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Tan SHX, Lee GKY, Goh CE, Tong HJ, Chuang JCP, Ang KY, Lim DGX, Gao X. Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore. Community Dent Oral Epidemiol 2024; 52:336-343. [PMID: 38644526 DOI: 10.1111/cdoe.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND/AIM(S) Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. METHODS Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. RESULTS Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. CONCLUSION Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Charlene Enhui Goh
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Huei Jinn Tong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | | | | | - David Guang Xu Lim
- Tzu Chi Singapore Free Clinic, Buddhist Compassion Relief Tzu Chi Foundation, Singapore, Singapore
- National Dental Centre Singapore, Singapore, Singapore
| | - Xiaoli Gao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Yap AU, Tan SHX. Conceptualising TMD symptom burden in youths: Symptom duration, frequency, intensity and interference. J Oral Rehabil 2024. [PMID: 38706175 DOI: 10.1111/joor.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/15/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE This study aimed to conceptualise Temporomandibular disorder (TMD) symptom burden and severity and explored their interrelationships with somatic symptoms and psychological distress. METHODS Participants were recruited from a local polytechnic. The quintessential five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) were appraised and extended to evaluate the duration, frequency, intensity and interference of discrete TMD symptoms. Global TMD severity (GS) was computed by totaling the points for all TMD symptoms and dimensions. TMD (TS) and somatic symptom (SS) burden were assessed based on the Somatic Symptoms Scale-8, while psychological distress was measured with the Depression, Anxiety and Stress Scales-21. Statistical analyses were performed using Kruskal-Wallis/Dunn tests and Spearman's correlation (α = .05). RESULT Of the 366 eligible participants (mean age 19.1 ± 2.3 years), 51.4% were 5Ts-negative and 48.6% were 5Ts-positive. Among the 5Ts-positive individuals, 25.3%/64.0% were 'bothered a little' whereas 4.5%/10.7% were 'bothered a lot' by TMD pain/headache. Correspondingly, 32.6%/12.4%/5.1% were 'bothered a little' while 2.8%/2.8%/1.1% were 'bothered a lot' by TMJ sounds/closed/open locking. TS burden was moderate-to-strongly correlated to aggregate symptom duration, frequency, intensity, interference, GS and SS burden (rs = .50-.88). While TS burden and GS were weakly associated with psychological distress (rs = .18-.36), SS burden was moderately related to depression, anxiety and stress (rs = .47-.53). CONCLUSIONS TS burden can serve as a proxy for global TMD severity and may be more meaningful than the mere presence of TMD symptoms in clinical and research settings.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, National Dental Research Institute Singapore, Singapore, Singapore
| | - Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Yap AU, Lee DZR, Tan SHX. The Physical Symptom Scale-8: Psychometric Characteristics of a Short-Form Version of the PHQ-15 and its Use in TMD-Related Assessment and Research. J Oral Facial Pain Headache 2023; 37:159-165. [PMID: 37698952 PMCID: PMC10664702 DOI: 10.11607/ofph.3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 12/10/2022] [Indexed: 09/14/2023]
Abstract
AIMS To describe the development of the Physical Symptom Scale-8 (PSS-8) and to examine its psychometric properties and use in temporomandibular disorder (TMD)-related assessment and research. METHODS An online survey comprising demographic variables, the DC/TMD pain screener (TPS), Short-Form Fonseca Anamnestic Index (SFAI), PSS-8, PHQ-15, and Depression, Anxiety, and Stress Scale-21 (DASS-21) was administered to young adults attending a technical college. The PSS-8 adopted the Somatic Symptom Scale-8 (SSS-8) items but maintained the 3-point response scale and 4-week time frame of the PHQ-15. Internal consistency and reliability of the PSS-8 were determined by its Cronbach α value. Known-groups and concurrent/convergent validity were examined using Mann-Whitney U test and Spearman correlation (α = .05), respectively. RESULTS Responses from 400 participants (mean age 18.8 ± 1.5 years; 52.3% women) were evaluated. Pain-related (WPT) and all (WAT) TMDs were present in 8.5% and 17.3% of the sample, respectively. The PSS-8 exhibited good internal consistency (α = 0.82) and sound known-groups validity, with the WPT/WAT groups having significantly higher PSS-8 scores than those without TMDs. Good concurrent and convergent validity were also observed, with moderate to strong correlations with the PHQ-15 (rs = 0.97) and DASS-21 scores (rs = 0.48 to 0.60). Correlations with the TPS and SFAI scores were weaker (rs = 0.28 to 0.34). CONCLUSION The PSS-8 presented good psychometric properties and performed similarly to the PHQ-15. It holds promise as the "de facto" shortened version of the PHQ-15 for TMDs and related work.
