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Predictors of dental care utilization in north‐central Appalachia in the USA
Objectives Dental utilization is an important determinant of oral health and well‐being. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north‐central Appalachia, USA, a region where oral health disparities are profo...
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| Published in: | Community dentistry and oral epidemiology 2019-08, Vol.47 (4), p.283-290 |
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| cited_by | cdi_FETCH-LOGICAL-c4483-6ec26126d33234f85cc3975229235d16972428d5cc1b67121b7bf56275a52bdb3 |
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| container_end_page | 290 |
| container_issue | 4 |
| container_start_page | 283 |
| container_title | Community dentistry and oral epidemiology |
| container_volume | 47 |
| creator | Chen, Mengxia Wright, Casey D. Tokede, Oluwabunmi Yansane, Alfa Montasem, Alexander Kalenderian, Elsbeth Beaty, Terri H. Feingold, Eleanor Shaffer, John R. Crout, Richard J. Neiswanger, Katherine Weyant, Robert J. Marazita, Mary L. McNeil, Daniel W. |
| description | Objectives
Dental utilization is an important determinant of oral health and well‐being. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north‐central Appalachia, USA, a region where oral health disparities are profound.
Methods
This study used household‐based data from the Center for Oral Health Research in Appalachia (COHRA1) study in north‐central Appalachia, including 449 families with 868 adults. The generalized estimating equation (GEE) approach was used to determine the best‐fitting predictor model for dental utilization among adult family members.
Results
On average across West Virginia and Pennsylvania, having dental insurance was associated with greater dental utilization over a 3‐year time period (OR = 2.20, 95% CI = 1.54, 3.14). When stratified by state, the association held for only West Virginia (OR = 2.41, 95% CI = 1.54, 3.79) and was nonsignificant for Pennsylvania residents (OR = 1.50, 95% CI = 0.80, 2.79). Individuals from Pennsylvania were more likely to utilize dental care and participants from West Virginia less so (2.31, 95% CI = 1.57, 3.40). Females from Pennsylvania were more likely than males to regularly seek dental care (OR = 1.44, 95% CI = 1.00, 2.05), and a higher income was associated with greater frequency of regular dental visits (OR = 1.21, 95% CI = 1.09, 1.34) in West Virginia. Individuals from Pennsylvania who scored higher on the Physiological Arousal subscale of the Dental Fear Survey were more likely to attend routine care visits (OR = 1.18, 95% CI = 1.03, 1.35). Across both states, more fatalistic beliefs related to oral health care also predicted less routine care (OR = 0.87, 95% CI = 0.81, 0.94), and more investment in or more positive attitudes towards one's oral health also was associated with higher utilization (OR = 1.18, 95% CI = 1.13, 1.23).
Conclusions
Overall, the findings of this study suggest state residency, sex, insurance, income, fatalistic beliefs, health values, and aspects of dental care‐related anxiety and fear predicted dental care utilization in north‐central Appalachia. These findings reinforce the need to address insurance and other economic factors affecting utilization and to consider how individual‐level fatalistic beliefs and oral health values may affect utilization of routine oral health care. |
