Greenblatt A P, Estrada I, Schrimshaw E W, Metcalf S S, Kunzel C, Northridge M E
Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY, USA.
Section of Population Oral Health, Columbia University College of Dental Medicine, New York, NY, USA.
JDR Clin Trans Res. 2017 Oct;2(4):343-352. doi: 10.1177/2380084417716880. Epub 2017 Jun 28.
An aging and more racially and ethnically diverse population, coupled with changes in the health care policy environment, is demanding that the dental profession both redirect and expand its focus. Challenges include providing comprehensive care for patients with complicated medical needs while improving access to care for underserved groups. The purpose of this study is to examine the acceptability of screening for hypertension and diabetes in the dental setting for African American, Puerto Rican, and Dominican older adults who attend senior centers in northern Manhattan, New York City. Focus groups were conducted with 194 racial/ethnic minority men and women aged 50 y and older living in northern Manhattan who participated in 1 of 24 focus group sessions about improving oral health for older adults. All groups were digitally audio-recorded and transcribed for analysis. Groups that were conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Five themes were manifest in the data regarding the willingness of racial/ethnic minority older adults to receive hypertension and diabetes screening as part of routine dental visits: 1) chairside screening is acceptable, 2) screening is routine for older adults, 3) the interrelationship between oral and general health is appreciated, 4) chairside screening has perceived benefits, and 5) chairside screening may reduce dental anxiety. Reservations centered on 4 major themes: 1) dental fear may limit the acceptability of chairside screening, 2) there is a perceived lack of need for dental care and chairside screening, 3) screening is available elsewhere, and 4) mistrust of dental providers as primary care providers. This study provides novel evidence of the acceptability of screening for hypertension and diabetes in the dental setting among urban racial/ethnic minority senior center attendees. The results of this study may be used by oral health providers when deciding whether to conduct chairside screening for medical conditions such as hypertension and diabetes that could affect, or be affected by, the oral health of their patients. Patient experiences of care-along with clinical outcomes, avoidable hospital admissions, equity of services, and costs-are important outcomes to consider in meeting the needs of an aging and racially and ethnically diverse US population.
人口老龄化以及种族和民族多样性增加,再加上医疗保健政策环境的变化,要求牙科行业重新调整并扩大其关注重点。挑战包括为有复杂医疗需求的患者提供全面护理,同时改善弱势群体获得护理的机会。本研究的目的是调查在纽约市曼哈顿北部老年中心就诊的非裔美国人、波多黎各人和多米尼加老年人在牙科环境中接受高血压和糖尿病筛查的可接受性。对194名年龄在50岁及以上、居住在曼哈顿北部的种族/族裔少数群体男性和女性进行了焦点小组访谈,他们参加了24场关于改善老年人口腔健康的焦点小组会议中的一场。所有小组均进行了数字录音并转录以供分析。用西班牙语进行的小组先转录为西班牙语,然后再翻译成英语。使用主题内容分析法对转录本进行分析。关于种族/族裔少数群体老年人愿意在常规牙科就诊时接受高血压和糖尿病筛查的数据中体现出五个主题:1)椅旁筛查是可接受的,2)筛查对老年人来说是常规的,3)认识到口腔健康与整体健康之间的相互关系,4)椅旁筛查有可感知的益处,5)椅旁筛查可能会减轻牙科焦虑。保留意见集中在四个主要主题上:1)牙科恐惧可能会限制椅旁筛查的可接受性,2)认为对牙科护理和椅旁筛查缺乏需求,3)在其他地方可以进行筛查,4)不信任牙科提供者作为初级保健提供者。本研究提供了新的证据,证明城市种族/族裔少数群体老年中心参与者在牙科环境中接受高血压和糖尿病筛查的可接受性。口腔健康提供者在决定是否对可能影响患者口腔健康或受患者口腔健康影响的高血压和糖尿病等医疗状况进行椅旁筛查时,可使用本研究结果。患者的护理体验以及临床结果、可避免的住院、服务公平性和成本,都是满足美国老龄化且种族和民族多样化人口需求时需要考虑的重要结果。