Oral Health Literacy Workshop Summary (2013) / Chapter Skim
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5 Oral Health Literacy Programs
5 Oral Health Literacy Programs
Pages 33-64
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From page 33... ...
The clinic is participating in an environmental scan to better understand why effective preventive practices are not succeeding in the community. A recent New York Times article described the use of general anesthesia to treat extensive dental disease in preschoolers.1 In Wolpin's view, 1 "Preschools in surgery for a mouthful of cavities," New York Times, March 6, 2012.
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From page 34... ...
Wolpin said that this might be a sign of distrust of providers and described how many clients do not know when or how to ask questions about the treatment options that are present for them or for their children. Wolpin provided an illustration of the impact of low oral health literacy.
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A mail survey is planned that will go out to dental providers and cover communication techniques. Several important lessons resulted from the environmental scan process, Wolpin said.
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ORAL HEALTH LITERACY: HOW CAN WE IMPACT VULNERABLE POPULATIONS? Marsha Butler Colgate-Palmolive Company Marsha Butler, vice president of global oral health at ColgatePalmolive Company, discussed a children's oral health promotion campaign that has been implemented globally, the Colgate Bright Smiles, Bright Futures program.
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Butler cited the definition of oral health literacy from Healthy People 2010: "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services necessary to make appropriate health decisions" (HHS, 2000a) and enumerated some of the instructive findings from the health literacy literature: • Thirty percent of U.S.
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The Bright Smiles, Bright Futures program uses eight mobile vans to take the program to where children live, and where vulnerable populations reside. These mobile vans have traveled to more than 160 cities.
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ORAL HEALTH LITERACY PROGRAMS 39 FIGURE 5-1 A checklist to prevent dental caries. SOURCE: Butler, 2012.
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The program participates in large community festivals and multicultural events. In addition, partnerships have been formed with the media and public relations groups to promote oral health literacy.
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Third, more research is needed to better understand the impact of grassroots approaches to promote oral health literacy at both the individual and community level. DENTIST-PATIENT COMMUNICATION TECHNIQUES USED IN THE UNITED STATES: THE RESULTS OF A NATIONAL SURVEY Gary Podschun American Dental Association Podschun presented the results of a recent national survey sponsored by the American Dental Association (ADA)
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Alice M Horowitz, University of Maryland at College Park, School of Public Health • Brad Petersen, ADA Health Policy Resources Center • John Cantrell, University of North Carolina at Chapel Hill, Gillings School of Global Public Health The definition of oral health literacy adopted as ADA policy in 2006 is "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate oral health decisions." This definition was adapted from a definition of health literacy formulated at a 2004 National Institute of Dental and Craniofacial Research (NIDCR)
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Questionnaires were mailed to 6,300 sampled dentists and two mail and one telephone follow-ups were conducted to improve response rates. The questionnaire included 86 items that were developed by the ADA National Advisory Committee on Health Literacy and Dentistry.
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As part of the survey, dentists were asked whether they thought each of the 18 communication techniques were effective. A scale was created by summing the yes responses to each of the 18 techniques.
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Of the TABLE 5-1 Dentists' Routine Use of Oral Health Literacy Techniques Percent Technique Routinely Used Patient friendly 1. Ask patients how they learn best 4.9 2. Refer patients to Internet 11.1 3. Use interpreter 15.3 Teach back 4. Ask patient to repeat information or instructions* 16.0 5. Ask patient to tell you what they will do at home 23.5 to follow instructions*
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Podschun discussed how variables that measured some aspect of health literacy awareness, communication training, outcome expectancy, barriers, and practice-level change were also associated with the number of techniques used. One of the strongest predictors within this group of
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ORAL HEALTH LITERACY PROGRAMS 47 FIGURE 5-3 Practice characteristics and differences in mean numbers of techniques used. NOTE: © American Dental Association, All Rights Reserved.
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In his view, to advance dentist-patient communication effectiveness, oral health literacy tools need to be developed with a multidisciplinary research agenda. Lastly, Podschun stated that policies and
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To lay the groundwork for their project, Pew several years ago attempted to ascertain what, if anything, the public thought about community water fluoridation and how issues related to water fluoridation were playing out in different communities. Phone surveys and several focus groups were conducted.
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However, in many cases water fluoridation was considered a local community issue where this "tiptoe" approach worked quite well. This approach, however, has had some unintended negative consequences for oral health literacy.
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And yet, Jacob said, the one thing that has complicated the dynamic of community water fluoridation is that this issue, unlike other areas of dental health, has an opposition. According to Jacob, relatively few people oppose water fluoridation but these individuals are persistent, similar to the opposition organized around vaccines.
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To build public awareness, Jacob stated that it is critical to frame the issue of water fluoridation in the context of oral health. Pew is one of at least 30 organizations that have partnered to launch the Campaign for Dental Health.
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Building awareness in this area is vital according to Jacob. He cited a 2010 study indicating that parents' low level of health literacy was linked to a lower rate of sealant use by children (Mejia et al., 2011)
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Jacob mentioned the similarities between the anti-vaccine movement and the anti-fluoridation movement. Isham said that there are many opportunities for organizations to leverage their assets for educating the public and identified the different levels of intervention that are needed to meet the oral health literacy challenge.
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He noted that the ADA survey results showed that dentists with lowoutcome expectancies used fewer health literacy techniques. Ross asked, "Why did they have such low outcome expectancies?
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Roundtable member Pearson observed that health literacy and oral health literacy have followed a similar trajectory as a field in its development phase. The initial work often involves designing evaluation and research programs to identify where problems exist in the community.
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The dental residents shadow a primary care provider, so they learn about medicine. Rush asked Wolpin to describe the content of the training that is provided to his staff on health literacy.
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Brach asked Wolpin what systematic changes were made at the health center as a result of his participation in the oral health literacy environmental scan conducted there. She also asked how other health centers that are not participating in a research study could identify shortcomings and find resources to assist them in addressing oral health literacy.
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Finding out that a colleague has better outcomes following the adoption of oral health literacy practices could motivate change. Roundtable member Humphreys asked Butler how the materials developed for the Bright Smiles, Bright Futures campaign had to be adapted for use in different countries.
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Practices that are recommended in health literacy should be applied to oral health literacy. Butler agreed with Horowitz and added that it is important to look at oral health as a part of overall health.
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Second, while it may be too early to tell what distinguishes oral health literacy from health literacy in general, the important focus at this time is on implementing evidence-based findings. Third, the incorporation of evidence-based practice into dental practice seems to be an issue.
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That said, Horowitz concluded that incorporating oral health messages into general health literacy is very helpful. Wolpin described the evolution of dentistry during the past 20 years.
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Ismail encouraged the workshop participants to move beyond reports with recommendations and urged the participants to act. He stated that one action that could improve oral health literacy is the development of a tool for the assessment of literacy and a list of interventions that have been proven to change environments and organizations.
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