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Yap AU, Tan MWY, Tan SHX, Chua AP. Sleep bruxism events: an epiphenomenon of severe obstructive sleep apnea? Clin Oral Investig 2023; 27:4633-4642. [PMID: 37256429 DOI: 10.1007/s00784-023-05089-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 05/22/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES This study investigated the temporal relationships between apnea-hypopnea (AH) and sleep bruxism (SB) events and correlated SB to various respiratory/sleep indexes in adult patients with concomitant obstructive sleep apnea (OSA) and SB. MATERIALS AND METHODS Nocturnal PSG data of 147 consecutive OSA patients were examined for comorbid SB. Among the 49 subjects with coexisting OSA and SB, 26 were randomly selected for in-depth appraisal of temporal patterns which were classified as T1 (unrelated activities), T2 (AH events occur before SB events), T3 (SB events occur before AH events), and T4 (AH and SB events occur simultaneously). Data were analyzed using Mann-Whitney U tests and Spearman's correlation (α = 0.05). RESULTS The majority (84.5%) of AH events were unrelated to SB events. Of the 15.5% of related activities, T2 and T3 patterns occurred in 14.1% and 1.4%, respectively. SB events/index, the percentage of unrelated/related AH-SB events, and T2-T3 episodes were not associated with gender, age, body mass (BMI), and apnea-hypopnea (AHI) index. SB events were related to total sleep time (rs = 0.44), but no significant associations were discerned between SB and AH index. CONCLUSIONS As most AH events were unrelated to SB events, OSA and SB are probably epiphenomena in adult patients with concomitant conditions. Where AH-SB events were related, the T2 temporal pattern, where SB events were subsequent to AH events, featured predominantly alluding to a specific form of secondary SB triggered by sleep micro-arousals. CLINICAL RELEVANCE AH and SB events are probably epiphenomena in adult patients with coexisting OSA and SB. Even so, OSA patients should be routinely screened for SB and vice versa considering their frequent comorbidity.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, 1 Jurong East Street 21, Singapore, 609606, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Madeleine Wan Yong Tan
- Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, 1 Jurong East Street 21, Singapore, 609606, Singapore.
| | - Sharon Hui Xuan Tan
- Saw See Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ai Ping Chua
- Department of Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore
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Yong CW, Tan SHX, Teo GN, Tan TS, Ng WH. Should we stop dual anti-platelet therapy for dental extractions? An umbrella review for this dental dilemma. J Stomatol Oral Maxillofac Surg 2022; 123:e708-e716. [PMID: 35691560 DOI: 10.1016/j.jormas.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 05/28/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Dual Anti-platelet Therapy (DAPT) are prescribed to patients who had or are at risk of cerebrovascular or cardiovascular ischemic events. This umbrella review appraises existing systematic reviews on the risk of bleeding related complications during and after dental extractions for patients on DAPT. STUDY DATA AND SOURCES This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered to the PROSPERO (International prospective register of systematic reviews) database. A systematic electronic literature search was conducted according to the PRISMA guidelines, via PubMed, Ovid, Cochrane and Embase. STUDY SELECTION Four systematic reviews met the inclusion criteria and were included the analysis. They show DAPT increases the risk of bleeding related complications after dental extractions, but the differences may not be clinically significant as local haemostatic measures were adequate in controlling bleeding. CONCLUSION Despite the increased risk of bleeding after dental extractions in patients on DAPT, it may not be necessary to interrupt the anti-platelet therapy. Local haemostatic agents may be sufficient in controlling both the primary or secondary bleeding. On the other hand, the complications of discontinuing DAPT may be more severe and fatal.
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Affiliation(s)
- Chee Weng Yong
- Discipline of Oral Maxillofacial Surgery, Faculty of Dentistry, National University Centre for Oral Health, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Dr,117597, Singapore; School of Health and Social Sciences (Oral Health Therapy), Nanyang, Polytechnic, Singapore
| | - Guo Nian Teo
- Department of Oral & Maxillofacial Surgery, National Dental Centre Singapore, 5 Second Hospital Avenue, 168938, Singapore
| | - Teng Seng Tan
- Department of Oral & Maxillofacial Surgery, National Dental Centre Singapore, 5 Second Hospital Avenue, 168938, Singapore
| | - Wee Hsuan Ng
- Discipline of Oral Maxillofacial Surgery, Department of Dentistry, Khoo Teck Puat Hospital, Level 1, 90 Yishun Central, 768828, Singapore.
