Searched for: person:men6
in-biosketch:yes
Shifting the Focus Using Remote Training on Shared Decision-Making and Motivational Interviewing: A Quantitative Evaluation
Northridge, Mary E; Allen, Matthew; Franck, Etienne; Pipaliya, Chandni; Vazquez-Sanchez, Manuel R; Troxel, Andrea B; Lieberman, Martin
OBJECTIVE:To compare the pre-post intervention findings of dentists remotely trained to use shared decision-making (SDM) and motivational interviewing (MI) techniques. METHODS:In partnership with the New York Simulation Center for the Health Sciences and a Motivational Interviewing Network of Trainers consultant, three scenarios regarding interprofessional care were developed toward fostering the essential skills to build nonjudgmental dentist-patient partnerships: (1) screening and referral for the social determinants of health with an older adult dental patient; (2) parental consideration of the human papillomavirus vaccine for a 9-year-old dental patient; and (3) engagement with an obese adolescent dental patient to decrease their sugary drink intake. A Welch t-test was used to compare the importance and confidence ruler poll ratings pre-post intervention. RESULTS:In Fall 2024, four remote objective structured clinical exercise training sessions were conducted where standardized participants previously trained as patients rotated between three different breakout rooms so that dentist learners were able to participate in all three scenarios. The subset of dentist learners who responded to both the pre- and post-intervention surveys (37%) reported both greater use and usefulness of MI when discussing oral health recommendations with their patients/parents after the training. Poll results with 16 dentist learners were that they were more likely to feel confident in using SDM and MI techniques with parents/patients post- versus pre-intervention: mean difference [95% confidence interval] = 1.12 [-0.16, 2.41]. CONCLUSIONS:Respectful, participatory training strategies can shift the focus from healthcare providers as the authorities to patients as the agents of their behavior change.
PMID: 40189787
ISSN: 1930-7837
CID: 5823542
A feasibility and acceptability study of screening the parents/guardians of pediatric dental patients for the social determinants of health
Kaur, Raghbir; Lieberman, Martin; Mason, Margaret K; Dapkins, Isaac P; Gallager, Rebecca; Hopkins, Kathleen; Wu, Yinxiang; Troxel, Andrea B; Rashwan, Ayah; Hope, Chelsea; Kane, Daniel J; Northridge, Mary E
BACKGROUND:The social determinants of health (SDOH) are the conditions in which people are born, grow, work, live, and age. Lack of SDOH training of dental providers on SDOH may result in suboptimal care provided to pediatric dental patients and their families. The purpose of this pilot study is to report the feasibility and acceptability of SDOH screening and referral by pediatric dentistry residents and faculty in the dental clinics of Family Health Centers at NYU Langone (FHC), a Federally Qualified Health Center (FQHC) network in Brooklyn, NY, USA. METHODS:Guided by the Implementation Outcomes Framework, 15 pediatric dentists and 40 pediatric dental patient-parent/guardian dyads who visited FHC in 2020-2021 for recall or treatment appointments participated in this study. The a priori feasibility and acceptability criteria for these outcomes were that after completing the Parent Adversity Scale (a validated SDOH screening tool), ≥ 80% of the participating parents/guardians would feel comfortable completing SDOH screening and referral at the dental clinic (acceptable), and ≥ 80% of the participating parents/guardians who endorsed SDOH needs would be successfully referred to an assigned counselor at the Family Support Center (feasible). RESULTS:The most prevalent SDOH needs endorsed were worried within the past year that food would run out before had money to buy more (45.0%) and would like classes to learn English, read better, or obtain a high school degree (45.0%). Post-intervention, 83.9% of the participating parents/guardians who expressed an SDOH need were successfully referred to an assigned counselor at the Family Support Center for follow-up, and 95.0% of the participating parents/guardians felt comfortable completing the questionnaire at the dental clinic, surpassing the a priori feasibility and acceptability criteria, respectively. Furthermore, while most (80.0%) of the participating dental providers reported being trained in SDOH, only one-third (33.3%) usually or always assess SDOH for their pediatric dental patients, and most (53.8%) felt minimally comfortable discussing challenges faced by pediatric dental patient families and referring patients to resources in the community. CONCLUSIONS:This study provides novel evidence of the feasibility and acceptability of SDOH screening and referral by dentists in the pediatric dental clinics of an FQHC network.
PMCID:9996555
PMID: 36895054
ISSN: 2055-5784
CID: 5495522
The COVID-19 pandemic and the elevation of aging issues
Northridge, Mary E.
