Heightened vigilance and perceived discrimination in dental trainees' readiness for clinical practice.

PURPOSE/OBJECTIVE: The aims of this study were to examine associations between heightened vigilance and perceived discrimination on readiness for clinical practice and to examine the mediating effects of social support and resilience. METHODS: A survey was distributed to dental trainees (dental and dental hygiene students) enrolled at a US dental school located in the mid-Atlantic region. The survey assessed readiness for clinical practice and included measures of perceived discrimination, heightened vigilance, and the following wellness measures: perceived stress, resilience, anxiety, social support, and coping. Adjusted for gender, and race/ethnicity, we regressed heightened vigilance and perceived discrimination independently on students' readiness for clinical practice. To assess mediation, we computed the direct effects of heightened vigilance and perceived discrimination and potential indirect effects mediated through social support and resilience. RESULTS: A total of 250 students who completed the survey had complete data on all variables. Five percent identified as Black or African Americans, 34% as Asians, and 8% as Hispanic/Latino. Sixty-two percent were female and 91% were dental students. The overall mean (SD) heightened vigilance and perceived discrimination scores were 18.9 (4.9) and 10.5 (7.6), respectively. Only the mean score for heightened vigilance differed significantly by race/ethnicity (p = 0.02). Higher heightened vigilance (odds ratio [OR] = 0.75 95% confidence interval [CI]: 0.25, 2.23), and perceived discrimination (OR = 0.52, 95% CI: 0.33, 0.88) scores were independently associated with lower adjusted odds of reporting high confidence in readiness for clinical practice even after adjusting for the mediating effects of social support and resilience, although the association for heightened vigilance was not statistically significant. CONCLUSIONS: Heightened vigilance and perceived discrimination appear to negatively impact dental trainees' career readiness. Intentional efforts to prioritize an anti-racism approach within dental education programs and patient care across the nation are warranted.

Teledentistry Acceptability Among Latina/o/x Adults in Rural Southwest Virginia.

Inequitable access to dental care remains a barrier to optimal health for rural populations. With the COVID-19 pandemic, teledentistry to improve the delivery of oral health care has been emphasized. Few previous investigations of teledentistry acceptability have included Latina/o/x populations in rural areas of the United States. We recruited Latina/o/x adults (N=91) in rural southwest Virginia to participate in a survey to assess correlates related to teledentistry acceptability. More than half of participants (57%) reported no interest in using teledentistry if it were available. Having a yearly household income above $24,000 and not having dental insurance were positively associated with telehealth acceptability (p=.04 and p=.01, respectively). Inequitable access to dental care may persist even with broad availability of teledentistry services unless there is explicit integration of health equity.

Training for the future: Introducing foundational skills necessary to promote patient-centered care practice in medical physics graduate programs.

Current medical physics graduate training in the United States seldom explicitly includes education on foundational skills necessary to produce Patient-Centered Care (PCC)-focused healthcare providers. Such abilities include effective communication, critical reflection, and ethical decision-making. In this article, we present examples of curricula used to purposefully introduce these skills into graduate training to fill this gap. Presented didactic activities include an introduction to patient communication, ethics in medical physics, and a primer in health disparities for medical physicists. Although development of new curricula is resource-intensive when left to individual programs, we here propose resource-sharing and interprofessional collaboration to overcome these barriers.

Religiosity and COVID-19: Impact on Use of Remote Worship and Changes in Self-Reported Social Support.

Objective: This study examines associations between changes in the use of remote worship services and changes in the types of social support among religious adults during the COVID-19 pandemic. Materials and Methods: Cross-sectional, web survey data (n = 461; 15 May to 6 July 2020) were collected during the COVID-19 pandemic. Multinomial logistic regression models calculated unadjusted odds of increases and decreases of three types of perceived social support from before to during COVID-19 based on remote worship use. Results: Adults who initiated use of remote worship had lower odds of gaining social support for personal problems (OR: 0.38; 95% CI: 0.19, 0.79) and greater odds of reporting less ease of getting practical help from neighbors (OR: 1.77; 95% CI: 1.04, 3.02) compared to adults who never used or stopped using remote worship. Adults who continued using remote worship services were more likely to report less ease of getting practical help from their neighbors (OR: 2.23; 95% CI: 1.17, 4.25) and decreased interest and concern felt from other people (OR: 2.62; 95% CI: 1.24, 5.51) than adults who never used or stopped using remote worship. Conclusions: Adults who initiated and continued using remote worship during the COVID-19 pandemic had poorer perceived social support outcomes relative to adults who never used or stopped using remote services. Despite continued engagement with their religious communities, adults participating in worship remotely may have had residual personal, emotional, and instrumental social support needs that remote worship did not mitigate.

Association between periodontal disease and oral cancer screening among US adults: NHANES 2011-2014.