| doi_str_mv | 10.1111/cdoe.12453 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6631312</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2210957979</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4483-6ec26126d33234f85cc3975229235d16972428d5cc1b67121b7bf56275a52bdb3</originalsourceid><addsrcrecordid>eNp90ctKxDAUBuAgio6XjQ8gBTciVHOSJpluhGG8gqigrkOapk6k04xJq-jKR_AZfRIzzijqwmwCOR8_J_wIbQLeg3j2denMHpCM0QXUA45xihnpL6IephhSxjmsoNUQ7jEGQTlfRisU5zkVmeihiytvSqtb50PiqqQ0TavqRCtvkq61tX1RrXVNYpukcb4dvb--6Uh8NIPJRNVKj6yaTtuRSW6vB-toqVJ1MBvzew3dHh_dDE_T88uTs-HgPNVZ1qcpN5pwILyklNCs6jOtaS4YITmhrASeC5KRfhmfoeACCBSiqBgngilGirKga-hgljvpirEp5zvJibdj5Z-lU1b-njR2JO_co-ScAgUSA3bmAd49dCa0cmyDNnWtGuO6IAkBnDORizzS7T_03nW-id-LirFI-KfanSntXQjeVN_LAJbTmuS0JvlZU8RbP9f_pl-9RAAz8GRr8_xPlBweXh7NQj8A142c4A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2255979679</pqid></control><display><type>article</type><title>Predictors of dental care utilization in north‐central Appalachia in the USA</title><source>Wiley</source><creator>Chen, Mengxia ; Wright, Casey D. ; Tokede, Oluwabunmi ; Yansane, Alfa ; Montasem, Alexander ; Kalenderian, Elsbeth ; Beaty, Terri H. ; Feingold, Eleanor ; Shaffer, John R. ; Crout, Richard J. ; Neiswanger, Katherine ; Weyant, Robert J. ; Marazita, Mary L. ; McNeil, Daniel W.</creator><creatorcontrib>Chen, Mengxia ; Wright, Casey D. ; Tokede, Oluwabunmi ; Yansane, Alfa ; Montasem, Alexander ; Kalenderian, Elsbeth ; Beaty, Terri H. ; Feingold, Eleanor ; Shaffer, John R. ; Crout, Richard J. ; Neiswanger, Katherine ; Weyant, Robert J. ; Marazita, Mary L. ; McNeil, Daniel W.</creatorcontrib><description>Objectives
Dental utilization is an important determinant of oral health and well‐being. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north‐central Appalachia, USA, a region where oral health disparities are profound.
Methods
This study used household‐based data from the Center for Oral Health Research in Appalachia (COHRA1) study in north‐central Appalachia, including 449 families with 868 adults. The generalized estimating equation (GEE) approach was used to determine the best‐fitting predictor model for dental utilization among adult family members.
Results
On average across West Virginia and Pennsylvania, having dental insurance was associated with greater dental utilization over a 3‐year time period (OR = 2.20, 95% CI = 1.54, 3.14). When stratified by state, the association held for only West Virginia (OR = 2.41, 95% CI = 1.54, 3.79) and was nonsignificant for Pennsylvania residents (OR = 1.50, 95% CI = 0.80, 2.79). Individuals from Pennsylvania were more likely to utilize dental care and participants from West Virginia less so (2.31, 95% CI = 1.57, 3.40). Females from Pennsylvania were more likely than males to regularly seek dental care (OR = 1.44, 95% CI = 1.00, 2.05), and a higher income was associated with greater frequency of regular dental visits (OR = 1.21, 95% CI = 1.09, 1.34) in West Virginia. Individuals from Pennsylvania who scored higher on the Physiological Arousal subscale of the Dental Fear Survey were more likely to attend routine care visits (OR = 1.18, 95% CI = 1.03, 1.35). Across both states, more fatalistic beliefs related to oral health care also predicted less routine care (OR = 0.87, 95% CI = 0.81, 0.94), and more investment in or more positive attitudes towards one's oral health also was associated with higher utilization (OR = 1.18, 95% CI = 1.13, 1.23).