SCOPUS:85167979853
ISSN: 2667-0321
CID: 5568622
A feasibility and acceptability study of using an intra-oral camera and an asynchronous tele-mentoring protocol to detect and identify oral lesions
Northridge, Mary E; Weiserbs, Kera F; Sabounchi, Shabnam Seyedzadeh; Torroni, Andrea; Mohadjeri-Franck, Nathalie S; Gargano, Steven; George, Eliot; Littlejohn, Tina C; Troxel, Andrea B; Wu, Yinxiang; Testa, Paul A; Wismer, Jennifer; Zaremba, Kiah; Tylawsky, Peter; Bina, Babak
Background/UNASSIGNED:To examine the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the dental clinics of a Federally Qualified Health Center network. Design and Methods/UNASSIGNED:General Practice Residency faculty and residents completed research ethics courses and trained dentists to use intra-oral cameras at chairside to photograph oral lesions of patients at routine dental visits. These images were then uploaded into the patient electronic health records (EHRs) with attendant descriptions and an oral surgeon was notified, who reviewed the charts, placed his observations in the EHR, and communicated his findings via secure e-mail to the involved residents, who in turn contacted their patients regarding follow-up actions. Feasibility was assessed via checklists completed by provider participants and semi-structured interviews. Acceptability was assessed via brief exit interviews completed by patient participants. Results/UNASSIGNED:All 12 of the dentist participants reported that they had successfully provided the tele-mentoring intervention, and that the process (from EHR data entry to interaction with the oral surgeon over findings to patient referral) was clear and straightforward. Of 39 patient participants, most strongly agreed or agreed that the use of an intra-oral camera by their dentists helped them to better understand oral cancer screening (94.9%) and that dentists answered their questions about oral cancer and were able to provide them with resources (94.8%). Conclusions/UNASSIGNED:Findings support further implementation research into adapting tele-mentoring using intra-oral cameras for training dental residents to detect and identify oral lesions and educating patients about oral cancer across settings.
PMCID:9445478
PMID: 36081898
ISSN: 2279-9028
CID: 5337252
Oral health conditions and COVID-19: A systematic review and meta-analysis of the current evidence
Qi, Xiang; Northridge, Mary E; Hu, Mengyao; Wu, Bei
Background/UNASSIGNED:The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of understanding the underlying conditions that lead to COVID-19. Oral health has systemic implications in the maintenance of a healthy state. This study aimed to summarize evidence on the prevalence of oral health conditions in participants with COVID-19 and assess the associations between oral health conditions and COVID-19 related outcomes. Methods/UNASSIGNED:Article searches were conducted in five databases and the gray literature from December 1, 2019 to March 1, 2021. Studies that reported oral health conditions for participants with COVID-19 and/or examined associations between oral health and COVID-19 were included. Results/UNASSIGNED:We identified 15 articles that encompassed 5,377 participants with COVID-19 from 10 countries. Dry mouth was the most common oral health condition reported (41.0%), followed by oral lesions (38.8%), orofacial pain (18.3%), and periodontal symptoms (11.7%). Based on the pooled odds ratios (ORs), periodontal symptoms were not associated with COVID-19 positivity (ORÂ =Â 1.1; 95% confidence intervals [CI], 0.73-1.65) or mortality (ORÂ =Â 2.71; 95% CI, 0.64-11.51), but were associated with COVID-19 severity (ORÂ =Â 3.18; 95% CI, 1.81-5.58). Conclusions/UNASSIGNED:Oral health conditions are common in participants with COVID-19 and should be considered in both the onset and progression of this disease. Knowledge in this area is still limited, and the quality of the data extracted was low. Further longitudinal studies are needed to ascertain whether oral health conditions are a consequence of infection with SARS-CoV-2 or whether they predate infection and are risk factors for COVID-19.
