San Francisco Department of Public Health, 1525 Silver Avenue, San Francisco, CA 94134, USA.
J Public Health Dent. 2010 Jun;70 Suppl 1:S15-23. doi: 10.1111/j.1752-7325.2010.00175.x.
Oral health disparities currently exist in the United States, and workforce innovations have been proposed as one strategy to address these disparities. A framework is needed to logically assess the possible role of workforce as a contributor to and to analyze workforce strategies addressing the issue of oral health disparities.
Using an existing framework, A Strategic Framework for Improving Racial/Ethnic Minority Health and Eliminating Racial/Ethnic Health Disparities, workforce was sequentially applied across individual, environmental/community, and system levels to identify long-term problems, contributing factors, strategies/innovation, measurable outcomes/impacts, and long-term goals. Examples of current workforce innovations were applied to the framework.
Contributing factors to oral health disparities included lack of racial/ethnic diversity of the workforce, lack of appropriate training, provider distribution, and a nonuser-centered system. The framework was applied to selected workforce innovation models delineating the potential impact on contributing factors across the individual, environmental/community, and system levels. The framework helps to define expected outcomes from workforce models that would contribute to the goal of reducing oral health disparities and examine impacts across multiple levels. However, the contributing factors to oral health disparities cannot be addressed by workforce innovation alone.
The Strategic Framework is a logical approach to guide workforce innovation, solutions, and identification of other aspects of the oral healthcare delivery system that need innovation in order to reduce oral health disparities.
目前美国存在口腔健康方面的差异,有人提议创新劳动力资源策略来解决这些差异。需要有一个框架来逻辑地评估劳动力作为促成因素的可能作用,并分析解决口腔健康差异问题的劳动力策略。
使用现有的框架,即《改善种族/少数民族健康和消除种族/少数民族健康差异的战略框架》,依次将劳动力应用于个人、环境/社区和系统各级,以确定长期问题、促成因素、策略/创新、可衡量的结果/影响以及长期目标。将当前劳动力创新的示例应用于框架中。
口腔健康差异的促成因素包括劳动力缺乏种族/民族多样性、缺乏适当的培训、提供者分布以及非以用户为中心的系统。该框架适用于选定的劳动力创新模型,勾勒出对个人、环境/社区和系统各级促成因素的潜在影响。该框架有助于从劳动力模型中定义预期结果,这些结果将有助于实现减少口腔健康差异的目标,并检验多个层面的影响。然而,口腔健康差异的促成因素不能仅通过劳动力创新来解决。
战略框架是指导劳动力创新、解决方案以及确定口腔医疗保健提供系统需要创新的其他方面的逻辑方法,以减少口腔健康差异。