New Jersey FQHC Process Improvement Increases Oral Health Access for HIV Patients

2021 ◽  
pp. 1-6
Author(s):  
Sam Wakim ◽  
◽  
Rina Ramirez ◽  
Keyword(s):  
Health Care ◽  
New Jersey ◽  
Oral Health ◽  
Dental Care ◽  
Health Access ◽  
Hiv Patients ◽  
Improvement Project ◽  
Medical Needs ◽  
Ryan White ◽  
Hiv Aids

Introduction: Patients living with HIV/AIDS (PLWHA) have more unmet oral health care needs than the general population, outpacing unmet medical needs [1]. Poor oral health can impact a person’s confidence and ability to speak, eat, work, sleep, and socialize [2]. Lack of access to dental care is a national issue for HIV patients; providing access is a challenge faced by many health centers and practices, including Zufall Health in New Jersey, a federally qualified health center (FQHC). In collaboration with Northeast/Caribbean AIDS Education and Training Center (NECA AETC), Zufall embarked on an initiative to improve access to quality dental care for PLWHA. AETC is the training component of the Ryan White Program, a federally funded program that provides medical care, support services, and medications for PLWHA who are low income, uninsured, or underserved [3-5]. Materials and Methods: In 2019, Zufall Health launched a quality improvement project to increase oral health access and services for Ryan White patients by integrating all partners involved in providing health care: medical, dental, psychological, behavioral, and HIV/AIDS providers and case managers. The project goal was to increase the number of patients receiving dental care to improve oral and overall health. Results/Observations: As a result of the project, there were significant quantitative and qualitative improvements in the oral health and quality of life of PLWHA: more dental encounters, a higher percentage of patients with a dental home, and the surpassing of the project goal of a 10% increase in dental referrals.

scholarly journals GENDER DIFFERENCES IN ORAL CARE HABITS, ATTITUDES AND BEHAVIOURS OF ADOLESCENTS IN THE CITY OF KLAIPEDA

2018 ◽  
Vol 6 ◽  
pp. 870-875
Author(s):  
Šarūnė Barsevičienė ◽  
Eglė Žymantienė ◽  
Jurgita Andruškienė
Keyword(s):  
Health Care ◽  
Gender Differences ◽  
Oral Health ◽  
Dental Care ◽  
Oral Care ◽  
Oral Diseases ◽  
Care Needs ◽  
Dental Floss ◽  
Medical Needs ◽  
Study Results

Background. For many, the adolescent years can be a difficult emotional period and a time when dental and medical needs may be neglected. Oral health is one of the most unmet health care needs of adolescents. Oral diseases can have a profound effect on overall health, including pain, missed school, heart disease, and even death (Silk and Kwok, 2017).Aim of the survey: to study the gender differences in oral hygiene habits, attitudes and behaviours in Klaipeda city adolescents sample.Methods: There were 1206 questionnaires distributed (response rate 95.3 %). A total of 1150 adolescents participated in the study, with 52.4 % being girls, and the mean age was 13.4 years.Results. The study results demonstrated girls more often brushed their teeth than boys, 86.8 % and 68.5 %, respectively (p<0.001). Almost all the participants (98.5 %) used toothpaste and a toothbrush on a daily basis, but girls more often used dental floss (66.3 % as compared to boys 33.7 %, p<0.001), mouthwash (60.3 % as compared to boys 39.7 %, p<0.001) and other dental care products (79.5 % as compared to boys 20.5 %, p<0.05) for toothbrushing and daily dental care. The girls brushed their teeth in the morning (92.9 %) and before bedtime (91.0 %), as well as the boys (85.0 % and 77.5 %, respectively, p<0.001).Conclusions. Girls demonstrated better oral health care habits, comparing to boys. Boys had greater, as compared to girls, dental fear, restricting them from having regular appointments for check-ups at the dental office. Girls more frequently than boys had an attitude that teeth should be kept clean for aesthetic purposes and in order to ensure their longevity. Girls preferred to seek a dentist’s help as soon as it is needed and to maintain good oral health, because it’s essential to human health in general.

scholarly journals 20.F. Workshop: Dental care – coverage and access across countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
North America ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Dental Care ◽  
Financial Protection ◽  
Health Coverage ◽  
Universal Health

