An examination of predisposing and enabling factors that predict dental utilization among individuals with serious mental illness in Detroit, Michigan.
An examination of predisposing and enabling factors that predict dental utilization among individuals with serious mental illness in Detroit, Michigan.
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DOI：
10.1111/cdoe.12762
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发表时间：
2023-06
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
--
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这项研究评估了哪些诱发因素和使能因素前瞻性地预测了严重精神疾病患者在六个月内的牙科使用情况。从密歇根州底特律市的社区精神卫生中心招募了患有严重精神疾病的个体样本（86.3%为非洲裔美国人; 97.4%有公共医疗保险），并在基线时回答问卷，并在3个月或6个月时至少进行一次随访（N = 190）。基线评估包括人口统计和临床信息、既定的健康知识普及措施、健康保险知识普及、与精神疾病有关的耻辱感、种族歧视经历和医疗不信任。记录了牙科护理的保险范围和参与者精神健康中心的牙科服务的可用性。在随访中，参与者报告了自基线以来的医疗保健利用情况，包括牙科和初级保健。在双变量和多变量分析中，有三个因素成为有意义的牙科就诊预测因素：更多的医疗共病和牙科护理与精神卫生保健共存预测牙科就诊的可能性增加，而在医疗环境中经历过种族歧视预测在随访期间牙科就诊的几率较低。牙科保健与精神卫生保健的共同定位是最强的预测有一个牙科访问。将牙科保健与精神卫生保健放在一起可能会增加严重精神疾病患者的牙科利用率，这可能是因为减轻了这一人群的牙科保健障碍。在非裔美国人中，牙科保健与精神卫生保健的共同定位也可能会减弱先前在医疗环境中种族歧视对牙科利用的负面影响。
This study evaluated which predisposing and enabling factors prospectively predicted dental utilization over six months among people with serious mental illness. A sample of individuals with serious mental illness (86.3% African American; 97.4% with public health insurance) was recruited from community mental health centers in Detroit Michigan and responded to questionnaires at baseline and at least one follow-up visit at 3- or 6-months (N = 190). Baseline assessments included demographic and clinical information, established measures of health literacy, health insurance literacy, stigma related to mental illness, experiences of racial discrimination, and medical mistrust. Insurance coverage for dental care and the availability of dental services at the participants’ mental health centers was recorded. At follow-up visits, participants reported health care utilization, including dental and primary care, since baseline. Three factors emerged as meaningful predictors of having a dental visit in bivariate and multivariate analyses: more medical comorbidities and dental care co-located with mental health care predicted increased likelihood of a dental visit, whereas having experienced racial discrimination in a medical setting predicted lower odds of having a dental visit in the follow-up period. Co-location of dental care with mental health care was the strongest predictor of having a dental visit. Co-locating dental care with mental health care may increase dental utilization among people with serious mental illness, possibly by mitigating known barriers to dental care for this population. Among African Americans the co-location of dental care with mental health care may also attenuate the negative effect of prior racial discrimination in a medical setting on dental utilization.
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影响因子：
6.9
作者：
Jayatilleke N;Hayes RD;Chang CK;Stewart R
通讯作者：
Stewart R
影响因子：
3.5
作者：
Aguirre, AC;Ebrahim, N;Shea, JA
通讯作者：
Shea, JA
影响因子：
1.9
作者：
de Lima, V;Bezerra, MM;Ribeiro, RD
通讯作者：
Ribeiro, RD
影响因子：
2.4
作者：
Ho, H. D.;Satur, J.;Meldrum, R.
通讯作者：
Meldrum, R.
DOI：
10.14219/jada.archive.2011.0029
发表时间：
2011-01-01
影响因子：
3.9
作者：
Janardhanan, Thulasiram;Cohen, Carl I.;Rizvi, Batool F.
通讯作者：
Rizvi, Batool F.