Racism in oral healthcare settings: Implications for dental care-related fear/anxiety and utilization among Black/African American women in Appalachia.

Autor: Sokoto KC; Counseling Psychology, Department of Counseling and Learning Sciences, West Virginia University, Morgantown, West Virginia, USA.; Center for Oral Health Research in Appalachia, University of Pittsburgh and West Virginia University, Pittsburgh, Pennsylvania, and Morgantown, West Virginia, USA., Platt LF; Counseling Psychology, Department of Counseling and Learning Sciences, West Virginia University, Morgantown, West Virginia, USA., Alexander LA; Center for Oral Health Research in Appalachia, University of Pittsburgh and West Virginia University, Pittsburgh, Pennsylvania, and Morgantown, West Virginia, USA.; Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia, USA., Foxman B; Center for Oral Health Research in Appalachia, University of Pittsburgh and West Virginia University, Pittsburgh, Pennsylvania, and Morgantown, West Virginia, USA.; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Shaffer JR; Center for Oral Health Research in Appalachia, University of Pittsburgh and West Virginia University, Pittsburgh, Pennsylvania, and Morgantown, West Virginia, USA.; Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Marazita ML; Center for Oral Health Research in Appalachia, University of Pittsburgh and West Virginia University, Pittsburgh, Pennsylvania, and Morgantown, West Virginia, USA.; Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Clinical and Translational Science Institute and Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., McNeil DW; Center for Oral Health Research in Appalachia, University of Pittsburgh and West Virginia University, Pittsburgh, Pennsylvania, and Morgantown, West Virginia, USA.; Department of Psychology, West Virginia University, Morgantown, West Virginia, USA.; Department of Dental Public Health & Professional Practice, West Virginia University, Morgantown, West Virginia, USA.
Jazyk: angličtina
Zdroj: Journal of public health dentistry [J Public Health Dent] 2022 Mar; Vol. 82 Suppl 1, pp. 28-35.
DOI: 10.1111/jphd.12523
Abstrakt: Objective: To explore the association of racism in oral healthcare settings and dental care-related fear/anxiety with dental utilization among Black/African American women in Appalachia.
Methods: We analyzed self-report measures of racism in oral healthcare settings, dental care-related anxiety and fear, recency of a dental visit, and demographic information from 268 pregnant women participating in the Center for Oral Health Research in Appalachia (COHRA) SMILE cohort. All participants self-identified as African American or Black and resided in Appalachia (i.e., either West Virginia or Pittsburgh, PA).
Results: Over one-third of the participants reported at least one instance of racism in oral healthcare settings, with "not being listened to" due to their race or color as the most frequent issue (24.4%). Clinically significant levels of dental care-related anxiety and fear were reported by 14.3% of the sample. A mediational model demonstrated that the experience of racism in oral healthcare settings was a significant predictor of dental fear/anxiety, and that dental fear/anxiety was a significant predictor of dental utilization. There was a significant relationship between racism in oral healthcare settings and dental utilization only when mediated by the presence of dental care-related fear and anxiety.
Conclusions: Together, experiences of racism in oral healthcare settings and dental care-related fear/anxiety are predictive of decreased dental utilization for Black/African American women living in Appalachia. This study provides insight into racism in oral healthcare settings as a social determinant of dental anxiety/fear and inequities in dental utilization.
(© 2022 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals LLC on behalf of American Association of Public Health Dentistry.)
Databáze: MEDLINE
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