Perceptions of oral health in Appalachian Kentucky: implications for message design.

We conducted three studies to investigate Appalachian college students' perceptions and behavior concerning oral health for the purpose of identifying salient factors to consider in designing persuasive messages to promote oral health. In Study 1, we conducted seven focus groups with 67 college students at a state university in Appalachian Kentucky. Using thematic analysis, we found that students based their oral health behavior on the perception that people living in Appalachia have poor oral health and that students denied, confirmed, reframed, or fulfilled this "misconception." In Study 2, quantitative results from a representative survey of students (N = 587) at the same university indicated that the barriers to enacting good oral health behavior were primarily logistical in nature, whereas the facilitators of good oral health behavior were largely social. In Study 3, results from dental screenings (N = 364) of students at the university demonstrated that about one in five students presented with active, visible decay. We discuss how these results inform our understanding of oral health behavior in Appalachia and the implications of these results for designing messages to promote oral health in the region.

An Instrument to Measure Dental Students' Communication Skills With Patients in Six Specific Circumstances: An Exploratory Factor Analysis.

The aim of this study was to explore the internal structure of an instrument assessing dental students' confidence in their ability to communicate with patients in six specific circumstances (anxious, in pain, etc.) using exploratory factor analysis. In a Communication in the Dental Health Care Setting course at a U.S. dental school, second-year dental students in two years (2013 and 2014) responded to the six items on a survey instrument. Of the total 123 students, 122 fully completed the instrument, for a response rate of 99%. Analysis of the results identified a unidimensional scale with regards to patient-specific communication self-efficacy and explained 74% of the total variance. The scale had good internal consistency reflected by high Cronbach's alpha (α=0.929, 95% CI [0.907, 0.947]). These findings suggest the instrument may be a useful tool in assessing the development of patient communication skills in second-year dental students following a course in communication. Further exploration utilizing confirmatory analysis, determining predictive validity, and assessing convergent and discriminant evidence is warranted.

Dental school application timing: implications for full admission consideration and improving diversity of dental students.

The national underrepresentation of minorities in dental schools and the dental profession is a significant concern. Despite efforts over previous years, the number of practicing dentists from underrepresented minority (URM) groups has increased very little. Many dental schools have adopted a holistic admissions review process that uses noncognitive factors in an effort to increase diversity. However, application timing also significantly impacts the success of candidates. This study examined whether URM students' applying late in the application cycle contributes to their lower enrollment. This study attempted to fill a void in the dental admissions knowledge base by examining whether the timing of dental school applications in a rolling admissions system with a set number of interview spots favors those who apply early. De-identified applications (N=1,673) from one U.S. dental school in 2011 were examined. A binary logistic regression analysis revealed that URM applicants were significantly more likely to apply later in the admission cycle than non-URM applicants by a factor of 63 percent (p=0.001), increasing the competiveness for fewer remaining spots. These results suggest the need for pre-admission interventions and for future research to understand and address barriers that impact application timing.

Strategies for communicating with older dental patients.

BACKGROUND: Communication between dentists and patients 65 years or older is a critical aspect of providing optimum care, particularly given the increasing number of older adults and the communication barriers they often encounter. METHODS: The authors conducted a targeted literature review of the broad health communication literature and published health literacy guidelines to examine the barriers to effective communication that are specific to the older adult population, as well as strategies for overcoming these barriers. RESULTS: Findings from health communication and health literacy research provide insight into techniques to improve communication with older patients, such as preparing an agenda for the appointment, exhibiting warm nonverbal behavior, listening attentively, asking open-ended questions, using simple language, presenting key points one at a time and providing patients with written instructions. CONCLUSIONS: Physical, psychological and literacy issues pertaining to both patients and providers present barriers to effective communication. Practitioners can surmount these barriers by enacting communication strategies tailored to older adults. Practical Implications. Dentists can overcome barriers to communication and improve the quality of patient care by considering the communication barriers specific to older adults and enacting strategies to overcome these barriers.