Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California

Winston Tseng, Elizabeth Pleasants, Susan L. Ivey, Karen Sokal-Gutierrez, Jayanth Kumar, Kristin S. Hoeft, Alice M. Horowitz, Francisco Ramos-Gomez, Miku Sodhi, Jessica Liu and Linda Neuhauser
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Winston Tseng: Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA
Elizabeth Pleasants: Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA
Susan L. Ivey: Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA
Karen Sokal-Gutierrez: Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA
Jayanth Kumar: Office of Oral Health, California Department of Public Health, Sacramento, CA 95899, USA
Kristin S. Hoeft: Department of Preventive & Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA 94143, USA
Alice M. Horowitz: Department of Behavioral Health & Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
Francisco Ramos-Gomez: Division of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, CA 90095, USA
Miku Sodhi: Shasta Cascade Health Centers, McCloud, CA 96057, USA
Jessica Liu: Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA
Linda Neuhauser: Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA

IJERPH, 2020, vol. 18, issue 1, 1-17

Abstract: Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant interview study with 50 participants between November 2019 and March 2020, including 44 dental providers (dentists, hygienists, and assistants) in public or private practice in California and 6 oral health literacy (OHL) experts. We undertook thematic analysis of interview transcripts and descriptive statistics about interviewees from pre-surveys. Dental providers reported frequently speaking slowly, and using simple language and models/radiographs to communicate with patients, while infrequently using interpretation/translation, illustrations, teach-back, or motivational interviewing. Providers reported using only 6 of the 18 American Medical Association’s (AMA) recommended communication techniques and only 3 of the 7 AMA’s basic communication techniques. A majority of providers indicated using one of five oral health assessment and educational strategies. Key barriers to effective communication included limited time, financial incentives promoting treatment over prevention, lack of OHL training, limited plain-language patient education materials, and patients with low OHL knowledge. Dental organizations should prioritize supporting dental providers in effective patient communication practices. Standardizing OHL continuing education, creating an evidence-based OHL toolkit for dental teams, ensuring accessible interpretation/translation services, and incentivizing dental providers to deliver education could improve oral health literacy and outcomes.

Keywords: oral health; health literacy; oral health literacy; provider-patient communication; dental providers (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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