There is poor oral health awareness in Nigeria. This is mainly attributed to limited access to correct information on oral health as well as a lack of oral health care providers. The impact of the poor oral health awareness is worse in Northern Nigeria due to the uneven distribution of oral health care workers and training facilities. The purpose of this cross-sectional study was to describe the roles of community pharmacists (CPs) in Plateau State, Nigeria as sources of oral health information. Theoretical framework for this study was the theory of planned behavior (TPB). Background knowledge and practices of oral health care by CPs were assessed as related to their demographic characteristics. A 1 sample t-test was used to assess CPs' knowledge of oral health. A binary logistic regression model was conducted to evaluate if some demographic variables could predict Plateau State CPs' interest in becoming more involved in provision of services on oral health problems. According to the study findings, the CPs had a good disposition towards engaging in oral health prevention services by providing some oral health services to patients with oral health problems. In addition, 94.7% of the CPs were willing to advance the cause of oral health care. The disposition of CPs towards oral health could serve as a platform to help propagate oral health care and awareness in their communities. Engaging the CPs might help reduce oral health disparities by increasing oral health awareness, improving oral health-seeking behavior and oral hygiene practices, and improving quality of life via cost effective delivery of pharmacy-based oral health care services.

Oral health disparities in children is an important public health issue in the United States. A growing body of evidence exists supporting the social determinants of oral health, moving beyond individual predictors of disease to family- and community-level influences. The goal of this study is to examine one such social determinant, social capital, at the family and neighborhood levels and their relationships with oral health in Iowa children. A statewide representative data source, the 2010 Iowa Child and Family Household Health Survey, was analyzed cross-sectionally for child oral health status as the outcome, a four-item index of neighborhood social capital and four separate indicators for family social capital as the main predictors, and seven covariates. Soda consumption was checked as a potential mediator between the social capital variables and oral health status. A significant association was found between oral health status and the neighborhood social capital index (p=0.005) and family frequency of eating meals together (p=0.02) after adjusting for covariates. Neighborhood social capital and family function, a component of family social capital, may independently influence child oral health outcomes.

Professional practice change and the transfer of research into practice are critical issues for the public health field. The program of research presented here investigated the potential for practice change in dental hygienists’ and Emergency Department nurses’ provision of brief interventions targeting smoking (of tobacco) and alcohol consumption respectively. Smoking and risky alcohol consumption are two high prevalence public health issues that have a substantial impact on the burden of death and illness in Australia. Research on dental hygienists’ and nurses’ uptake of these interventions is limited and has largely focused on descriptions of perceived barriers. Little research has been conducted on the attitudes and motivations of health professionals to engage in these interventions. The present research was designed to address that gap. Specifically, two behaviours by dental hygienists and Emergency Department nurses were investigated: identification of patients at risk and provision of assistance to such patients. The program of research applied the Theory of Planned Behaviour to these behaviours in order to: 1) examine the role of dental hygienists and Emergency Department nurses in the provision of brief interventions for smoking and alcohol consumption respectively, 2) assess the ability of the Theory of Planned Behaviour to understand and predict health professionals’ identifying and assisting behaviour, 3) assess the ability of the theory to account for the influence of organisational factors on workers’ behaviour, and 4) design and evaluate a Theory of Planned Behaviour-based professional practice change intervention. This is the first research to apply the Theory of Planned Behaviour to these behaviours, to examine the potential of the theory to account for the influence of organisational factors on workers’ behaviour, and to trial an intervention targeting behaviour in an organisational setting. The four studies undertaken provided a comprehensive application of the Theory of Planned Behaviour. In the first study, a meta-analysis of published research examined the ability of the Theory of Planned Behaviour to predict behaviours in an organisational setting. This was the first meta-analysis of studies applying the Theory of Planned Behaviour applications to organisational settings. The findings were comparable to results of a meta-analysis of studies applying the theory to social and health behaviours, supporting the application of the theory to the organisational setting, and also highlighted the potential importance of perceived behavioural control for work behaviours. Studies 2 to 4 were designed to follow Ajzen and Fishbein’s (1975) 3-step methodology for applying the theory. In Study 2, the behavioural, normative, and control beliefs held by dental hygienists and Emergency Department nurses, and potentially relevant organisational factors, such as workload and available support, were identified through in-depth qualitative interviews. Study 3 measured the ability of the Theory of Planned Behaviour to predict dental hygienists’ and Emergency Department nurses’ frequency of identifying and assisting. The theory was most successful in predicting dental hygienists’ frequency of assisting patients who smoke. The self-efficacy dimension of perceived behavioural control was the strongest predictor of this behaviour. The findings for Emergency Department nurses indicated that subjective norms were an important predictor of intentions to identify and assist patients. The Theory of Planned Behaviour accounted for the influence of organisational factors on behaviour for both dental hygienists and nurses. Study 4 involved a randomised controlled trial which evaluated a professional intervention targeting dental hygienists’ assistance of patients who smoke. Trends indicated potential benefits of the intervention, but overall no significant changes in dental hygienists’ role adequacy, role legitimacy, and targeted control beliefs emerged. This outcome was attributed to ceiling effects and the influence of a media campaign that coincided with the intervention. The research presented here provides partial support for the application of the Theory of Planned Behaviour to professional practice change efforts. Specifically, the ability of the theory to explain the impact of organisational factors and identify variables most predictive of behaviour may provide valuable insight for prioritising future professional practice change efforts.