PMCID:8896863
PMID: 35281130
ISSN: 2667-0321
CID: 5220652
Disparities in Access to Oral Health Care
Northridge, Mary E; Kumar, Anjali; Kaur, Raghbir
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
PMID: 31900100
ISSN: 1545-2093
CID: 4252262
Implementing a Patient-Centered and Cost-Effective School-Based Oral Health Program
Mason, Margaret; Gargano, Lynn; Kumar, Anjali; Northridge, Mary E
PMID: 31598972
ISSN: 1746-1561
CID: 4130692
Advancing Oral Health Equity Through School-Based Oral Health Programs: An Ecological Model and Review
Gargano, Lynn; Mason, Margaret K; Northridge, Mary E
In the United States and elsewhere, children are more likely to have poor oral health if they are homeless, poor, and/or members of racial/ethnic minority and immigrant populations who have suboptimal access to oral health care. As a result, poor oral health serves as the primary marker of social inequality. Here, the authors posit that school-based oral health programs that aim to purposefully address determinants of health care access, health and well-being, and skills-based health education across multiple levels of influence (individual/population, interpersonal, community, and societal/policy) may be more effective in achieving oral health equity than programs that solely target a single outcome (screening, education) or operate only on the individual level. An ecological model is derived from previously published multilevel frameworks and the World Health Organization (WHO) concept of a health-promoting school. The extant literature is then examined for examples of evaluated school-based oral health programs, their locations and outcomes(s)/determinant(s) of interest, the levels of influence they target, and their effectiveness and equity attributes. The authors view school-based oral health programs as vehicles for advancing oral health equity, since vulnerable children often lack access to any preventive or treatment services absent on-site care provision at schools. At the same time, they are incapable of achieving sustainable results without attention to multiple levels of influence. Policy solutions that improve the nutritional quality of children's diets in schools and neighborhoods and engage alternative providers at all levels of influence may be both effective and equitable.
PMCID:6901974
PMID: 31850296
ISSN: 2296-2565
CID: 4250692
Developing an agent-based model of oral healthcare utilization by Chinese Americans in New York City
Zhang, Qiuyi; Metcalf, Sara S; Palmer, Harvey D; Northridge, Mary E
Many Chinese Americans experience certain barriers (e.g., low income, English as a second language, lack of insurance, cultural differences, discrimination) when they seek oral healthcare services. These barriers may contribute to health disparities by discouraging use (leading to reduced utilization) of preventive and treatment services. This research adopts a modeling approach to develop theory that accounts for dynamic relationships operating at multiple levels, from individuals to families to communities. A multi-method and multi-level modeling approach allows for the interaction of factors at different levels of aggregation. This research applies spatially explicit agent-based modeling to examine how demographic, socioeconomic, and geographic factors shape access to oral healthcare for low-income Chinese Americans in New York City. The simulation model developed in this research was used to test different intervention scenarios involving community health workers who facilitate care coordination and other health promotion activities. In addition to demographic characteristics and socioeconomic factors, this study also considers geographic factors and spatial behavior, such as distance and activity space. The overarching contribution of this study is to provide a complex systems science framework to better understand access to oral healthcare for urban Chinese Americans, toward adapting it for other racial/ethnic minority groups, by integrating health-seeking behaviors at the individual level, barriers to care at multiple levels, and opportunities for health promotion at the community level.
PMID: 35063878
ISSN: 1873-2054
CID: 5132022
Spatial Analysis of Chinese American Ethnic Enclaves and Community Health Indicators in New York City
Zhang, Qiuyi; Metcalf, Sara S; Palmer, Harvey D; Northridge, Mary E
In New York City, the population of Chinese Americans has grown faster than that of any other minority racial/ethnic group, and now this community constitutes almost half of all Chinese Americans living in the northeastern United States. Nonetheless, scant research attention has been given to Chinese American ethnic enclaves and little is known about the health status of their residents. This study aims to help address this gap in the literature by: (1) improving our understanding of the spatial settlement of Chinese Americans living in New York City from 2000 to 2016; and (2) assessing associations between a New York City resident's likelihood of living in a Chinese American enclave and their access to health care and perceived health status, two measures of community health. In support of this aim, this study establishes a robust criterion for defining ethnic enclaves at the Census tract level in New York City as the communities of interest in this paper. An ethnic enclave is defined as an area at the Census tract level with high dissimilarity and a spatial cluster of Chinese Americans. The spatial findings were that Chinese Americans in New York City were least segregated from other Asian American residents, somewhat segregated from White residents, and most segregated from Black residents. Also, the population density of Chinese Americans increased since 2000, as reflected by their declining exposure index with other Asian Americans. Results from logistic regression indicated that the probability of living in a Chinese American enclave was negatively associated with positive self-perception of general health and positively associated with delays in receiving health care. For Chinese American residents of New York City, living in an ethnic enclave was also associated with both lower socioeconomic status and poorer community health.
PMCID:8831844
PMID: 35155326
ISSN: 2296-2565
CID: 5167322