodos , Alfabetización en Salud/métodos , Humanos , Entrevistas como Asunto , Directorios de Señalización y Ubicación , Masculino , Maryland/epidemiología , Salud BucalAsunto(s)
Investigación Biomédica/educación , Higienistas Dentales/educación , Grupos Focales , Entrevistas como Asunto , Salud Bucal , Proyectos de Investigación , Animales , Actitud Frente a la Salud , Aromatizantes , Fragaria , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , LecheRESUMEN
OBJECTIVES: The objective of this qualitative study was to obtain information on low-income women's knowledge, beliefs, and practices regarding oral heath during pregnancy and for infant care. METHODS: A professional focus group moderator conducted four focus groups (n=34) among low-income women in Maryland who were either pregnant or had children aged two and younger. Purposeful sampling and qualitative content analysis were employed. RESULTS: Women were reasonably well informed about oral health practices for themselves and their children; however, important myths and misperceptions were common. Several themes emerged; a central one being that most women had not received oral health information in time to apply it according to recommended practice. CONCLUSIONS: The focus groups with low-income women provided rich and insightful information and implications for future communication strategies to help prevent dental diseases among pregnant women and their infants.
Asunto(s)
Actitud Frente a la Salud , Conocimientos, Actitudes y Práctica en Salud , Cuidado del Lactante , Salud Bucal , Embarazo , Preescolar , Información de Salud al Consumidor , Atención Odontológica , Caries Dental/prevención & control , Femenino , Grupos Focales , Educación en Salud Dental , Promoción de la Salud , Accesibilidad a los Servicios de Salud , Humanos , Lactante , Maryland , Higiene Bucal , Pobreza , Salud Rural , Autocuidado , Cepillado Dental/instrumentación , Pastas de Dientes/uso terapéutico , Salud UrbanaRESUMEN
The purpose of this study was to examine patterns and predictors of complementary and alternative medicine (CAM) among breast cancer patients. A review of the existing survey literature on CAM use for breast cancer was conducted with a series of eight focus groups (N = 67) to further examine the perspectives of breast cancer patients on CAM. The rates of CAM use varied from 17 to 75%, with a mean of 45%. Vitamins and minerals and herbs were the most frequently cited categories. Users tended to be younger, more educated, and more likely to have used CAM prior to their diagnosis. Focus group data indicate that breast cancer patients use a wide array of CAM for a variety of reasons, including symptom management, improving quality of life, and enhancing immune function. Although women rely on a variety of resources for information, they frequently experience frustration owing to the absence or conflicting nature of such information. Communication with conventional providers about CAM is frequently experienced as either unsupportive or not helpful by many patients. The results point to the value of developing better evidence-based informational resources related to CAM and cancer and the need for physicians to become better educated about CAM and how to communicate more effectively with their breast cancer patients about it.
Asunto(s)
Neoplasias de la Mama/terapia , Terapias Complementarias/estadística & datos numéricos , Pacientes/psicología , Adulto , Anciano , Investigación Biomédica , Neoplasias de la Mama/psicología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
PURPOSE: The purpose of this qualitative study was to obtain in-depth information on dental hygienists' awareness and opinions of oral cancer, oral cancer examinations, and related factors. These findings were intended to supplement a previous statewide survey of Maryland dental hygienists on the subject. METHODS: A professional focus group moderator conducted two focus groups in Maryland. Two types of focus groups were used--one face-to-face focus group session with 10 dental hygienists in the Baltimore area and one telephone focus group among 7 dental hygienists who practiced on the Eastern Shore. Criterion-purposeful sampling and qualitative content analysis were used. RESULTS: Six major themes emerged from the focus groups: dental hygienists' lack of awareness of Maryland's oral cancer statistics, level of training to provide oral cancer examinations, provision of oral cancer examinations and barriers for not providing them, reactions to Maryland surveys of dental hygienists and dentists, assessment of oral cancer risk factors, and interest in additional training. CONCLUSIONS: The focus groups provided in-depth information about why oral cancer examinations are or are not provided on a routine basis, as well as ideas for providing updates on oral cancer prevention and early detection for dental hygienists. Moreover, some participants recommended that updates on how to conduct an oral cancer examination be a requirement, as updates on infection control are now.
Asunto(s)
Actitud del Personal de Salud , Higienistas Dentales/educación , Higienistas Dentales/psicología , Neoplasias de la Boca/diagnóstico , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Maryland , Neoplasias de la Boca/prevención & controlRESUMEN
OVERVIEW: In any given 12-month period, Maryland ranks 27th among all states and the District of Columbia in estimated new cases of oral cancer. The state also has the seventh highest overall mortality rate for oral cancer. Because of earlier research indicating that Maryland adults had little knowledge and many misconceptions about oral cancer, the authors undertook a study to obtain in-depth information from Maryland adults 40 years of age or older on oral cancer, oral cancer examinations and factors associated with having an oral cancer examination. METHODS: The authors conducted a qualitative descriptive study using information gathered from three focus groups consisting of nine, 10 and seven adults respectively, and which met at two locations. The authors hired a private focus group research firm, which randomly selected participants from a telephone list of local residents. A professionally trained moderator conducted all focus groups using a semistructured interview guide. RESULTS: Participants were struck by the fact that they rarely hear about this type of cancer. Many said that they never had had an oral cancer examination and did not know there was such a thing. Many participants also reported that they likely would be more comfortable discussing oral cancer with their physicians than with their dentists. CONCLUSIONS: These findings provide additional in-depth insights to earlier work about Maryland adults' oral cancer knowledge, opinions and practices. The state plans to use this information to develop educational materials and interventions for the public to promote oral cancer prevention and early detection in Maryland. CLINICAL IMPLICATIONS: Extensive public education about oral and pharyngeal cancers should be provided in dental offices and clinics, as well as in mass media of all types. More clinicians should include comprehensive oral cancer screenings in their oral examinations, and they should explain to patients what they are doing when they provide these screenings.
Asunto(s)
Actitud Frente a la Salud , Neoplasias de la Boca/prevención & control , Neoplasias de la Boca/psicología , Adulto , Anciano , Recolección de Datos , Femenino , Grupos Focales , Educación en Salud Dental , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Maryland , Persona de Mediana Edad , Neoplasias de la Boca/diagnósticoRESUMEN
The purpose of this study was to obtain in-depth information on Maryland physicians' knowledge, opinions and practices about oral cancer examinations. The qualitative descriptive study used one focus group conducted in a conference facility and nine one-on-one interviews at private medical offices. A criterion-purposeful sampling was used for selection of participants. Generally, we found low awareness of, and surprise about, Maryland's high oral cancer mortality rates. Physicians were not surprised that they detect more lesions than dentists, although most physicians did not provide oral cancer examinations on a routine basis. Physicians were interested in attending continuing medical education (CME) courses on oral cancer prevention and early detection but only if worked into other CME programs on cancer. They were very interested in having hands-on training on performing an oral cancer examination. These findings will be used to implement educational interventions for Maryland physicians to help increase early detection of oral cancers.