Ensuring access to health care by FQHCs as states reopen amid COVID-19.

One in 5 Americans utilizes federally qualified health center (FQHC) services for their primary care, preventive, and community health needs. Medicaid and FQHC programs have been partners at the forefront of addressing population health needs for more than 50 years. Although testing and contact tracing during the coronavirus disease 2019 (COVID-19) crisis are helping rural FQHC patients, there are other vital Medicaid services that are both available right now and ripe for enhancement to ensure the accessibility of services during and after the COVID-19 emergency. A primary example is nonemergency medical transportation (NEMT). Community health centers must focus on NEMT use to ensure access to care for rural patients as states reopen. This commentary defines NEMT and ways that FQHCs can enhance it as a Medicaid benefit as states reopen amid COVID-19.

Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California.

Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant interview study with 50 participants between November 2019 and March 2020, including 44 dental providers (dentists, hygienists, and assistants) in public or private practice in California and 6 oral health literacy (OHL) experts. We undertook thematic analysis of interview transcripts and descriptive statistics about interviewees from pre-surveys. Dental providers reported frequently speaking slowly, and using simple language and models/radiographs to communicate with patients, while infrequently using interpretation/translation, illustrations, teach-back, or motivational interviewing. Providers reported using only 6 of the 18 American Medical Association's (AMA) recommended communication techniques and only 3 of the 7 AMA's basic communication techniques. A majority of providers indicated using one of five oral health assessment and educational strategies. Key barriers to effective communication included limited time, financial incentives promoting treatment over prevention, lack of OHL training, limited plain-language patient education materials, and patients with low OHL knowledge. Dental organizations should prioritize supporting dental providers in effective patient communication practices. Standardizing OHL continuing education, creating an evidence-based OHL toolkit for dental teams, ensuring accessible interpretation/translation services, and incentivizing dental providers to deliver education could improve oral health literacy and outcomes.