No description available.

Oral health has dramatically improved in most industrialized countries over the latter half of the 20th century. However, profound oral health disparities still exist especially for those most at risk of developing oral diseases and associated systemic consequences such as populations residing in long-term care facilities. Despite the growing body of literature that supports the link between oral microflora and the importance of oral hygiene in limiting the risk of pneumonia development, there are still gaps in our knowledge to effectively manage this risk. The research included in this dissertation sought to further our understanding of oral health and oral care in the context of pneumonia pathogenesis (chapter 3) and, by exploring the perspective of various stakeholders in oral health, we sought to further understand the factors that influence care provision (chapter 5). Additionally, a novel knowledge translation approach was tested to challenge traditional oral care interventions in order to promote improvements in front-line oral care practices (chapter 6). The relationship between oral microflora, oral care and pneumonia was found to be complex. It directs us to consider converging risk factors including a patient’s health status, health behaviours and access to oral care services. Different professional groups were found to possess different definitions of oral health, which influenced both their motivation to provide care as well as their focus of care. Definitions of oral health could also potentially influence the saliency of different types of oral care information to different targeted groups; therefore, this should be considered in developing education and training initiatives aimed at improving the provision of oral care. An appreciative knowledge translation approach was found to be effective in bridging the gap between oral care knowledge and the provision of care. Regardless of the type of intervention chosen, organizations were reported to play a crucial role in promoting oral health and supporting the successful implementation of oral care programs.

Objective: To assess the efficacy of personal support worker (PSW) mouth care education to improve the oral health of residents of long term care homes. Methodology: Experimental PSWs received mouth care education at baseline before taking the knowledge test. PSWs‟ mouth care knowledge was measured using a 20-item knowledge test at baseline, post-test (supervised); 6-months (un-supervised). Residents‟ oral health outcomes assessed at baseline and 6-months using the modified Plaque Index and modified Gingival Index. Results: Experimental PSWs‟ post-test knowledge (n=32;M=17.59;SD=1.43) significantly increased from pre-test (M=15.34;SD=2.10), F(2,72)=4.90;p<.05. 39 control residents and 41 experimental residents participated. Experimental residents‟ PI significantly decreased at 6-months compared to baseline, F(1,156)=5.52;p<.05, there was no significant difference in their GI between baseline and 6-months, F(1,156)=3.29;p=.07. Conclusion: PSWs‟ mouth care knowledge significantly increased after receiving mouth care education and was sustained over six months. Only experimental residents‟ PI significantly improved after 6 months.

Objective: To assess the efficacy of personal support worker (PSW) mouth care education to improve the oral health of residents of long term care homes. Methodology: Experimental PSWs received mouth care education at baseline before taking the knowledge test. PSWs‟ mouth care knowledge was measured using a 20-item knowledge test at baseline, post-test (supervised); 6-months (un-supervised). Residents‟ oral health outcomes assessed at baseline and 6-months using the modified Plaque Index and modified Gingival Index. Results: Experimental PSWs‟ post-test knowledge (n=32;M=17.59;SD=1.43) significantly increased from pre-test (M=15.34;SD=2.10), F(2,72)=4.90;p<.05. 39 control residents and 41 experimental residents participated. Experimental residents‟ PI significantly decreased at 6-months compared to baseline, F(1,156)=5.52;p<.05, there was no significant difference in their GI between baseline and 6-months, F(1,156)=3.29;p=.07. Conclusion: PSWs‟ mouth care knowledge significantly increased after receiving mouth care education and was sustained over six months. Only experimental residents‟ PI significantly improved after 6 months.

