scholarly journals Predictors of use of dental care by children in north-central Appalachia in the USA

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0250488
Author(s):  
Cecelia I. Nelson ◽  
Casey D. Wright ◽  
Jamey T. Brumbaugh ◽  
Katherine Neiswanger ◽  
Richard J. Crout ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Care ◽  
Behavioral Model ◽  
Future Research ◽  
Dental Services ◽  
North Central ◽  
Dental Utilization ◽  
Central Appalachia ◽  
The Usa ◽  
Anxiety And Fear

Use of dental services in childhood, especially preventive care, is associated with many important oral health outcomes throughout life. The Andersen behavioral model of healthcare utilization posits that predisposing characteristics, enabling resources, and need factors predict utilization in oral and other healthcare domains. Inequities that produce lower utilization of dental services in north-central Appalachia have been documented in comparison to the USA generally. Additionally, within Appalachia, there are disparities, such as those across different states related to varying public policies and resources supporting healthcare. Predictors of dental utilization in Appalachia have been a focus in adults, but less so in children. The aim of the current study was to understand predictors of dental utilization in children in north-central Appalachia in order to inform future research about how to intervene to address these disparities. In this study, there were 1,178 children, ages 1 through 10 years, from selected representative counties in West Virginia and Pennsylvania, along with a parent/caregiver, who were part of the Center for Oral Health Research in Appalachia (COHRA1) cohort. Use of dental services by their child was indicated by parents/caregivers, who also reported on sociodemographic, dental care-related anxiety and fear, and values and attitudes associated with oral healthcare. Results indicated that use of professional dental services by children was related to child age, dental anxiety and fear, and parental oral health values and attitudes. Older children in this age group, those who evidenced more dental care-related anxiety and fear, and whose parent/caregiver placed higher value on oral health and healthcare for themselves, were more likely to have had a dental visit in the past year.

scholarly journals Predictors of dental care utilization in north‐central Appalachia in the USA

2019 ◽  
Vol 47 (4) ◽  
pp. 283-290 ◽  
Author(s):  
Mengxia Chen ◽  
Casey D. Wright ◽  
Oluwabunmi Tokede ◽  
Alfa Yansane ◽  
Alexander Montasem ◽  
...  
Keyword(s):  
Dental Care ◽  
Care Utilization ◽  
North Central ◽  
Dental Care Utilization ◽  
Central Appalachia ◽  
The Usa

Transportation Barriers and Use of Dental Services among Medicaid-Insured Adults

2017 ◽  
Vol 3 (1) ◽  
pp. 101-108 ◽  
Author(s):  
S.C. McKernan ◽  
J.C. Reynolds ◽  
A. Ingleshwar ◽  
M. Pooley ◽  
R.A. Kuthy ◽  
...  
Keyword(s):  
Low Income ◽  
Dental Care ◽  
Behavioral Model ◽  
Medicaid Expansion ◽  
Dental Services ◽  
Dental Utilization ◽  
Access To Dental Care ◽  
Transportation Barriers ◽  
General Dentist ◽  
Improve Access

This study explores how travel distance and other transportation barriers are associated with dental utilization in a Medicaid expansion population. We analyzed data from the Iowa Dental Wellness Plan (DWP), which provides comprehensive dental benefits for low-income adults aged 19 to 64 y as part of Iowa’s Medicaid expansion. Transportation and geographical characteristics were evaluated as enabling factors within the framework of Andersen’s behavioral model of health services use. In March 2015, a random sample of DWP members ( n = 4,800) was surveyed; adjusted survey response rate was 30% ( n = 1,258).The questionnaire was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey and assessed need for dental care, use of dental services and transportation to visits, and self-perceived oral health status. Respondent and dentist addresses were geocoded and used to calculate distance to the nearest DWP general dentist. A logistic regression model predicting utilization of dental care was developed using variables representing each domain of the behavioral model. Most respondents (57%) reported a dental visit since enrolling. Overall, 11% of respondents reported unmet dental need due to transportation problems. Median distance to the nearest general dentist was 1.5 miles. In the adjusted model, travel distance was not significantly associated with the likelihood of dental utilization. However, other transportation-related issues were significantly associated with utilization, including concern about cost of transportation and driver/passenger status. As concern about transportation cost increased, likelihood of having a dental visit decreased. Targeted approaches to assisting low-income populations with transportation barriers should be considered in designing policies and interventions to improve access to dental care. Knowledge Transfer Statement: The results of this study can be used by policy makers and public health planners when designing programs and interventions to improve access to dental care. Consideration of transportation availability and costs could improve utilization of routine dental care, especially among low-income populations.

