Post on 23-Feb-2016
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Oral Health Literacy: A Pathway to Reducing Oral Health Disparities in
Maryland
2011 Maryland Oral Health Summit: Pathways to Common Ground and Action
October 20, 2011Alice M. Horowitz, PhD
Dushanka V. Kleinman, DDS, MScD SCHOOL OF PUBLIC HEALTH
Remember
•Efforts to improve quality, reduce costs and reduce oral health disparities cannot succeed without simultaneous improvements:
• In oral health literacy of the public, health care providers and policy makers; and
•Ensuring the user friendliness of our dental facilities.
Health Literacy is:
the interaction between skills of individuals and demands of the healthcare system(s)
IOM Report 2004
Oral Health Literacy - Defined
“The degree to which individuals have the capacity to obtain, process and understand basic oral health information and services needed to make appropriate health decisions.”
Healthy People 2010
Importance of Literacy Skills
Literacy influences one’s ability to access information and to navigate the highly literate environments of today’s society.
influences
Oral Health Literacy is Associated With:
•Knowledge and understanding of preventive measures
•Frequency of dental visits
•Severity of dental caries
•Oral health and quality of life
What’s the Problem?
•Health literacy varies by race, ethnicity, level of education, and poverty level.
•The lower the health literacy the more likely the individual will have poor health, use fewer preventive procedures and use costly ER services.
•Less likely to manage chronic health conditions. National Assessment of Adult Literacy 2003
Maryland’s Approaches to Meet This Challenge
• Establish state needs
• Determine what the public knows and does regarding caries prevention & early detection
• Determine the public’s perceptions of providers communication skills
• Determine what health providers know and practice regarding caries prevention & early detection
• Determine communication techniques of healthcare providers
Health Literacy Fits in the Oral Health Plan
•A major topic in Maryland’s oral health plan is oral health literacy & education
What We Have Done to Date:
• Phone survey of MD adults 18 years of age and older. KOP’s about caries prevention & their perception of dental staff communication skills.
• Focus groups of MD adults 18 years & older• [4 in English; 2 in Spanish]
• Surveyed physicians, dentists, dental hygienists and nurse practitioners. KOP’s about caries prevention & use of communication techniques.
What We Have Done (Con’t)
•Focus groups/interviews of all four provider groups
MD Adults’ Understanding of Caries Prevention
•97.9% said they had heard of fluoride
•Only 58% knew the purpose of fluoride
•64.9 % had heard of dental sealants
•Of those, only 46% knew their purpose
•Only 23% could identify an early sign of tooth decay
Perceptions of Communication Skills of Dentist & Staff
• AA were significantly more likely to express lower satisfaction with the amount of time DDS spent with them than Caucasians, and
• AA were more than twice as likely to report they were treated unfairly due to race, ethnicity, or education
• Those with private dental insurance were significantly more likely than those with Medicaid to report favorably about providers listening practices.
Use of Tap Water
•Adults with high school education or less were significantly less likely to: • Know if their tap water was fluoridated• Drink tap water• Give it to their child
•Medicaid recipients were less likely to drink tap water than non-Medicaid.
Demands of Our Healthcare System
• Health literacy is dependent on the demands of the healthcare and public health systems. Individuals need to:
• Know how to locate and navigate a health facility• Read, understand, and complete many kinds of forms to
receive treatment and payment reimbursement• Articulate their signs and symptoms• Know about various types of health professionals and what
services they provide and how to access those services • Trust us• Know how and when to ask questions or ask for clarification
when they do not understand
What We Are Working On…..
•Determining user friendliness of dental clinics in community health settings
•Surveying Head Start & WIC personnel regarding their KOP’s about caries prevention
•Conducting focus groups of Head Start and WIC personnel
Remember
•Efforts to improve quality, reduce costs and reduce oral health disparities cannot succeed without simultaneous improvements:
• In oral health literacy of the public, health care providers and policy makers; and
•Ensuring the user friendliness of our dental facilities.
Improving Oral Health Literacy
•Of the public, health providers and policy makers is one essential pathway to eliminating disparities among Marylanders.
Healthy People 2020
Plain Language Act Oral Health Literacy Workshop2011 IOM Reports
Surgeon General Reports
Health Literacy Call to Action
Evidence-based Protocols
State, County & Local
Agencies and
Professional Organizations
Research and Development
State Oral Health Plan and State Oral Health Policies
Program Evaluation and Refinement
Education and Practice
Increased Health
Increased Disease Prevention Programs & Services
Increased Healthcare Delivery
Drivers Assessment Policy Development Assurance
Maryland Oral Health Literacy Model: Moving Science into Action
THANK YOU!