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Yap AU, Tan SHX, Marpaung C. Temporomandibular disorder symptoms in young adults: Three‐dimensional impact on oral health‐related quality of life. J Oral Rehabil 2022; 49:769-777. [DOI: 10.1111/joor.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/27/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry National University Health System Singapore
- National Dental Research Institute Singapore National Dental Centre Singapore and Duke‐NUS Medical School Health Services Singapore Singapore
- Department of Prosthodontics, Faculty of Dentistry Trisakti University Indonesia
- School of Health & Social Sciences (Oral Health Therapy) Nanyang Polytechnic Singapore
| | - Sharon Hui Xuan Tan
- School of Health & Social Sciences (Oral Health Therapy) Nanyang Polytechnic Singapore
- Saw See Hock School of Public Health National University of Singapore Singapore
| | - Carolina Marpaung
- Department of Prosthodontics, Faculty of Dentistry Trisakti University Indonesia
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Abstract
This study estimates SARS-CoV-2 infections and disease severity with the receipt of a booster and by type of booster.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Lin-Fa Wang
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | | | | | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Tan SHX, Lee CKJ, Yong CW, Ding YY. Scoping review: Facilitators and barriers in the adoption of teledentistry among older adults. Gerodontology 2021; 38:351-365. [PMID: 34523172 DOI: 10.1111/ger.12588] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE/BACKGROUND Access to oral health care among older adults is a key issue in society, which has been exacerbated by social distancing measures and lockdowns during the COVID-19 pandemic. Older adults would greatly benefit from teledentistry, yet little information exists on the enablers and challenges of adopting this technology for use with this group. The aim of this scoping review is to summarise the applications and key factors associated with the adoption of teledentistry among older adults. MATERIALS AND METHODS This scoping review was developed in accordance with Arksey and O'Malley's five-stage framework and the Joanna Briggs Institute scoping review protocol guidelines. Publications on teledentistry involving direct clinical services for older adults aged 60 and above were included. Publications that focused solely on teleeducation were excluded. A systematic search was carried out on major electronic databases until 25 August 2020. Out of 1084 articles screened, 25 articles were included. Facilitators and barriers were categorised using the socio-ecological model. RESULTS/DISCUSSION Teleconsultation and telediagnosis were the most reported applications of teledentistry among older adults. Reported policy-level factors were data privacy issues (n = 7) and regulations (n = 17). Community-level facilitators and barriers included the availability of resources (n = 15) and support (n = 3). Familiar care settings (n = 2) and effective administration (n = 20) were key organisational-level factors. Staff attitudes and education (n = 23) and individual patient knowledge, attitudes and practices (n = 10) can influence teledentistry adoption while complex medical conditions (n = 8) may pose a challenge. CONCLUSION Key factors in the uptake of teledentistry among older adults span across policy, community, organisational, interpersonal and individual factors. Commonly reported barriers included technical issues, lack of funding, consent issues and cognitive impairments.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,School of Health and Social Sciences (Oral Health Therapy), Nanyang Polytechnic, Singapore, Singapore.,Policy Research and Evaluation Division, Ministry of Health, Singapore, Singapore
| | | | - Chee Weng Yong
- Department of Oral and Maxillofacial Surgery, National University Centre for Oral Health Singapore, National University of Singapore, Singapore, Singapore
| | - Yew Yoong Ding
- Geriatric Education and Research Institute, Singapore, Singapore.,Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
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Tay JRH, Ng E, Nair R, Tan ZS, Tan SHX. Economic evaluations in the treatment and evaluation of patients with periodontal disease: A critical review. J Clin Periodontol 2021; 48:679-694. [PMID: 33768622 DOI: 10.1111/jcpe.13456] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/22/2021] [Accepted: 02/28/2021] [Indexed: 12/25/2022]
Abstract
AIM To evaluate the types and quality of reporting of economic evaluations carried out in the clinical management of periodontal disease over 32 years from 1987 to 2019. MATERIAL AND METHODS A systematic search of articles from 1987 to 2019 was conducted using PubMed, Web of Science, The Cochrane Central Register of Controlled Trials, Health Technology Assessment Database and Embase. The quality of the economic evaluations was assessed based on the Consolidated Health Economic Evaluation Reporting Standard checklist. Due to considerable between-study heterogeneity, a meta-analysis was not performed. RESULTS Twenty one publications were included. 11 studies used cost-effectiveness analysis, five used cost-minimization analysis, four used cost-utility analysis and two used cost-benefit analysis. Comparators, choice of health outcomes, estimating resources and costs were fully reported in all studies. Many studies had inadequate reporting in terms of estimating resources and costs, choice of health outcomes, characterizing heterogeneity and study perspective. CONCLUSIONS There has been an increase in health economics studies in the field of clinical periodontology over the past decade. Several studies did not report study perspective, and the health outcomes chosen were not relevant for some studies. Future studies should follow an economic evaluation checklist for high-quality reporting and consistency.