Transportation Barriers and Use of Dental Services among Medicaid-Insured Adults

2019 ◽  
Author(s):  
Susan C McKernan ◽  
Julie C Reynolds ◽  
Aparna Ingleshwar ◽  
Mark Pooley ◽  
Raymond A Kuthy ◽  
...  
Keyword(s):  
Low Income ◽  
Dental Care ◽  
Behavioral Model ◽  
Medicaid Expansion ◽  
Dental Services ◽  
Dental Utilization ◽  
Access To Dental Care ◽  
Transportation Barriers ◽  
General Dentist ◽  
Improve Access

This study explores how travel distance and other transportation barriers are associated with dental utilization in a Medicaid expansion population. We analyzed data from the Iowa Dental Wellness Plan (DWP), which provides comprehensive dental benefits for low-income adults aged 19 to 64 y as part of Iowa's Medicaid expansion. Transportation and geographical characteristics were evaluated as enabling factors within the framework of Andersen's behavioral model of health services use. In March 2015, a random sample of DWP members ( n = 4,800) was surveyed; adjusted survey response rate was 30% ( n = 1,258).The questionnaire was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey and assessed need for dental care, use of dental services and transportation to visits, and self-perceived oral health status. Respondent and dentist addresses were geocoded and used to calculate distance to the nearest DWP general dentist. A logistic regression model predicting utilization of dental care was developed using variables representing each domain of the behavioral model. Most respondents (57%) reported a dental visit since enrolling. Overall, 11% of respondents reported unmet dental need due to transportation problems. Median distance to the nearest general dentist was 1.5 miles. In the adjusted model, travel distance was not significantly associated with the likelihood of dental utilization. However, other transportation-related issues were significantly associated with utilization, including concern about cost of transportation and driver/passenger status. As concern about transportation cost increased, likelihood of having a dental visit decreased. Targeted approaches to assisting low-income populations with transportation barriers should be considered in designing policies and interventions to improve access to dental care. Knowledge Transfer Statement: The results of this study can be used by policy makers and public health planners when designing programs and interventions to improve access to dental care. Consideration of transportation availability and costs could improve utilization of routine dental care, especially among low-income populations.

scholarly journals Socioeconomic Inequalities in the Utilization of Dental Services Among Adults in Saudi Arabia

2021 ◽  
Author(s):  
Deema A. Sahab ◽  
Mohammed S. Bamashmous ◽  
Amitha Ranauta ◽  
Vanessa Muirhead
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Dental Care ◽  
Household Wealth ◽  
Socioeconomic Inequalities ◽  
Dental Services ◽  
Services Utilization ◽  
Dental Utilization ◽  
Dental Services Utilization ◽  
Utilization Of Dental Services

