Identifying Public Policy and Advocacy Practices Among Millennial Pediatric Dental Residents.

Purpose: This study's purpose was to identify public policy and advocacy practices among millennial pediatric dental residents in order to provide recommendations for engagement to the American Academy of Pediatric Dentistry (AAPD) leadership and pediatric dental residency program directors. Methods: A total of 138 residents from the 2016 Public Policy Advocacy Conference (PPAC) participated in a 13-item survey addressing demographics, advocacy education experience, student debt and financial contributions, resident training interests, the impact of the PPAC, and technology utilization. Sixty responses (45 percent response) were analyzed using SPSS software. Results: Residents believed that the PPAC was more beneficial than advocacy didactic education (P=0.008). The impact of the PPAC versus clinical experience was not significant (P=0.61). Pediatric dental residents were more likely to contribute financial donations to the AAPD's advocacy efforts following attendance of a program like the PPAC (P=0.051). Conclusion: Pediatric dental residents who participated in the PPAC or a local clinically oriented experience, perceived these two types of activities to provide greater value in their advocacy education than that of a didactic lecture in this subject area. Study results can be used to guide program directors in developing millennial-specific, resident-driven advocacy education experiences to fulfill Commission on Dental Accreditation advocacy curricula requirements.

Strengthening the American Academy of Pediatric Dentistry's Public Policy Advocate Network: Identifying Advocacy Efforts and Recommendations.

PURPOSE: The purposes of this study were to collect information on involvement, training, and barriers to participation in advocacy efforts for Public Policy Advocates (PPAs) of the American Academy of Pediatric Dentistry (AAPD) and make recommendations to the AAPD. METHODS: Preliminary data were collected from the PPAs during structured AAPD program meetings, conference calls, and individual interviews. Based on these data, a survey was created, piloted, and sent electronically to all PPAs. Data were analyzed and collated by frequencies. RESULTS: Responses from 38 PPAs (100 percent) revealed they were involved with state legislatures and state chapters of the AAPD and American Dental Association. Eighty-two percent of the PPAs requested additional public policy training and clearer communication channels within the network. PPAs are funding their own advocacy efforts, and the time and resources spent away from patient care is a financial barrier. CONCLUSIONS: The Public Policy Advocate network holds a broad policy skill set and voluntarily commits time and resource to advocate for the support of the pediatric dental patient at state and federal government levels. The American Academy of Pediatric Dentistry can strengthen the PPA's self-directed leadership role at state and federal levels through formalized training, restructuring of the network, and increased resources.

The Affordable Care Act and Health Insurance Exchanges: Advocacy Efforts for Children's Oral Health.

PURPOSE: To evaluate legislative differences in defining the Affordable Care Act's (ACA) pediatric dental benefit and the role of pediatric advocates across states with different health insurance Exchanges. METHODS: Data were collected through public record investigation and confidential health policy expert interviews conducted at the state and federal level. RESULTS: Oral health policy change by the pediatric dental profession requires advocating for the mandatory purchase of coverage through the Exchange, tax subsidy contribution toward pediatric dental benefits, and consistent regulatory insurance standards for financial solvency, network adequacy and provider reimbursement. CONCLUSIONS: The pediatric dental profession is uniquely positioned to lead change in oral health policy amidst health care reform through strengthening state-level formalized networks with organized dentistry and commercial insurance carriers.

The Affordable Care Act and health insurance exchanges: effects on the pediatric dental benefit.

PURPOSE: To examine the relationship between state health insurance Exchange selection and pediatric dental benefit design, regulation and cost. METHODS: Medical and dental plans were analyzed across three types of state health insurance Exchanges: State-based (SB), State-partnered (SP), and Federally-facilitated (FF). Cost-analysis was completed for 10,427 insurance plans, and health policy expert interviews were conducted. One-way ANOVA compared the cost-sharing structure of stand-alone dental plans (SADP). T-test statistics compared differences in average total monthly pediatric premium costs. RESULTS: No causal relationships were identified between Exchange selection and the pediatric dental benefit's design, regulation or cost. Pediatric medical and dental coverage offered through the embedded plan design exhibited comparable average total monthly premium costs to aggregate cost estimates for the separately purchased SADP and traditional medical plan (P=0.11). Plan designs and regulatory policies demonstrated greater correlation between the SP and FF Exchanges, as compared to the SB Exchange. CONCLUSIONS: Parameters defining the pediatric dental benefit are complex and vary across states. Each state Exchange was subject to barriers in improving the quality of the pediatric dental benefit due to a lack of defined, standardized policy parameters and further legislative maturation is required.