Community Based Dental
Partnership
(CBDPP)
College of Dental Medicine
Columbia University
Noreen Myers-Wright RDH, MA, CHES
Project STAY
Joanna Pudil MA, LCSW
Program P.I. Burton Edelstein DDS, MPH
Supported by HRSA Ryan White HIV/AIDS Program Grant H65HA00014
S
CBDPP Partners
S Harlem United
S
S
S
A community AIDS center in Harlem, N.Y.
Adults and Older Adults
Community Service Learning for Advanced General Dentistry Residents (AEGD)
S Dominican Sisters
S
S
S
Provider of family health services in the South Bronx, N.Y.
Women of young children
Community Service Learning for Dental Public Health Residents
S Project STAY
S
S
S
Washington Heights, N.Y
Adolescents and Young Adults
Oral Health Education provided by Registered Dental Hygienist/Health Educator
Comprehensive Health
Program (CHP)
S Established 1988, in New York Presbyterian Hospital
S Multidisciplinary care
S Patients living with HIV and other chronic conditions
S Children, adolescent, young adults and adults
Project STAY(P.S.)
(Service to Assist Youth)
S Provides comprehensive care for young people 14 – 24 years
S
Sexually high risk
S
HIV Positive Adolescents & Young Adults
S Community Outreach
S Young Adult Health Clinic
S
Farrell Community Health Center
S Specialized Care Center
S
New York Presbyterian/Columbia University Medical Center
Patient Centered Collaborative Comprehensive Care
Project
Stay
Patient
Referred for Care
to CDM
Project STAY Services Provided
S Medical examinations
S STI screenings
S Medication management
S Mental health services
S
Individual, group & family therapy
S Case management services
S
Housing, transportation, educational support, employment, benefits
S Nutritional counseling
Oral Health Education Services
S Patient Concerns Assessed
S
S
S
Pain
Gingival Condition
Appearance
S Caries Risk Assessment
S
S
S
Sugar sweetened beverage consumption
Dietary Habits
Home oral health habits
S Motivational Interviewing Techniques Employed
S
S
Home Oral Health Instruction
Brief tobacco cessation counseling
S Dental Exam Appointments Facilitated
Theory and Evidence
S National Research Council & Institute Medicine
Adolescent Health Services, Missing Opportunities Report
S Healthy People 2020 objectives
S Poor utilization of dental care by young adults
S Ecological model
S Principles of Motivational Interviewing
College of Dental Medicine
Services
S Triage Center
S
S
S
Medical History
Radiographs
Referral for care supervised by dental faculty
S Advanced General Dentistry & General Practice Residents
S
S
S
Examination
Treatment plan
Prophylaxis, restorations
S Oral & Maxillofacial Surgery
S
Extractions
S Prosthodontic
S
Removable prosthetic appliances
Patient Oral Health Concerns
S Gingival Health
S Bleeding
S Sensitivity
S Tooth Decay
S Tooth Loss
S Appearance of Teeth
S Privacy Regarding Health Information
S Continuity of Provider Care
CDM Accommodations
S Combined visits for P.S. patients
S Medical history& radiographs
S Examination, Treatment Planning & Dental Prophylaxis
S CDM staff education
S Increased awareness of P.S. patient needs
S Efforts to ensure privacy
S Change in electronic health record to conceal HIV status
S Efforts to accommodate minors not living with family
S Triage team huddle to strategize
S Routine engagement with CDM’s patient advocate
Trends & Outcomes
Reduction in dental phobia
Detection of oral health issues P.S. providers have missed
Successful change in oral health habits
Increased Oral Health Literacy
27% of patients referred for care kept appointment, July
– September 2014
S 35% increase in # of unduplicated patients referred for
care in 2014
S 80% of P.S. patients have received oral health education
and oral health products
S
S
S
S
S
Future Goals
S Reduction in dental no show rate
S Implement fluoride varnish program
S Increase number of tobacco quit attempts
S Change CDM culture of routine tooth extraction to tooth
retention
S Work with CDM to improve tracking of treatment plan
completions
S Implement incentive program for patient treatment
completion
Program Replication
Possibilities
S Diabetes comprehensive centers
S Cardiovascular care centers
S Medical comprehensive care centers for older adults
S Conclusions
References
Committee on Adolescent Health Care Services and Models of Care for Treatment,
Prevention and Healthy Development (2009). Lawrence, R.S., Appleton Gootmand, J. &
Sim, L.J.. (Eds). Adolescent Health Services: Missing Opportunities. Washington D.C.:
National Academic Press.
Hayden, J. (2009). Introduction to Health Behavior Theory. Sudbury, MA: Jones & Bartlett.
Viner, R. Ozer, E., Denny, S. Malmot, M. Reznick, M., Fatusi, A. & Currie, C. (2012).
Adolescence and the social determinants of health. The Lancet, 379, 1641-52.
Vujicic, M. & Nasseh, K.( 2013). A decade of dental care utilization. Health Services
Research, (1-21). Doi:10.1111/475-6773/12130