Abstract Background This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other predictors of utilization, to inform future planning of dental care services. Methods In this cross-sectional study, we conducted secondary analysis using national data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS). The survey consisted of two interviewer-administered questionnaires, one for the household and one individual interview. The questionnaires included questions covering predisposing factors (age, gender, marital status, nationality, education, employment), enabling factors (income, household wealth, area-based socioeconomic class, health insurance, eligibility for free governmental health care, transportation and region of residence) and self-reported need for dental treatment. The main outcome was dental utilization. The independent variables were the predisposing, enabling and need factors. Hierarchical logistic regression analyses identified significant predictors of dental utilization, applying survey weights to adjust for the complex survey design. Adjusted odds ratios with 95% confidence intervals and p values were reported in the final model. Results The final dataset included 8,535 adults (response rate = 95.4%). Twenty percent of adults visited the dentist at least once in the past year (95%CI: 18% -21%). The socioeconomic factors associated with the higher likelihood of dental service utilization in the final fully adjusted model were high household income (OR = 1.43, p = 0.043), second and middle household wealth status (OR = 1.51, p = 0.003 and OR = 1.57, p = 0.006) and access to free governmental health care (OR = 2.05, p = 0.004). In addition to self-reported oral problems (OR= 52.09, p < 0.001). Conclusion Socioeconomic inequalities in the utilization of dental services exist in Saudi Arabia. The main driver of dental services utilization in adults was the need for treatment suggesting predominantly symptomatic attendance. Increasing awareness about the importance of preventive dental visits rather than symptomatic attendance could be an important policy implication to improve oral health and optimize dental care expenditure. Further research should explore the drivers for adults to seek preventive care in the absence of any recognized dental problems.

scholarly journals Utilization of dental services and associated factors among preschool children in China

2019 ◽  
Author(s):  
Xiaoli Gao ◽  
Min Ding ◽  
Mengru Xu ◽  
Huijing Wu ◽  
Chunzi Zhang ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Service ◽  
Service Utilization ◽  
Urban Areas ◽  
Health Service Utilization ◽  
Health Knowledge ◽  
Dental Services ◽  
Cross Sectional ◽  
The Past ◽  
Dental Utilization

Abstract Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making.Methods: A cross-sectional study utilizing data from the Fourth National Oral Health Survey was performed from August 2015 to December 2016. Survey data for children in the 3- to 5-year-old age groups were extracted. Patient data were collected using a questionnaire answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and logistic regression results were then analysed to assess associations.Results : The oral health service utilization rates during the prior 12 months were 9.5% among 3-year-old children, 12.1% among 4-year-old children, and 17.5% among 5-year-old children. “No dental diseases” and “dental disease was not severe” were the principal reasons that children had not attended a dental visit in the past 12 months. Greater child age, increased parental educational level, and good oral health brief by parents was associated with an increased likelihood that the child received dental services within the past 12 months. Children who lived in urban areas and who belonged to families with high annual per capita incomes tended to have relatively higher oral health service utilization rates in the past 12 months. In addition, dental pain, evaluated dental health, and decayed, missing, and filled surface (DMFS) scores were significantly linked to dental visits. The results also demonstrated that children were more likely to see a dentist if they brushed their teeth more frequently or brushed their teeth with their parents’ help.Conclusion: The rate of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.

scholarly journals Contextual and individual factors associated with public dental services utilisation in Brazil: A multilevel analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254310
Author(s):  
Maria Helena Rodrigues Galvão ◽  
Arthur de Almeida Medeiros ◽  
Angelo Giuseppe Roncalli
Keyword(s):  
Oral Health ◽  
Multilevel Analysis ◽  
Behavioral Model ◽  
Dental Service ◽  
Individual Factors ◽  
Service Utilisation ◽  
Health Coverage ◽  
Dental Services ◽  
Cross Sectional ◽  
Public Dental Service

Background This study verified the association between contextual and individual factors and public dental services utilisation in Brazil. Methods The study was conducted based on a cross-sectional population-based household survey performed in Brazil (National Health Survey– 2019)). Data was collected between August 2019 and March 2020. Total sample included 43,167 individuals aged ≥15 years who had at least one dental appointment in the last 12 months before interview. Study outcome was ‘public dental service utilisation’, and Andersen’s behavioral model was adopted for selecting independent variables. A multilevel analysis was performed using individual factors as first level and federation units as second level. Results The highest prevalence of public dental service utilisation on an individual level was observed among unable to read or write people (PR: 3.31; p<0.001), indigenous (PR: 1.40; p<0.001), black or brown (PR: 1.16; p<0.001), with per capita household income of up to U$124 (PR: 2.40; p<0.001), living in the rural area (PR: 1.28; p<0.001), and who self-rated oral health as regular (PR: 1.15; p<0.001) or very bad/bad (PR: 1.26; p<0.001). On the contextual level, highest PR of public dental service utilisation was observed among those living in federal units with increased oral health coverage in primary health care. Conclusions Public dental service utilisation is associated with individual and contextual factors. These results can guide decision-making based on evidence from policymakers, demonstrating the potential for mitigating oral health inequalities and increasing service coverage in a public and universal health system.

