The Impact of an Interprofessional Pediatric Oral Health Clerkship on Advancing Interprofessional Education Outcomes.

The aim of this study was to evaluate the effectiveness of an innovative pediatric interprofessional education clinical experience using oral-systemic health as the clinical population example for improving the self-reported interprofessional competencies of family nurse practitioner, dental, and medical students. The objectives of the interprofessional experience were for students to apply pediatric oral health assessment, identify the pediatric oral-systemic connection, and practice a team-based approach to improve oral-systemic outcomes. In spring 2015, fall 2015, and spring 2016, a total of 162 family nurse practitioner, dental, and medical students participated in this interprofessional experience at Bellevue Pediatric Outpatient Clinics together with a pediatric dental resident. Team members collaborated in reviewing the patient chart, taking the patient's medical and dental history, performing an oral assessment, applying fluoride varnish, and providing education and anticipatory guidance. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used as a pretest and posttest to evaluate the degree to which students perceived changes in their attitudes about interprofessional competencies following the learning experience. In the results, all students had improved mean scores from pretest to posttest after the experience, and these changes were statistically significant for all students: nurse practitioner (p<0.01), dentistry (p<0.01), and medicine (p<0.001). The mean change from pretest to posttest was statistically significant for each of the six interprofessional competency domains (p<0.01). In both pediatric dental and primary care settings, the changes from pre- to posttest were significant (p<0.001). The experience was similarly effective for all groups of students in increasing their attitudes about interprofessional collaboration. These findings suggest that a clinical approach can be an effective strategy for helping health professions students develop interprofessional competence.

OHEP: an oral health education program for mothers of newborns.

INTRODUCTION: The purposes of the study were to determine (a) the knowledge base of mothers of newborns on oral health for newborns and young infants and (b) the effectiveness of an oral health education program provided to mothers of newborns prior to discharge from the postpartum unit. METHODS: Ninety-four mothers of healthy newborns on a postpartum unit were randomized to the treatment or control group. A pretest was administered to each mother to assess the mother's knowledge of infant oral health. The treatment intervention was a DVD designed collaboratively by an interprofessional team of nurse practitioners and dental faculty to educate the mothers on oral health care for their newborns. The control intervention was a DVD on newborn nutrition. All participants received routine newborn nursery discharge instructions by the postpartum nurses and physicians. Follow-up appointments were scheduled 6 and 12 months later for administration of the posttest to the mothers and for oral health assessments of the infants. RESULTS: Pretest questionnaire results revealed that most mothers lacked knowledge about oral health care for infants and young children, especially concerning vertical transmission of streptococcus mutans through food-sharing practices. In addition, 28.4% of the mothers were not aware of the benefits of fluoride as a prevention strategy for dental caries. A significant no-show rate for the planned follow-up visits in the dental clinic hindered our plans to evaluate the effectiveness of the oral health educational program on prevention of dental white spots or decay when the study infants were 6 and 12 months old, respectively. DISCUSSION: The knowledge deficit of mothers of newborns regarding oral health care for infants may be one of the contributing factors to the high prevalence rate of dental caries in children younger than 71 months. An oral health educational program provided to mothers on the postpartum unit prior to discharge from the hospital may help increase mothers' knowledge about oral health care and prevention of dental caries in infants and young children.

Perceived barriers and facilitators to dental treatment among female caregivers of children with and without HIV and their health care providers.

PURPOSE: This study sought to identify barriers and facilitators to dental care among families of predominately low socioeconomic status having children with and without HIV. METHODS: Twelve focus group sessions with African-American and Hispanic caregivers and 18 individual semistructured interviews with key informant health care providers were held at two sites: a hospital-based program (HBP) and a dental school-based program (DSBP), that provide pediatric dental services. SPSS Textsmart software was used to analyze qualitative data within and across group types and sites. RESULTS: Focus group participants (n = 72, averaging 6 women per group) included: HIV-seropositive biological mothers of HIV-seropositive children (4 groups); HIV-seronegative caregivers of HIV-seropositive children (4 groups); and Medicaid-eligible, HIV-seronegative caregivers of HIV-seronegative children (4 groups). The most commonly expressed barrier to dental care across groups was poor interpersonal communication between dental staff and caregiver/child. HIV-seronegative groups cited health care delivery system factors as barriers to receiving dental care more frequently than HIV-seropositive caregivers who cited shame/anger and family illness as being more important. Common facilitators were positive communication and transportation assistance. Unique facilitators for HIV-seropositive groups were coordination of the dental visits with medical appointments at the HBP. Key informants acknowledged high stress in families having children with HIV/AIDS, cited dental fear among caregivers as a barrier to dental treatment adherence and reported that dental care seemed to be a low priority among many of these families. CONCLUSIONS: Facilitators and barriers to care included factors in the family, dental care and health care delivery systems as well as interpersonal communication between the dental providers and the families.