Department of Stomatology, Division of Population Oral Health, Medical University of South Carolina, Charleston, South Carolina (Drs Nelson and Martin); Department of Health Promotion, Education, & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (Drs Spencer and Blake); and Department of Family & Community Medicine, and Department of Epidemiology & Prevention, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (Dr Moore).
J Public Health Manag Pract. 2018 May/Jun;24(3):e19-e24. doi: 10.1097/PHH.0000000000000622.
Because of persistent effects of early childhood caries and impacts of dental health professional shortages areas, the integration of oral health in primary care settings is a public health priority. In this study, we explored oral health interprofessional practice (OHIP) as an integrative pathway to reduce oral health disparities. OHIP can include performing oral health risk assessments, describing the importance of fluoride in the drinking water, implementing fluoride varnish application, and referring patients to a dental home.
To conduct a formative evaluation of how 15 pediatric primary care practices implemented the adoption of OHIP in their clinical settings.
Using an ecological framework, we conducted a qualitative process evaluation to measure the factors that inhibited and facilitated OHIP adoption into pediatric settings. Document review analysis and qualitative interviews were conducted with pediatric practices to contextualize challenges and facilitators to OHIP adoption.
A total of 15 Children's Health Insurance Program Reauthorization Act pediatric practices located in 13 South Carolina counties participated in this study.
Outcomes of interest were the facilitators and challenges of OHIP adoption into pediatric primary care practices.
Thematic analysis revealed challenges for OHIP adoption including limited resources and capacity, role delineation for clinical and administrative staff, communication, and family receptiveness. OHIP training for clinical practitioners and staff and responsiveness from clinical staff and local dentists were facilitators of OHIP adoption. Twelve key recommendations emerged on the basis of participant experiences within OHIP, with developing an active dental referral network and encouraging buy-in from clinical staff for OHIP adoption as primary recommendations.
We demonstrated the effectiveness of a learning collaborative meeting among pediatric primary care providers to adopt OHIPs. This work reveals an actionable pathway to support oral health equity advancement for children through an additional access point of preventive oral care, reinforcement of positive oral health behaviors, and interaction between parent and child for overall health and wellness of the family.
由于儿童期龋病的持续影响和牙医短缺地区的影响，将口腔健康纳入初级保健机构是公共卫生的重点。在这项研究中，我们探讨了口腔健康跨专业实践（OHIP）作为减少口腔健康差距的综合途径。OHIP 可以包括进行口腔健康风险评估、描述饮用水中氟化物的重要性、实施氟化物涂料应用以及将患者转介到牙科之家。
对 15 家儿科初级保健实践采用 OHIP 进行临床实践的情况进行形成性评估。
使用生态框架，我们进行了定性过程评估，以衡量阻碍和促进 OHIP 在儿科环境中采用的因素。对儿科实践进行了文件审查分析和定性访谈，以了解 OHIP 采用的挑战和促进因素。
本研究共有 13 个南卡罗来纳州的儿童健康保险计划再授权法案儿科实践参与。
感兴趣的结果是 OHIP 采用儿科初级保健实践的促进因素和挑战。
主题分析显示，OHIP 采用的挑战包括资源和能力有限、临床和行政人员的角色界定、沟通和家庭接受程度。OHIP 培训临床医生和工作人员以及临床工作人员和当地牙医的回应是 OHIP 采用的促进因素。根据参与者在 OHIP 中的经验，提出了 12 项关键建议，其中主要建议是建立积极的牙科转诊网络，并鼓励临床工作人员接受 OHIP 以促进口腔健康公平。
我们展示了儿科初级保健提供者之间学习合作会议采用 OHIP 的有效性。这项工作揭示了通过额外的预防口腔保健接入点、强化积极的口腔健康行为以及父母与子女之间的互动来促进儿童口腔健康公平的可行途径，以实现家庭的整体健康和幸福。
