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J Dent Educ. 2019 Feb;83(2):161-172. doi: 10.21815/JDE.019.019.

The Role of Dental Providers in Preventing HPV-Related Diseases: A Systems Perspective.

Author information

1
Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX. edaley@health.usf.edu.
2
Ellen M. Daley is Professor, Department of Community and Family Health, and Associate Dean of Research and Practice, College of Public Health, University of South Florida; Cheryl A. Vamos is Assistant Professor, Department of Community and Family Health, College of Public Health, University of South Florida; Erika Thompson is Assistant Professor, Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center; Coralia Vázquez-Otero is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Stacey B. Griner is a doctoral research assistant, Department of Community and Family Health, College of Public Health, University of South Florida; Laura Merrell is Assistant Professor, Department of Health Sciences, James Madison University; Nolan Kline is Assistant Professor, Department of Anthropology, Rollins College; Kimberly Walker is Assistant Professor, Zimmerman School of Advertising & Mass Communications, University of South Florida; Annelise Driscoll is Clinical Assistant Professor, Restorative Dental Sciences, College of Dentistry, University of Florida; and John Petrila is Vice President of Adult Policy, Meadows Mental Health Policy Institute, Dallas, TX.

Abstract

Successfully educating dental providers and patients about the link between human papillomavirus (HPV) and oropharyngeal cancer requires coordinated efforts to increase HPV-related prevention practices. The aim of this study was to identify, using a systems perspective, the multi-level determinants related to how dental providers can promote HPV prevention in dental practices. Data for this qualitative study were collected in 2015-16 from focus groups with dentists (four focus groups, n=33), focus groups with dental hygienists (four focus groups, n=48), and in-depth interviews with dental opinion leaders (n=13). Results were triangulated and mapped along micro, meso, and macro system levels. At the micro level, participants identified patient characteristics and low self-efficacy as influential determinants when discussing HPV prevention. At the meso level, relationships among dentists, dental hygienists, and the physical practice environment were factors affecting dental providers' HPV prevention efforts. At the macro level, professional organizations impacted how dental providers interacted with their patients on this topic. These results suggest that improving HPV prevention among dental providers requires a multi-level approach that considers the distinctive context of dental settings, dental training, and perceptions of professional roles. The findings suggested that the macro- and meso-level determinants may be challenging to modify due to the distinctive culture and practice models of dentistry. Nevertheless, the association between HPV and oral cancer requires an expansion of prevention strategies used in dental practices. Improving dental providers' self-efficacy to communicate HPV prevention through continuing education and integration of skill-guided training in dental and dental hygiene curricula could facilitate this process.

KEYWORDS:

HPV; HPV prevention strategies; HPV-related oropharyngeal cancer; dental hygienists; dental practice; dentists; public health dentistry; systems perspective

PMID:
30709991
DOI:
10.21815/JDE.019.019

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