ORAL HEALTH CARE PROFESSIONAL RESPONSE TO DOMESTIC VIOLENCE

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Physical injuries from domestic violence commonly appear in the areas of the face, head, and neck. For this reason, oral health care professionals have an important role to play in addressing this major public health problem. Recent studies have revealed that many oral health care professionals are unaware of this significant relationship between head and neck injuries and domestic violence, and are uncertain of their role in addressing this issue with their patients. Furthermore, other studies suggest that many oral health care professional feel uncomfortable offering assistance to domestic violence victims. In a randomized, controlled trial, we propose to develop and test the effectiveness of an educational and behavioral change intervention designed to help oral health care professionals effectively overcome reluctance to identify and treat victims of domestic violence, and to effect positive changes in their knowledge, attitudes, and behaviors with respect to caring for this patient population. The ultimate goal of this undertaking is to help prevent victims of domestic violence who seek dental care from being subjective to further violence and oral trauma. Research subjects will be recruited from among all practicing, office- based dentists and dental hygienists in Northern California and randomly assigned to either an Experimental or a Control Group. All subjects will be asked to complete the Oral Health are Professional Written Survey at each of three measurement points--pre-test, post-test (immediately following conclusion of an intervention), and six-month follow-up. This survey asks about dentists' and dental hygienists knowledge, attitudes, and practices regarding identifying, assessing, and intervening with patients who are victims are domestic violence. Experimental Group participants will receive a targeted educational and behavioral change intervention based upon interventions shown to be successful by this research team and by others, but incorporating unique elements as well. The components of the intervention will include 1) individualized feedback of pretest scores (compared against either an "ideal" response or the average response of all subjects); 2) Skills-based Course consisting of a seminar module and an internet-based, self-study module; 3) Dental Record Reminder Cards (to be inserted into the dental record of all new patients of subjects in the Experimental Group) that provide a handy checklist of domestic violence assessment questions, referral information regarding community-based assistance programs and tips for providing validation and support to victims; and, 4) Practice-oriented newsletters exploring oral health care professionals' perceptions of some of the barriers to identifying and aiding victims of domestic violence in a dental care setting, and suggesting ways to remove or reduce these barriers. The main outcome measures will be dentists' and dental hygienists' knowledge, attitudes, and behaviors regarding treating and assisting patients who are victims of domestic violence as measured by the Oral Health Care Professional Written Survey.