Conclusions
Overall, the findings of this study suggest state residency, sex, insurance, income, fatalistic beliefs, health values, and aspects of dental care‐related anxiety and fear predicted dental care utilization in north‐central Appalachia. These findings reinforce the need to address insurance and other economic factors affecting utilization and to consider how individual‐level fatalistic beliefs and oral health values may affect utilization of routine oral health care.</description><identifier>ISSN: 0301-5661</identifier><identifier>EISSN: 1600-0528</identifier><identifier>DOI: 10.1111/cdoe.12453</identifier><identifier>PMID: 30993747</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Adult ; Anxiety ; Appalachia ; Appalachian Region ; avoidance of dental care ; Dental care ; Dental Care - statistics & numerical data ; dental care‐related anxiety and fear ; Dental Health Services - statistics & numerical data ; Dental insurance ; dental utilization ; Fear ; Female ; Health Behavior ; Health services utilization ; Humans ; Insurance, Dental - statistics & numerical data ; Male ; Oral Health ; Oral hygiene ; Pennsylvania ; Rural Population - statistics & numerical data ; West Virginia</subject><ispartof>Community dentistry and oral epidemiology, 2019-08, Vol.47 (4), p.283-290</ispartof><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4483-6ec26126d33234f85cc3975229235d16972428d5cc1b67121b7bf56275a52bdb3</citedby><cites>FETCH-LOGICAL-c4483-6ec26126d33234f85cc3975229235d16972428d5cc1b67121b7bf56275a52bdb3</cites><orcidid>0000-0002-7695-5685 ; 0000-0002-5252-9120 ; 0000-0003-2898-6484 ; 0000-0002-7644-1705 ; 0000-0003-1897-1131 ; 0000-0002-2648-2832 ; 0000-0003-1189-5877 ; 0000-0002-1250-6813 ; 0000-0002-0766-8455 ; 0000-0003-4770-4200 ; 0000-0003-0479-8673</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcdoe.12453$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcdoe.12453$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,786,790,891,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30993747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Mengxia</creatorcontrib><creatorcontrib>Wright, Casey D.</creatorcontrib><creatorcontrib>Tokede, Oluwabunmi</creatorcontrib><creatorcontrib>Yansane, Alfa</creatorcontrib><creatorcontrib>Montasem, Alexander</creatorcontrib><creatorcontrib>Kalenderian, Elsbeth</creatorcontrib><creatorcontrib>Beaty, Terri H.</creatorcontrib><creatorcontrib>Feingold, Eleanor</creatorcontrib><creatorcontrib>Shaffer, John R.</creatorcontrib><creatorcontrib>Crout, Richard J.</creatorcontrib><creatorcontrib>Neiswanger, Katherine</creatorcontrib><creatorcontrib>Weyant, Robert J.</creatorcontrib><creatorcontrib>Marazita, Mary L.</creatorcontrib><creatorcontrib>McNeil, Daniel W.</creatorcontrib><title>Predictors of dental care utilization in north‐central Appalachia in the USA</title><title>Community dentistry and oral epidemiology</title><addtitle>Community Dent Oral Epidemiol</addtitle><description>Objectives
Dental utilization is an important determinant of oral health and well‐being. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north‐central Appalachia, USA, a region where oral health disparities are profound.
Methods
This study used household‐based data from the Center for Oral Health Research in Appalachia (COHRA1) study in north‐central Appalachia, including 449 families with 868 adults. The generalized estimating equation (GEE) approach was used to determine the best‐fitting predictor model for dental utilization among adult family members.
Results
On average across West Virginia and Pennsylvania, having dental insurance was associated with greater dental utilization over a 3‐year time period (OR = 2.20, 95% CI = 1.54, 3.14). When stratified by state, the association held for only West Virginia (OR = 2.41, 95% CI = 1.54, 3.79) and was nonsignificant for Pennsylvania residents (OR = 1.50, 95% CI = 0.80, 2.79). Individuals from Pennsylvania were more likely to utilize dental care and participants from West Virginia less so (2.31, 95% CI = 1.57, 3.40). Females from Pennsylvania were more likely than males to regularly seek dental care (OR = 1.44, 95% CI = 1.00, 2.05), and a higher income was associated with greater frequency of regular dental visits (OR = 1.21, 95% CI = 1.09, 1.34) in West Virginia. Individuals from Pennsylvania who scored higher on the Physiological Arousal subscale of the Dental Fear Survey were more likely to attend routine care visits (OR = 1.18, 95% CI = 1.03, 1.35). Across both states, more fatalistic beliefs related to oral health care also predicted less routine care (OR = 0.87, 95% CI = 0.81, 0.94), and more investment in or more positive attitudes towards one's oral health also was associated with higher utilization (OR = 1.18, 95% CI = 1.13, 1.23).
