Racial disparities in breast cancer screening, morbidity, and mortality persist for Black women. This study examines Black women’s mammography beliefs and experiences with specific focus on barriers to mammography access in an urban city in the South East, United States. This retrospective, qualitative study used Penchansky and Thomas’ conceptualization of health care access as the framework for the data analysis. In-depth, semistructured interviews were conducted with 39 Black women. Structural and personal factors continue to create barriers to mammography among Black women. Barriers to mammography were identified for each of the Penchansky and Thomas five dimensions of access to care: accessibility, affordability, availability, accommodation, and acceptability. Clinical practice strategies to increase mammography screening in Black women must be multifactorial, patient-centered, and culturally congruent. Policy development must address the structural barriers to mammography screening through expansion of health insurance coverage and increased accessibility to health care.
Purpose/objectives Dental educators have played a critical role in addressing the opioid public health crisis. Methods The American Dental Education Association (ADEA) conducted a semi‐structured survey with all 66 accredited U.S. dental schools in 2019. The survey was organized into four modules to facilitate response and descriptive statistics and qualitative thematic analyses were performed. Results Seventy percent of the dental schools consented to participate. Each module varied in response rate: curricular (Module 1, 48%), clinical (Module 2, 47%), implemented curricular/clinical changes (Module 3, 56%), and willingness to participate in future studies (Module 4, 47%). The survey revealed that 87% of respondent dental schools have implemented curricular changes or curricular changes were in process in response to the opioid epidemic. Ninety‐three percent of responding schools reported making clinical changes or that clinical changes were in process. Schools reported two factors that most frequently influence changes made: the adoption of state‐specific regulations/mandates and the Commission on Dental Accreditation (CODA) Standard 2‐24e, which requires competency in prescription practices on substance use disorders. An analysis of the open‐ended questions found four overarching themes to curricular changes, in order of frequency: didactic curriculum; integration of opioid epidemic subject matter experts in curricula; Screening, Brief, Intervention, and Referral to Treatment (SBIRT) training; and prescription guidelines. Similarly, four overarching themes were identified for clinical changes: protocol and policy development, Prescription Drug Monitoring Programs (PDMP), faculty and provider education, and prescription guidelines. Conclusions This research shows that dental educators are working to ensure that new dental professionals gain the necessary competencies in substance abuse, specifically related to opioids, to prevent and minimize prescription drug misuse.
This study assessed the impact of the COVID-19 pandemic on U.S. dental schools and their school-based clinic operations and finances during the first eight months (April to December 2020) of the outbreak. School-based clinics are critical to training and educating future dentists and delivering oral health care services to underserved communities. Methods: The American Dental Education Association (ADEA) conducted a structured survey with the 67 accredited U.S. dental schools between November 2020 and January 2021 to assess the impact of the COVID-19 pandemic on their operations, especially on their school-based clinics. The response rate was 67%. The authors employed descriptive statistics and text analysis to examine the survey results.Results: This study revealed that from April to December 2020, dental schools experienced a 50% reduction in patient visits at dental school clinics, a 7% median decrease in budget, a 42% decline in revenue, changes in clinical and nonclinical faculty and staff, and investments related to infection control measures to remain operational. Ninety-two percent of dental school clinics suspended communitybased patient care experiences outside the dental school in the first eight months of the pandemic compared to the same time period the year prior. Conclusions:This research shows the extent of the operational and financial challenges dental school clinics faced in the pandemic's first eight months, April to December 2020. In these unique times, dental school clinics continued to train and educate the dentists of tomorrow and deliver oral health care services to vulnerable communities while implementing safeguards and infection control measures to combat the propagation of the COVID-19 virus in their institutions.
Letter to the Editor We are writing regarding the Innovations in Pharmacy commentary entitled, “Evidentiary Standards for Patient-Centered Core Impact Value Claims.”(1) We thank Dr. Langley for commenting on the National Health Council’s work on patient-centered core impact sets (PC-CIS), an initiative spearheaded by the nonprofit organization and its membership with multi-stakeholder representation and input.(2-4) While we have tried to be clear and transparent about the intent of PC-CIS, the commentary made it apparent to us we need to (and will) do more to be explicit about what a PC-CIS is and is not, and its possible downstream uses. We believe the PC-CIS concept was misrepresented in the commentary and want to provide clarification for readers so they can consider the merits of the initiative for themselves.
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