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Affiliation(s)
- John Rong Hao Tay
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore City, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, Singapore City, Singapore
| | - Ethan Ng
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore City, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, Singapore City, Singapore
| | - Rahul Nair
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Zhe Sheng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore
| | - Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore
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Tan SHX, Ansari A, Ali NMI, Yap AU. Simulation design and students' satisfaction with home-based simulation learning in oral health therapy. J Dent Educ 2021; 85:847-855. [PMID: 33660871 DOI: 10.1002/jdd.12576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/10/2021] [Accepted: 01/30/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The COVID-19 pandemic presents a challenging situation for dental education, with school closures worldwide. While practical sessions are important for the acquisition of clinical skills, few studies have examined the role of home-based simulation learning (HBSL). This study aims to identify key aspects of simulation design and factors associated with students' satisfaction with HBSL. METHODS During a "circuit-breaker" period in Singapore, the Nanyang Polytechnic School of Health & Social Sciences (Oral Health Therapy) distributed portable manikins and instruments to students and staff for use at home. Synchronous teaching sessions with real-time feedback were carried out over the Zoom teleconferencing platform. A cross-sectional survey of students was conducted after 3 weeks of the HBSL program. Multiple linear regression analyses were carried out to assess the association between satisfaction with domains of simulation design and overall satisfaction with HBSL. RESULTS The top three factors of importance to students in HBSL were feedback and guided reflection, support, and objectives and information. Final-year students expressed higher levels of overall satisfaction and self-confidence following HBSL than first-year students. Satisfaction with the objectives (β = 0.42, 95% CI 0.26-0.57), support (β = 0.27, 95% CI 0.11-0.42), and problem-solving (β = 0.28, 95% CI 0.10-0.46) domains in the Simulation Design Scale were positively associated with overall student satisfaction and self-confidence in learning. CONCLUSION The findings can aid educators in the design of future HBSL programs, with a focus on areas of simulation design that are of importance to students.
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Affiliation(s)
- Sharon Hui Xuan Tan
- School of Health & Social Sciences (Oral Health Therapy), Nanyang Polytechnic, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Ministry of Health, Singapore
| | - Anshad Ansari
- School of Health & Social Sciences (Oral Health Therapy), Nanyang Polytechnic, Singapore
| | | | - Adrian Ujin Yap
- School of Health & Social Sciences (Oral Health Therapy), Nanyang Polytechnic, Singapore.,Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore.,Faculty of Dentistry, National University of Singapore, Singapore.,Oral Health Academic Clinical Programme at Duke-NUS Medical School, Singapore.,National Dental Research Institute Singapore, National Dental Centre Singapore, SingHealth, Singapore
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Tan SHX, Vernazza CR, Nair R. Critical review of willingness to pay for clinical oral health interventions. J Dent 2017; 64:1-12. [PMID: 28662842 PMCID: PMC5558873 DOI: 10.1016/j.jdent.2017.06.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES This critical review aimed to identify, consolidate and evaluate the quality of Willingness to Pay (WTP) studies applied to clinical contexts in the field of dentistry. METHODS PubMed and Web of Science databases were systematically searched for relevant publications. Screening and data extraction was then performed. Primary literature in English-language were included to assess the WTP for oral health interventions, when the valuations were applied to a clinical measure. Twenty-six publications met the inclusion criteria. RESULTS WTP was elicited mainly via face-to-face interviews (13 publications) and questionnaires (12 publications). The majority (24) of publications selected an out-of-pocket payment vehicle. Eleven publications adopted a bidding method, nine publications adopted an open-ended format, and the remaining six studies adopted a payment card or choice method. Pre-testing was reported in only nine publications, and few studies accounted for starting point bias. Eight of 11 publications found that higher incomes were associated with higher WTP values. The female gender, a younger age and higher education levels were associated with a higher WTP in select studies. CONCLUSIONS Only a small minority of the studies used strategies to avoid well documented biases related to WTP elicitation. Cost versus benefit of many clinical scenarios remain uninvestigated. CLINICAL SIGNIFICANCE WTP studies in dentistry may benefit from pre-testing and the inclusion of a script to minimise hypothetical bias. They may also be better conducted face-to-face and via a shuffled payment card method. Income levels, and potentially education levels, gender and age, should be assessed for their influence on WTP values.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Ministry of Health Holdings, Singapore 1 Maritime Square, 099253, Singapore.
| | - Christopher R Vernazza
- Centre for Oral Health Research, Newcastle University Framlington Place, Newcastle Upon Tyne, NE2 4BW, United Kingdom.
| | - Rahul Nair
- University of Adelaide, ARCPOH, Adelaide Dental School, Level 9, AHMS Building, Adelaide, SA 5005, Australia.
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