Differently Abled – A Dental Public Health Challenge

2011 ◽  
Vol 5 (1) ◽  
pp. 1-3
Author(s):  
Gaurav Gupta ◽  
Manu Narayan ◽  
Navin A Ingle ◽  
Sabyasachi Saha ◽  
Sahana Shivkumar
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Dental Public Health ◽  
Critical Levels ◽  
Dental Services ◽  
Scant Attention ◽  
Significant Disability ◽  
Public Health Challenge

ABSTRACT Oral health care for children and adults with disabilities is a health care area that has received scant attention. It is seen that most persons with a significant disability cannot find a professional resource to provide appropriate and necessary dental care. Lack of access to dental services for this growing segment of our population is reaching critical levels and is a national dilemma.

Strategies to improve access to and uptake of dental care by people experiencing homelessness in Australia: a grey literature review

2020 ◽  
Vol 44 (2) ◽  
pp. 297
Author(s):  
Jacqueline Goode ◽  
Ha Hoang ◽  
Leonard Crocombe
Keyword(s):  
Oral Health ◽  
Dental Care ◽  
Service Providers ◽  
Grey Literature ◽  
Homeless People ◽  
Dental Service ◽  
Dental Services ◽  
Free Care ◽  
Improve Access

Objectives The poor oral health of Australians experiencing homelessness negatively affects their quality of life. Better oral health is associated with having annual dental check-ups. Because there is limited peer-reviewed literature describing strategies that improve access to and uptake of dental care by homeless people, in this study we searched the grey literature to discover what strategies are used. Methods The Informit database and Google and Bing search engines were searched using the keywords ‘homeless and oral and dental services’. Bing and Google were searched unrestricted by site and Google was searched for sites ending in ‘org.au’. Searches were restricted to Australia from June 2008 to June 2018. The first 300 websites were read, and those describing or linking to pages describing a strategy that improved access to or uptake of dental care were included in the study. The content of the webpages was evaluated and summarised, with common strategies reported as a narrative description. Results Nineteen programs were described. Common strategies were providing free care, in-reach care, outreach care and the need to work closely with support organisations. Conclusions To improve access to and uptake of dental care by people experiencing homelessness, dental services need to be free and organised in collaboration with support organisations. What is known about the topic? The peer-reviewed literature describing strategies used to improve access to and uptake of dental care by people experiencing homelessness in Australia is limited. The authors could only locate two such studies, one based in Melbourne and one in Brisbane. Both programs had a similar aim, but used different strategies to achieve it, suggesting a lack of consensus about the best way to encourage dental visiting by people experiencing homelessness. What does this paper add? This paper used the grey literature to describe common strategies used in Australia to improve access to and uptake of dental care by people experiencing homelessness. What are the implications for practitioners? Dental service providers aiming to increase access to and uptake of dental care by people experiencing homelessness need to work collaboratively with support organisations and provide care free of charge.

Oral health and related risk indicators in north‐central Appalachia differ by rurality

2020 ◽  
Author(s):  
Yuqiao Zhou ◽  
Richard Cuddy ◽  
Daniel W. McNeil ◽  
Casey D. Wright ◽  
Richard J. Crout ◽  
...  
Keyword(s):  
Oral Health ◽  
Risk Indicators ◽  
North Central ◽  
Related Risk ◽  
Central Appalachia
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