OBJECTIVES: To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD. MATERIALS AND METHODS: We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥30 years. PD status was classified as no PD, mild/moderate PD and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral or both types of oral cancer screenings among adults with PD. Control variables included age, sex, race/ethnicity, health insurance, education, income level, smoking status, alcohol use and last dental visit. RESULTS: The analytic sample included 6962 adults weighted to the national population of adults who had a periodontal examination during 2011-2014. Overall, 31.5%, 26.8% and 20.9% of adults reported receipt of intraoral, extraoral and both types of oral cancer screening, respectively. Almost 40% of adults had some form of PD (7.6% severe and 32.4% mild/moderate PD). A higher proportion of 45-64-year-olds, males, non-Hispanic Blacks, those with less than high school education, with income level less than 200% federal poverty level, or those with no insurance had severe PD than no PD. In adjusted analyses, adults with severe PD were significantly more likely to report no receipt of intraoral (RR = 1.25, 95% CI = 1.12-1.40), extraoral (RR = 1.17, 95% CI = 1.07-1.27) or both types of oral cancer screenings (RR = 1.18, 95% CI = 1.10-1.27) than those with no PD. CONCLUSIONS: Significantly low proportion of adult's age ≥30 years with severe PD reported receiving any type of oral cancer screening. The association between PD and risk of oral cancers points to the need to improve oral cancer screening rates among adults with PD.

SARS-CoV-2 Vaccine Hesitancy in a Sample of US Adults: Role of Perceived Satisfaction With Health, Access to Healthcare, and Attention to COVID-19 News.

Understanding which communities are most likely to be vaccine hesitant is necessary to increase vaccination rates to control the spread of SARS-CoV-2. This cross-sectional survey of adults (n = 501) from three cities in the United States (Miami, FL, New York City, NY, San Francisco, CA) assessed the role of satisfaction with health and healthcare access and consumption of COVID-19 news, previously un-studied variables related to vaccine hesitancy. Multilevel logistic regression tested the relationship between vaccine hesitancy and study variables. Thirteen percent indicated they would not get vaccinated. Black race (OR 2.6; 95% CI: 1.38-5.3), income (OR = 0.64; 95% CI: 0.50-0.83), inattention to COVID-19 news (OR = 1.6; 95% CI: 1.1-2.5), satisfaction with health (OR 0.72; 95% CI: 0.52-0.99), and healthcare access (OR = 1.7; 95% CI: 1.2-2.7) were associated with vaccine hesitancy. Public health officials should consider these variables when designing public health communication about the vaccine to ensure better uptake.

A descriptive pilot study of the immediate impacts of COVID-19 on dental and dental hygiene students' readiness and wellness.

BACKGROUND: The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has impacted dental students training across the U.S. academic dental institutions by moving classroom instruction to an online modality, limiting patient care, canceling external rotations, and rescheduling of licensure examinations. OBJECTIVE: The aim of this study was to assess the immediate impacts of COVID-19 on students' readiness to enter clinical practice or residency and its association with well-being (anxiety, perceived stress, coping and social support, and resilience). METHODS: An online REDCap survey was distributed to 407 D1-D4 year dental students and 29 DH3-DH4 year dental hygiene students enrolled at a U.S. dental school. The survey consisted of readiness and wellness measures as well as socio-demographic variables. RESULTS: Overall response rate was 58% (N = 252) ranging from 40% among D4 students to 72% among D1 students. About half (55%) of the respondents were White, a third (34%) Asians and 5% were African Americans. Ninety-two percent were non-Hispanics while 62% were female. Overall mean (SD) anxiety score was 6.5 (5.3) and 26% of respondents reported moderate or severe levels of anxiety. Anxiety score differed significantly by gender with females reporting higher anxiety levels, mean (SD) = 7.3 (5.5) versus 5.2 (4.7) for males; P = 0.002). Furthermore, mean anxiety score differed significantly among the dental school classes, ranging from 5.5 (5.3) among D2 students to 11.8 (6.2) in DH4 students (P = 0.02). CONCLUSION: Academic dental institutions need to be responsive to the heightened anxiety and uncertainly levels of students and provide responsive training and support to mitigate its effects.

Lifestyle risk factor related disparities in oral cancer examination in the U.S: a population-based cross-sectional study.

BACKGROUND: Oral cancers account for 3% of annual U.S. cancer diagnosis, 2 in 5 of which are diagnosed late when prognosis is poor. The purpose of this study was to report the population-level prevalence of oral cancer examination among adult smokers and alcohol drinkers and assess if these modifiable lifestyle factors are associated with receiving an oral cancer examination. METHODS: Adult participants ≥30 years (n = 9374) of the 2013-2016 cycles of the National Health and Nutrition Examination Survey were included. Oral cancer examination (yes/no), smoking (never, former, current) and alcohol use (abstainers, former, current) were self-reported. Survey-logistic regression estimated odds ratios (OR) and 95% confidence intervals (CIs) of ever and past year oral cancer examination adjusted for age, gender, race/ethnicity, education, income, and time since last dental visit. RESULTS: One third (33%) reported ever been examined for oral cancer, 66% of whom reported an examination in the past year. Adjusted OR (95% CI) of past year examination comparing current and former smokers to non-smokers were 0.51 (0.29, 0.88) and 0.74 (0.53, 1.04) respectively. Similarly, current and former alcohol drinkers relative to abstainers were less likely to report a past year oral cancer examination, OR (95% CI) = 0.84 (0.53, 1.30) and 0.50 (0.30, 0.83) respectively. CONCLUSION: This study showed that smokers and alcohol users were less likely than abstainers to self-report a past year oral cancer examination. Access to affordable and targeted oral cancer examination within the dental care setting might ensure that these high-risk individuals get timely examinations and earlier diagnosis that might improve prognosis and survival.