The impact of an oral health intervention on the quality of life among San Francisco welfare reform participants.

摘要

This dissertation is composed of three studies on the oral health and oral health-related quality of life (OHRQoL) of a San Francisco welfare reform population.; This dissertation is a natural history study of the intervention affects of the San Francisco Personal Assisted Employment Services (PAES) Dental Program on the OHRQoL and employment status of welfare recipients.; Objectives. To describe the baseline oral health, dental treatment needs, and OHRQoL of participants in the PAES Dental Program. To assess the intervention effects of receiving the rehabilitative dental treatment on the OHRQoL and employment status of study participants. To evaluate the levels of participation and patient satisfaction for the PAES Dental Program.; Methods. A convenience sample of 377 participants in the novel San Francisco PAES Dental Program received baseline oral examinations, oral health-related quality of life (OHIP-14) questionnaires, treatment plans, and restorative dental care.; Results. Eighty-five percent of participants had missing teeth, 84% had decayed teeth, and 63% had severe or emergency dental treatment urgency. Thirty-two percent of participants reported frequent/constant problems with psychological discomfort, and 27% had frequent/constant pain. OHIP-14 scores were associated with general health (p = 0.0244), number of missing teeth (p = 0.0001), treatment urgency classification (p 0.0001), and treatment cost (p = 0.0077) in the regression model. Seventy-nine percent of participants exhibited improvement in their OHIP-14 scores following the rehabilitative dental treatment, and moderate to large effect sizes (0.41–1.09) were obtained for 6 of the 7 OHIP-14 subscales. In the regression model, OHIP-14 change scores were associated with race (p = 0.0066), overall health (p = 0.0375), treatment urgency (p = 0.0133), baseline OHIP-14 scores (p 0.0001), patient satisfaction with the resolution of their chief complaint (p = 0.0028), and patient satisfaction with the Dental Program (p = 0.0010). Those who completed their dental treatment were twice as likely to achieve a favorable or neutral employment outcome (67%) than an unfavorable outcome (32%). High levels of patient satisfaction (77–97%) for process and outcome measures were reported for the Dental Program. (Abstract shortened by UMI.)