Conclusions
Overall, the findings of this study suggest state residency, sex, insurance, income, fatalistic beliefs, health values, and aspects of dental care‐related anxiety and fear predicted dental care utilization in north‐central Appalachia. These findings reinforce the need to address insurance and other economic factors affecting utilization and to consider how individual‐level fatalistic beliefs and oral health values may affect utilization of routine oral health care.</description><subject>Adult</subject><subject>Anxiety</subject><subject>Appalachia</subject><subject>Appalachian Region</subject><subject>avoidance of dental care</subject><subject>Dental care</subject><subject>Dental Care - statistics & numerical data</subject><subject>dental care‐related anxiety and fear</subject><subject>Dental Health Services - statistics & numerical data</subject><subject>Dental insurance</subject><subject>dental utilization</subject><subject>Fear</subject><subject>Female</subject><subject>Health Behavior</subject><subject>Health services utilization</subject><subject>Humans</subject><subject>Insurance, Dental - statistics & numerical data</subject><subject>Male</subject><subject>Oral Health</subject><subject>Oral hygiene</subject><subject>Pennsylvania</subject><subject>Rural Population - statistics & numerical data</subject><subject>West Virginia</subject><issn>0301-5661</issn><issn>1600-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp90ctKxDAUBuAgio6XjQ8gBTciVHOSJpluhGG8gqigrkOapk6k04xJq-jKR_AZfRIzzijqwmwCOR8_J_wIbQLeg3j2denMHpCM0QXUA45xihnpL6IephhSxjmsoNUQ7jEGQTlfRisU5zkVmeihiytvSqtb50PiqqQ0TavqRCtvkq61tX1RrXVNYpukcb4dvb--6Uh8NIPJRNVKj6yaTtuRSW6vB-toqVJ1MBvzew3dHh_dDE_T88uTs-HgPNVZ1qcpN5pwILyklNCs6jOtaS4YITmhrASeC5KRfhmfoeACCBSiqBgngilGirKga-hgljvpirEp5zvJibdj5Z-lU1b-njR2JO_co-ScAgUSA3bmAd49dCa0cmyDNnWtGuO6IAkBnDORizzS7T_03nW-id-LirFI-KfanSntXQjeVN_LAJbTmuS0JvlZU8RbP9f_pl-9RAAz8GRr8_xPlBweXh7NQj8A142c4A</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Chen, Mengxia</creator><creator>Wright, Casey D.</creator><creator>Tokede, Oluwabunmi</creator><creator>Yansane, Alfa</creator><creator>Montasem, Alexander</creator><creator>Kalenderian, Elsbeth</creator><creator>Beaty, Terri H.</creator><creator>Feingold, Eleanor</creator><creator>Shaffer, John R.</creator><creator>Crout, Richard J.</creator><creator>Neiswanger, Katherine</creator><creator>Weyant, Robert J.</creator><creator>Marazita, Mary L.</creator><creator>McNeil, Daniel W.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7695-5685</orcidid><orcidid>https://orcid.org/0000-0002-5252-9120</orcidid><orcidid>https://orcid.org/0000-0003-2898-6484</orcidid><orcidid>https://orcid.org/0000-0002-7644-1705</orcidid><orcidid>https://orcid.org/0000-0003-1897-1131</orcidid><orcidid>https://orcid.org/0000-0002-2648-2832</orcidid><orcidid>https://orcid.org/0000-0003-1189-5877</orcidid><orcidid>https://orcid.org/0000-0002-1250-6813</orcidid><orcidid>https://orcid.org/0000-0002-0766-8455</orcidid><orcidid>https://orcid.org/0000-0003-4770-4200</orcidid><orcidid>https://orcid.org/0000-0003-0479-8673</orcidid></search><sort><creationdate>201908</creationdate><title>Predictors of dental care utilization in north‐central Appalachia in the USA</title><author>Chen, Mengxia ; Wright, Casey D. ; Tokede, Oluwabunmi ; Yansane, Alfa ; Montasem, Alexander ; Kalenderian, Elsbeth ; Beaty, Terri H. ; Feingold, Eleanor ; Shaffer, John R. ; Crout, Richard J. ; Neiswanger, Katherine ; Weyant, Robert J. ; Marazita, Mary L. ; McNeil, Daniel W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4483-6ec26126d33234f85cc3975229235d16972428d5cc1b67121b7bf56275a52bdb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Anxiety</topic><topic>Appalachia</topic><topic>Appalachian Region</topic><topic>avoidance of dental care</topic><topic>Dental