Browsing by Subject "Oral Health"
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Item Investigating the Complex Relationship Between Adverse Childhood Experiences and Oral Health-Related Quality of Life(2017-05) Kabani, Faizan A.; Lykens, Kristine A.Dental caries is one of the most common chronic disease in children and continues to be a significant global public health concern. Evidence indicates that chronic diseases, and adverse childhood experiences (ACEs), have destructive impacts on overall quality of life, health outcomes, and health care expenditures. The ACE investigation identified cumulative dose-response relationships between ACEs and development of diverse health and social consequences later in life. Research is scarce on investigating causal pathways to facilitate contextualized public health interventions addressing this seismic threat. Data was utilized from the 2011-2012 National Survey of Children's Health, inclusive of ages 1-17 for dentate status. The dependent variables identified untreated oral health care needs and preventive dental utilization. The key independent variable, ACEs, included exposure to parental death, parental divorce, parental incarceration, mental health illnesses, domestic violence, neighborhood violence, and racial discrimination. Exogenous variables included age, sex, race/ethnicity, number of children in household, socioeconomic status proxies, health insurance status, and presence of special health care needs. Path analysis, a special subcomponent of structural equation modeling was utilized to explore direct, indirect, and mediating causal pathways. The data, when adjusted for complex survey design, proportionately represents children in the United States. The results of the adjusted logistic regressions revealed ACEs demonstrating varying magnitudes of significance across diverse racial and ethnic profiles. Exposures to parental divorce and parental death particularly exhibited critical magnitudes of influence. Adjusted path analyses demonstrated alternative family structures contributing a mediating role between ACEs and oral health-related quality of life (OHRQoL). In keeping with the Pareto Principle, exposure to certain ACEs, namely parental divorce and parental death, potentially introduces more profound social and health-related consequences later in life. Moreover, invocation of Occam's razor, can assist in theorizing that exposure to alternative family structures (i.e. via parental divorce and/or parental death) initiate a concatenated deteriorating domino effect sequela of secondary ACEs. Therefore, contextualized interventions should prioritize psychotherapeutic child, marriage, and family counseling services improving the home, as an enabling environment, to potentially minimize detriments of ACEs on OHRQoL.Item Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers(BioMed Central Ltd., 2023-10-12) Vamos, Cheryl A.; Cayama, Morgan Richardson; Mahony, Helen; Griner, Stacey B.; Quinonez, Rocio B.; Boggess, Kim; Beckstead, Jason; Daley, Ellen M.BACKGROUND: Poor oral health during pregnancy has significant implications across the life course, including increased risk for adverse pregnancy, birth outcomes, and the development of early childhood caries. In efforts to improve perinatal oral health in the United States, a set of national interprofessional guidelines were developed that include recommended practice behaviors for both oral health providers and prenatal providers. The purpose of this study was to examine guideline awareness, familiarity, beliefs, and practice behaviors among both provider types. METHODS: Prenatal providers and oral health providers in Florida were recruited via random and convenience sampling to complete an online survey guided by the Consolidated Framework for Implementation Research (CFIR) and the Cabana Framework. The present analysis focused on the Individuals Involved domain (CFIR), awareness and familiarity with the guidelines (Cabana Framework), confidence, and practice behaviors as recommended by prenatal oral health guidelines (assess, advise, refer, share/coordinate). Data were analyzed using chi-square tests, independent samples t-tests, Pearson correlation coefficients, and one-way analysis of variance (ANOVA) and analyses were conducted in SPSS. RESULTS: Prenatal and oral health providers did not differ significantly in their awareness of the guidelines, but awareness was significantly associated with three of the four practice behaviors for prenatal providers. Familiarity with the guidelines was significantly higher among oral health providers and was associated with all four practice behaviors for both provider types. Five out of ten oral health belief items were significantly associated with practicing the guidelines among prenatal providers, but only two among oral health providers. Confidence in performing the practice behaviors was significantly associated with guideline implementation among both groups. Years in practice was significantly associated with performing practice behaviors for prenatal providers, but not for oral health providers. CONCLUSIONS: Our findings highlight the importance of professional organizations and the role of clinical guidelines on practice behaviors. Although provider education is a key implementation strategy, organizational and policy-level system changes could also be critical in supporting practice behaviors.