Abstract Oral health is a central element of general health with significant impact in terms of pain, suffering, impairment of function and reduced quality of life. Although most oral disease can be prevented by health promotion strategies and routine access to primary oral health care, the GBD study 2017 estimated that oral diseases affect over 3.5 billion people worldwide (Watt et al, 2019). Given the importance of oral health and its potential contribution to achieving universal health coverage (UHC), it has received increased attention in public health debates in recent years. However, little is known about the large variations across countries in terms of service delivery, coverage and financing of oral health. There is a lack of international comparison and understanding of who delivers oral health services, how much is devoted to oral health care and who funds the costs for which type of treatment (Eaton et al., 2019). Yet, these aspects are central for understanding the scope for improvement regarding financial protection against costs of dental care and equal access to services in each country. This workshop aims to present the comparative research on dental care coverage in Europe, North America and Australia led by the European Observatory on Health Systems and Policies. Three presentations will look at dental care coverage using different methods and approaches. They will compare how well the population is covered for dental care especially within Europe and North America considering the health systems design and expenditure level on dental care, using the WHO coverage cube as analytical framework. The first presentation shows results of a cross-country Health Systems in Transition (HiT) review on dental care. It provides a comparative review and analysis of financing, coverage and access in 31 European countries, describing the main trends also in the provision of dental care. The second presentation compares dental care coverage in eight jurisdictions (Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States) with a particular focus on older adults. The third presentation uses a vignette approach to map the extent of coverage of dental services offered by statutory systems (social insurance, compulsory insurance, NHS) in selected countries in Europe and North America. This workshop provides the opportunity of a focussed discussion on coverage of dental care, which is often neglected in the discussion on access to health services and universal health coverage. The objectives of the workshop are to discuss the oral health systems in an international comparative setting and to draw lessons on best practices and coverage design. The World Conference on Public Health is hence a good opportunity for this workshop that contributes to frame the discussion on oral health systems in a global perspective. Key messages There is large degree of variation in the extent to which the costs of dental care are covered by the statutory systems worldwide with implications for oral health outcomes and financial protection. There is a need for a more systematic collection of oral health indicators to make analysis of reliable and comparable oral health data possible.

Dentists’ perception of barriers to dental care for children with special health care needs in bengaluru, india

2018 ◽  
Vol 10 (2) ◽  
pp. 3-8
Author(s):  
Mufeedha K Nazar ◽  
Divya Reddy C ◽  
Santhosh T Paul
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Validated Questionnaire ◽  
Oral Hygiene Instructions ◽  
Special Health

INTRODUCTION: Despite advances in dental care in recent decades, the oral health of people with disabilities remains poor. The treatment of children with special health care needs (CSHCN) presents challenges for the dentists that may ultimately become a barrier. Identification of barriers can be the first step in addressing the deficiencies in dental care for such patients. AIM: To identify barriers to oral/dental care for CSHCN as perceived by dentists Materials and Methods: 110 randomly selected dental professionals were interviewed through a validated questionnaire for their perceived barriers to provide oral health care for CSHCN RESULTS: Majority of respondents attended CSHCN (77.3%) and mostly provided restorations, oral hygiene instructions including preventive measures and basic restorative care. Dentists perceived concern regarding medical history (50%) and patient co-operation (38%) as the main barriers to provide dental care to CSHCN. CONCLUSION: Our findings conclude that majority of dentists are willing to treat CSHCN despite the challenges they faced. Minimizing the barriers is essential to provide comprehensive dental care to CSHCN.

scholarly journals “Part of Getting to Where We Are is Because We Have Been Open to Change”Integrating Community Health Workers on Care Teams at Ten Ryan White HIV/AIDS Program Recipient Sites

2021 ◽  
Author(s):  
Linda Sprague Martinez ◽  
Melissa Davoust ◽  
Serena Rajabiun ◽  
Allyson Baughman ◽  
Sara Bachman ◽  
...  
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Care Delivery ◽  
Implementation Strategies ◽  
Hiv Care ◽  
Organizational Policies ◽  
Ryan White ◽  
Aids Program ◽  
Group Interviews ◽  
Hiv Aids

Abstract Background: Community Health Workers (CHWs) have long been integrated in the delivery of HIV care, in middle- and low-income countries. However, less is known about CHW integration into HIV care teams in the United States (US). To date, US based CHW integration studies have studies explored integration in the context of primary care and patient-centered medical homes.There is a need for research related to strategies that promote the successful integration of CHWs into HIV care delivery systems. In 2016, the Health Resources and Services Administration HIV/AIDS Bureau launched a three-year initiative to provide training, technical assistance and evaluation for Ryan White HIV/AIDS Program (RWHAP) recipient sites to integrate CHWs into their multidisciplinary care teams, and in turn strengthen their capacity to reach communities of color and reduce HIV inequities. Methods: Ten RWHAP sites were selected from across eight states. The multi-site program evaluation included a process evaluation guided by RE-AIM to understand how the organizations integrated CHWs into their care teams. Site team members participated in group interviews to walk-the-process during early implementation and following the program period. Directed content analysis was employed to examine program implementation. Codes developed using implementation strategies outlined in the Expert Recommendations for Implementing Change project were applied to group interviews (n=20). Findings: Implementation strategies most frequently described by sites were associated with organizational-level adaptations in order to integrate the CHW into the HIV care team. These included revising, defining, and differentiating professional roles and changing organizational policies. Strategies used for implementation, such as network weaving, supervision, and promoting adaptability, were second most commonly cited strategies, followed by training and TA strategies. Conclusions: Wrapped up in the implementation experience of the sites there were some underlying issues that pose challenges for health care organizations. Organizational policies and the ability to adapt proved significant in facilitating CHW implementation. The integration of the CHW role may present an occasion for health care delivery organizations to reassess policies that may unintentionally marginalize communities and both limit career opportunities and patient engagement.