care</topic><topic>Dental Care - statistics & numerical data</topic><topic>dental care‐related anxiety and fear</topic><topic>Dental Health Services - statistics & numerical data</topic><topic>Dental insurance</topic><topic>dental utilization</topic><topic>Fear</topic><topic>Female</topic><topic>Health Behavior</topic><topic>Health services utilization</topic><topic>Humans</topic><topic>Insurance, Dental - statistics & numerical data</topic><topic>Male</topic><topic>Oral Health</topic><topic>Oral hygiene</topic><topic>Pennsylvania</topic><topic>Rural Population - statistics & numerical data</topic><topic>West Virginia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Mengxia</creatorcontrib><creatorcontrib>Wright, Casey D.</creatorcontrib><creatorcontrib>Tokede, Oluwabunmi</creatorcontrib><creatorcontrib>Yansane, Alfa</creatorcontrib><creatorcontrib>Montasem, Alexander</creatorcontrib><creatorcontrib>Kalenderian, Elsbeth</creatorcontrib><creatorcontrib>Beaty, Terri H.</creatorcontrib><creatorcontrib>Feingold, Eleanor</creatorcontrib><creatorcontrib>Shaffer, John R.</creatorcontrib><creatorcontrib>Crout, Richard J.</creatorcontrib><creatorcontrib>Neiswanger, Katherine</creatorcontrib><creatorcontrib>Weyant, Robert J.</creatorcontrib><creatorcontrib>Marazita, Mary L.</creatorcontrib><creatorcontrib>McNeil, Daniel W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Community dentistry and oral epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Mengxia</au><au>Wright, Casey D.</au><au>Tokede, Oluwabunmi</au><au>Yansane, Alfa</au><au>Montasem, Alexander</au><au>Kalenderian, Elsbeth</au><au>Beaty, Terri H.</au><au>Feingold, Eleanor</au><au>Shaffer, John R.</au><au>Crout, Richard J.</au><au>Neiswanger, Katherine</au><au>Weyant, Robert J.</au><au>Marazita, Mary L.</au><au>McNeil, Daniel W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of dental care utilization in north‐central Appalachia in the USA</atitle><jtitle>Community dentistry and oral epidemiology</jtitle><addtitle>Community Dent Oral Epidemiol</addtitle><date>2019-08</date><risdate>2019</risdate><volume>47</volume><issue>4</issue><spage>283</spage><epage>290</epage><pages>283-290</pages><issn>0301-5661</issn><eissn>1600-0528</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>MC – MPH project design, data analysis and interpretation, write-up, approval of final manuscript; CDW – Data management, data analysis and interpretation, write-up, approval of final manuscript; OT, AY, AM, and EK – Data analysis and interpretation, approval of final manuscript; THB- Supervision of MC and overall MPH project; approval of final manuscript; EF, JRS – Data processing, data analysis, interpretation, write-up, approval of final manuscript; RJC, KN, RJW – Design of COHRA project, supervision of data collection, interpretation of results; final approval of manuscript; KN – Data management, write-up, approval of final manuscript; MLM – Overall COHRA project supervision; approval of design; data analysis plan, approval of final manuscript; DWM - Overall COHRA project supervision; approval of design; data analysis plan, supervision of MC and CDW, write-up, approval of final manuscript.</notes><notes>Statement of Author Contributions</notes><abstract>Objectives
Dental utilization is an important determinant of oral health and well‐being. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north‐central Appalachia, USA, a region where oral health disparities are profound.
Methods
This study used household‐based data from the Center for Oral Health Research in Appalachia (COHRA1) study in north‐central Appalachia, including 449 families with 868 adults. The generalized estimating equation (GEE) approach was used to determine the best‐fitting predictor model for dental utilization among adult family members.
