Dental health aides in Alaska: A qualitative assessment to improve paediatric oral health in remote rural villages.
Dental health aides in Alaska: A qualitative assessment to improve paediatric oral health in remote rural villages.
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DOI：
10.1111/cdoe.12385
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发表时间：
2018-08
影响因子：
2.3
通讯作者：
Cunha-Cruz J
中科院分区：
文献类型：
--
作者：
Senturia K;Fiset L;Hort K;Huebner C;Mallott E;Milgrom P;Nelson L;Parrish C;Cunha-Cruz J
阿拉斯加的偏远村庄在口腔健康和获得护理方面存在差距。牙科保健员，如初级牙科保健员（PDHA）和牙科保健治疗师（DHAT），在阿拉斯加提供牙科保健方面发挥着关键作用。我们的目标是从社区和医疗保健系统的角度来描述生活在阿拉斯加偏远村庄的儿童的儿科牙科保健的优势和障碍。这项定性研究通过与社区成员（n=19）和医疗保健工作者（n = 19）以及患者（n=31名青少年和16名12岁以下儿童的照顾者）的半结构化关键线人访谈收集数据，这些患者居住在阿拉斯加的三个偏远村庄或为这些村庄提供医疗保健。使用诱导开发的代码本和叙事方法，三名研究人员独立阅读和主题分析的成绩单。出现了两个主题：（1）PDHA和DHAT被认为是可持续的，并且能够满足农村社区的独特牙科需求;（2）PDHA和DHAT面临限制其有效性的障碍，其独特的角色需要澄清和行政支持。牙齿健康助手，包括PDHA和DHAT，在阿拉斯加的村庄里很受欢迎。对文化规范的内在理解和护理的连续性是推动村庄满意度的关键因素。通过实施临床和办公室系统战略来提高牙科团队的效率，在行政上有可能加强这一模式。适应文化的实施战略对于成功扩大正在解决健康差距的新劳动力模式至关重要。
Isolated villages in Alaska face disparities in oral health and access to care. Dental health aides such as the primary dental health aide (PDHA) and the dental health therapist (DHAT) fill a critical role for providing dental care in Alaska. Our objective was to describe strengths and barriers to pediatric dental care for children living in remote Alaska villages from the perspectives of the community and the health care system. This qualitative study collected data through semi-structured key informant interviews with community members (n=19) and healthcare workers (n=19) and focus groups with patients (n=31 adolescents and 16 caregivers of children under 12 years) living in or providing health care to three remote villages in Alaska. Using an inductively-developed codebook and a narrative approach, three researchers independently read and thematically analyzed the transcripts. Two themes emerged: (1) PDHAs and DHATs are perceived as sustainable and strongly positioned to meet the unique dental needs of the rural communities; (2) PDHAs and DHATs face barriers that limit their effectiveness, and their distinct roles require clarification and administrative support. Dental health aides, both PDHAs and DHATs, are well accepted in Alaska villages. An innate understanding of cultural norms and continuity of care are key elements driving village satisfaction. The potential exists administratively to strengthen the model with the implementation of clinical and office-system strategies to increase efficiency of the dental team. Culturally-adapted implementation strategies will be critical to the successful expansion of new workforce models that are addressing health disparities.
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影响因子：
1.3
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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通讯作者：
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影响因子：
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作者：
Gao SS;Zhang S;Mei ML;Lo EC;Chu CH
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