Programs and Policies Targeted to Improve Access to Dental Care for Low Income Adults and Children in the US: An Integrative Literature Review

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Davis AL ◽  
◽  
Zare H ◽  
Kanwar O ◽  
McCleary R ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Literacy ◽  
Literature Review ◽  
Low Income ◽  
Dental Care ◽  
Oral Health Care ◽  
Oral Health Literacy ◽  
The Us ◽  
Access To Dental Care

Objective: The authors conducted an integrative literature review of recent studies that explored the impact of interventions implemented in the U.S. that focused on improving access to dental care for low-income and vulnerable populations. Methods: The authors conducted an integrative literature review of studies published between 2012-2018 that addressed six oral health policy spheres. 1) Community-based dental access programs; (2) Medicaid reimbursement and expansion; (3) Student loan support; (4) Oral health services in non-traditional settings and dental residency programs; (5) Programs to improve oral health literacy; and (6) Use of dental therapists. Results: The authors included 39 articles for qualitative synthesis. Numerous public health initiatives and programs exist in the US aimed at increasing access to quality oral health care. Medicaid expansion, increased Medicaid fee-for-service reimbursement rates, and state loan repayment programs have demonstrated some success in improving access among underserved populations. A diversified dental workforce, with community dental health workers and mid-level providers like dental therapists, as well as interprofessional training of nurses and primary-care physicians in oral health have also shown positive impacts in advancing health equity. Further studies are needed to understand how oral health literacy programs can affect access and utilization of dental services. Conclusions: Improvements to the oral health care safety net will require a holistic and multifaceted approach in order to reduce oral health disparities. Policy levers should work, not in isolation, but rather in complementary fashion to one another.

scholarly journals “Got to build that trust”: the perspectives and experiences of Aboriginal health staff on maternal oral health

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ariana C. Kong ◽  
Mariana S. Sousa ◽  
Lucie Ramjan ◽  
Michelle Dickson ◽  
Joanne Goulding ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Pregnant Women ◽  
Dental Care ◽  
Health Workers ◽  
Aboriginal Health ◽  
Health Staff ◽  
Care Providers ◽  
Aboriginal Women ◽  
Family Partnership

Abstract Background In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. Methods A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. Results A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. Conclusions The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.

scholarly journals Financing Oral Health Care for Low-Income Adults Living with HIV/AIDS

2012 ◽  
Vol 127 (2_suppl) ◽  
pp. 82-86 ◽  
Author(s):  
Helene Bednarsh ◽  
David A. Reznik ◽  
Carol R. Tobias
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Low Income ◽  
Oral Health Care ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals SPECIAL NEEDS OF SPECIAL CHILDREN-PARENTAL VIEW

2015 ◽  
Vol 05 (02) ◽  
pp. 038-044
Author(s):  
Amitha M. Hegde ◽  
Aiswarya Ann Babu ◽  
Anshad Mohammed ◽  
Anu John ◽  
Kanwardeep Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Treatment Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Medical Needs ◽  
Dental Needs ◽  
Special Health

AbstractIndividuals with special health care needs experience poor oral hygiene and periodontal status and are more likely to have unmet dental needs than any other medical needs. The study was conducted to assess the views, attitudes and perceptions of oral health and treatment needs among the parents of 250 children with disabilities at 3 special schools in Mangalore based on questionnaire method. Data collected were subjected to statistical analysis.The educational status of the parents were assessed and it was seen that more than 50% of the parents had school education of class 10 and below. 52% of the parents felt that dental treatment is not as important medical treatment and 69 % of the parent's preferred general dentist and only 12.3% had consulted Pedodontist for any dental needs of their children. Only 11% followed a regular dental check-up and 57% of the parents interviewed visited dentist only when required. 30% of the parents reported lack of awareness as the greatest barrier faced by them in rendering dental care for their children.There was a generalised lack of information regarding oral health and treatment needs seen among the parents of the children with special health care needs. The level of knowledge appeared to be low and the parents were not aware of the unique problems faced by these children.

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