Results
On average across West Virginia and Pennsylvania, having dental insurance was associated with greater dental utilization over a 3‐year time period (OR = 2.20, 95% CI = 1.54, 3.14). When stratified by state, the association held for only West Virginia (OR = 2.41, 95% CI = 1.54, 3.79) and was nonsignificant for Pennsylvania residents (OR = 1.50, 95% CI = 0.80, 2.79). Individuals from Pennsylvania were more likely to utilize dental care and participants from West Virginia less so (2.31, 95% CI = 1.57, 3.40). Females from Pennsylvania were more likely than males to regularly seek dental care (OR = 1.44, 95% CI = 1.00, 2.05), and a higher income was associated with greater frequency of regular dental visits (OR = 1.21, 95% CI = 1.09, 1.34) in West Virginia. Individuals from Pennsylvania who scored higher on the Physiological Arousal subscale of the Dental Fear Survey were more likely to attend routine care visits (OR = 1.18, 95% CI = 1.03, 1.35). Across both states, more fatalistic beliefs related to oral health care also predicted less routine care (OR = 0.87, 95% CI = 0.81, 0.94), and more investment in or more positive attitudes towards one's oral health also was associated with higher utilization (OR = 1.18, 95% CI = 1.13, 1.23).
Conclusions
Overall, the findings of this study suggest state residency, sex, insurance, income, fatalistic beliefs, health values, and aspects of dental care‐related anxiety and fear predicted dental care utilization in north‐central Appalachia. These findings reinforce the need to address insurance and other economic factors affecting utilization and to consider how individual‐level fatalistic beliefs and oral health values may affect utilization of routine oral health care.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>30993747</pmid><doi>10.1111/cdoe.12453</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7695-5685</orcidid><orcidid>https://orcid.org/0000-0002-5252-9120</orcidid><orcidid>https://orcid.org/0000-0003-2898-6484</orcidid><orcidid>https://orcid.org/0000-0002-7644-1705</orcidid><orcidid>https://orcid.org/0000-0003-1897-1131</orcidid><orcidid>https://orcid.org/0000-0002-2648-2832</orcidid><orcidid>https://orcid.org/0000-0003-1189-5877</orcidid><orcidid>https://orcid.org/0000-0002-1250-6813</orcidid><orcidid>https://orcid.org/0000-0002-0766-8455</orcidid><orcidid>https://orcid.org/0000-0003-4770-4200</orcidid><orcidid>https://orcid.org/0000-0003-0479-8673</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0301-5661 |
| ispartof | Community dentistry and oral epidemiology, 2019-08, Vol.47 (4), p.283-290 |
| issn | 0301-5661 1600-0528 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6631312 |
| source | Wiley |
| subjects | Adult Anxiety Appalachia Appalachian Region avoidance of dental care Dental care Dental Care - statistics & numerical data dental care‐related anxiety and fear Dental Health Services - statistics & numerical data Dental insurance dental utilization Fear Female Health Behavior Health services utilization Humans Insurance, Dental - statistics & numerical data Male Oral Health Oral hygiene Pennsylvania Rural Population - statistics & numerical data West Virginia |
| title | Predictors of dental care utilization in north‐central Appalachia in the USA |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-22T01%3A58%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Predictors%20of%20dental%20care%20utilization%20in%20north%E2%80%90central%20Appalachia%20in%20the%20USA&rft.jtitle=Community%20dentistry%20and%20oral%20epidemiology&rft.au=Chen,%20Mengxia&rft.date=2019-08&rft.volume=47&rft.issue=4&rft.spage=283&rft.epage=290&rft.pages=283-290&rft.issn=0301-5661&rft.eissn=1600-0528&rft_id=info:doi/10.1111/cdoe.12453&rft_dat=%3Cproquest_pubme%3E2210957979%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4483-6ec26126d33234f85cc3975229235d16972428d5cc1b67121b7bf56275a52bdb3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2255979679&rft_id=info:pmid/30993747&rfr_iscdi=true |