Oral health has dramatically improved in most industrialized countries over the latter half of the 20th century. However, profound oral health disparities still exist especially for those most at risk of developing oral diseases and associated systemic consequences such as populations residing in long-term care facilities. Despite the growing body of literature that supports the link between oral microflora and the importance of oral hygiene in limiting the risk of pneumonia development, there are still gaps in our knowledge to effectively manage this risk. The research included in this dissertation sought to further our understanding of oral health and oral care in the context of pneumonia pathogenesis (chapter 3) and, by exploring the perspective of various stakeholders in oral health, we sought to further understand the factors that influence care provision (chapter 5). Additionally, a novel knowledge translation approach was tested to challenge traditional oral care interventions in order to promote improvements in front-line oral care practices (chapter 6). The relationship between oral microflora, oral care and pneumonia was found to be complex. It directs us to consider converging risk factors including a patient’s health status, health behaviours and access to oral care services. Different professional groups were found to possess different definitions of oral health, which influenced both their motivation to provide care as well as their focus of care. Definitions of oral health could also potentially influence the saliency of different types of oral care information to different targeted groups; therefore, this should be considered in developing education and training initiatives aimed at improving the provision of oral care. An appreciative knowledge translation approach was found to be effective in bridging the gap between oral care knowledge and the provision of care. Regardless of the type of intervention chosen, organizations were reported to play a crucial role in promoting oral health and supporting the successful implementation of oral care programs.

Syftet var att beskriva en grupp värmländska ungdomars tobaks- och munhälsovanor samt undersöka möjliga associationer av dessa till ett tobakspreventivt program i skolan och tilltro till egen förmåga (self-efficacy). Urvalet var elever (15-16 år, n=631) som genomgått ett tobakspreventivt program med information och värderingsövningar i klass 5 och 7. Rökning var vanligare bland flickor än bland pojkar (13% resp 8%), med omvänt förhållande avseende snusning (6% resp 15%). Tandborstning &lt;2 gånger/dag var vanligare bland pojkarna (21%) än bland flickorna (12%). Flickorna hade som grupp lägre self-efficacy. Hög grad av self-efficacy gav signifikant högre sannolikhet att uppleva påverkan av tandvårdens tobakslektioner (p=0.004). I en multivariat modell identifierades tre signifikanta riskfaktorer för att inte uppleva påverkan av tandvårdens tobakslektioner: snusning (OR 2.77; 95% CI 1.42-5.41), låg self-efficacy (OR 1.70; 95% CI 1.19-2.42) och boende utan två vuxna (OR 1.71; 95% CI 1.17-2.51). Ålder &lt;15 år (OR 0.65; 95% CI 0.46-0.93) gav lägre risk för att inte uppleva påverkan. Stratifierat på kön kvarstod statistisk signifikans av samtliga ovanstående variabler för flickor och boende utan två vuxna för pojkar.  Den kunskap som genererats i studien kan ge underlag för planering av preventions- och promotionsstrategier både i den kliniska verksamheten och vid hälsofrämjande arbete i skolan. / The aim was to examine adolescents in the Swedish county of Värmland, their tobacco and oral health habits, and possible associations of these to a tobacco prevention program and their self-efficacy. The sample were students (15-16 years, n = 631) who had undergone a tobacco prevention program in grade 5 and 7. Smoking was more common among girls than among boys (13% vs. 8%), with inverse relationship for snus use (6% vs. 15%). Toothbrushing &lt;2 times/day were more common among boys (21%) than among girls (12%). The girls had as a group, lower self-efficacy. High degree of self-efficacy entailed a greater probability for self-perceived impact of tobacco lessons (p = 0.004). In a multivariate model three significant risk factors for not experiencing influence from tobacco lessons were identified: snus use (OR 2.77, 95% CI 1.42-5.41), low self-efficacy (OR 1.70; 95% CI 1.19-2.42) and living without two adults (OR 1.71; 95% CI 1.17-2.51). Age &lt;15 years (OR 0.65, 95% CI 0.46-0.93) yielded a lower risk for not experiencing influence. Stratified on gender statistical significance persisted regarding all above for girls and living without two adults for boys.  The knowledge generated in this study may serve as a base for planning of prevention and promotion strategies in both clinical practice and in schools.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2010.