Impact of the Health Resources and Services Administration's state oral health workforce grant program on dental workforce density and access to oral health care.

BACKGROUND: The Health Resources and Services Administration's Grants to States to Support Oral Health Workforce Activities, otherwise known as the State Oral Health Workforce Program (SOHWP), help states develop and implement innovations that address the workforce needs of dental Health Professional Shortage Areas in a manner appropriate to the states' individual needs. AIM: This cross-sectional study explores the broad impact of the SOHWP by comparing measures of dental workforce density and access to oral health care in states with multiple years of funding versus states with few or no years of funding. METHODS: We used data for 2006-2016 SOHWP awardees together with data from the 2016-2017 Area Health Resources Files and the 2016 Behavioral Risk Factor Surveillance System to compare numbers of dentists per 100,000 population and age-adjusted prevalence of annual dental visits among adults for long-term SOHWP-funded states versus states with few or no years of funding. RESULTS: Multi-year SOHWP funding is associated with higher workforce density and greater access to oral health care, especially in the Midwest and West. CONCLUSION: Allowing states funding utilization flexibility may result in improved outcomes. This finding can help inform planning and policy about whether and how to scale future training and workforce programs to achieve greater impact.

Assistive technology curriculum structure and content in professional preparation service provider training programs.

Assistive technology (AT) and AT services enable children and youth with disabilities and special health care needs to participate in society and are increasingly a part of service provider practice. It is not clear how professional preparation programs are meeting the challenge of preparing service providers to provide AT/AT services. An electronic survey was sent to the program directors for occupational therapy, physical therapy, special education, and speech-language pathology programs in the United States (n = 959) to determine the extent to which AT/AT services were included in the curriculum. The results (n = 153) showed that nearly all of the programs that responded covered AT/AT services in their curriculum, used similar types of faculty and teaching method patterns, and were generally satisfied with the amount of time they spent on the subject. The programs differed, however, in terms of the time spent and emphasis of content specific to their program type. Gaps existed in the extent to which programs covered the influence of culture on the use of AT and addressing the requirement to discuss AT/AT services at every Individualized Education Program meeting. These gaps and emphasis on specific topics within program types indicate that service providers may leave programs with a narrow scope of knowledge about AT/AT services. Information from this survey suggests that to promote contemporary practice in the areas of AT/AT services, entry-level curricula should be enriched or expanded to comprehensively present AT information instruction in this growing service area.

Telepsychiatry improves paediatric behavioural health care in rural communities.

In the US, children with special health care needs are underserved by both the medical and educational systems. This problem is especially serious in rural states. Telemedicine is a technique that can reduce these gaps in service and help connect the two systems. The technology required has become cheaper and more accessible. Progress on reimbursement for such services has also been made. For some years, we have provided telepsychiatry for children in Washington State using videoconferencing. Interviews with families and service providers were conducted in Washington and Missouri. Some parents reported that their child actually preferred telepsychiatry to conventional consultation. The telepsychiatry service model was built on the existing system of outreach clinics, thus involving specialists who were familiar with the community and who were known and trusted by the community. Before starting, we ensured that all relevant service delivery agencies and providers were comfortable about using videoconferencing as a method of service delivery. In the 18-month period ending in March 2003, three providers in Seattle saw 159 patients by telepsychiatry and 210 patients face-to-face at the hospital clinic. The main barrier to further growth of the telepsychiatry service is the absence of reimbursement for telepsychiatry.