RESUMEN
Purpose: Childhood caries disproportionately effects children who are poor, live in low-income rural and urban areas, and come from racial and ethnic minority groups. The purpose of this study was to explore the effect of public policy related to dental hygienists' level of supervision and policy uptake at the state level on the organization, delivery, and financing of school-based oral health programs (SBOHP).Methods: A multiple case study methodology was used to compare SBOHPs in the states of Missouri and Kansas. Interviews were conducted with an administrator, dental hygienist, and dentist at each Federally Qualified Health Center (FQHC) that operated a SBOHP. Mixed methods were used to conduct and analyze interviews, examine supporting documents, and to report descriptive details. Analytic categories were used to examine the various facets of the organizational structures, delivery processes, financing and billing, and operations.Results: Five themes revealing differences between two states emerged; historical development of SBOHPs, the structure of SBOHPs, staffing and professional relationships, finance and billing, and capacity of school-based oral health network.Conclusion: Dental hygienists' supervision requirements play a critical role in school-aged children's access to oral health services and the capacity of SBOHPs. The variations in the degree of practice autonomy accorded to dental hygienists under the Missouri and Kansas dental practice acts resulted in different oral health delivery models. Greater autonomy for dental hygienists is essential for realizing the promise of dental public health.
Asunto(s)
Salud Bucal , Recursos Humanos , Niño , Higienistas Dentales , Etnicidad , Humanos , Kansas , Grupos Minoritarios , MissouriRESUMEN
OBJECTIVE: The purpose of this study was to examine knowledge, awareness, and support for campus smoke-free policies. PARTICIPANTS: 1,256 American Indian tribal college students from three tribal colleges in the Midwest and Northern Plains. METHODS: Data are from an observational cross-sectional study of American Indian tribal college students, collected through a web-based survey. RESULTS: Only 40% of tribal college students reported not being exposed to second hand smoke in the past 7 days. A majority of nonsmokers (66%) agreed or strongly agreed with having a smoke-free campus, while 34.2% of smokers also agreed or strongly agreed. Overall, more than a third (36.6%) of tribal college students were not aware of their campus smoking policies. CONCLUSIONS: Tribal campuses serving American Indian students have been much slower in adopting smoke-free campus policies. Our findings show that tribal college students would support a smoke-free campus policy.
Asunto(s)
Indígenas Norteamericanos/psicología , Política para Fumadores , Prevención del Hábito de Fumar/métodos , Fumar/psicología , Actitud Frente a la Salud , Estudios Transversales , Femenino , Humanos , Indígenas Norteamericanos/estadística & datos numéricos , Masculino , Fumar/epidemiología , Estudiantes/psicología , Universidades/estadística & datos numéricos , Adulto JovenRESUMEN
We examine a strategy for improving oral health in the United States by focusing on low-income children in school-based settings. Vulnerable children often experience cultural, social, economic, structural, and geographic barriers when trying to access dental services in traditional dental office settings. These disparities have been discussed for more than a decade in multiple US Department of Health and Human Services publications. One solution is to revise dental practice acts to allow registered dental hygienists increased scope of services, expanded public health delivery opportunities, and decreased dentist supervision. We provide examples of how federally qualified health centers have implemented successful school-based dental models within the parameters of two state policies that allow registered dental hygienists varying levels of dentist supervision. Changes to dental practice acts at the state level allowing registered dental hygienists to practice with limited supervision in community settings, such as schools, may provide vulnerable populations greater access to screening and preventive services. We derive our recommendations from expert opinion.