Community Dental Health Final Exam Review

Which research designs provides the highest level of evidence of all the study designs?

Experimental study

Which of the following is the outer rim of the Purnell Model for Cultural Competence? a. Family b. Person c. Community d. Global society

Global society -second rim represents the community -third rim represents the family -inner rim that represents the individual. -The interior of the figure contains 12 cultural domains that are not intended to stand alone because they affect one another

Which of the following types of learning experiences works best according to educational researchers such as John Dewey, Kurt Lewin, Jean Piaget, and Carl Rogers?

Hands-on

Which of the following is the base of the pyramid of public health services developed by the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB)? a. Population-based services b. Direct healthcare services c. Infrastructure building services d. Enabling services

Infrastructure building services

Which types of samples would have study participants with selection of every nth member of the population from a list or file of the total population?

Systematic *The n depends on the size of the sample desired in relation to the population; for example, 10% is every tenth member of the population.

Which of the following is the highest level of evidence for evidence-based decision making (EBDM)? a. One or more randomized controlled trials b. Systematic review with meta-analysis c. Well-designed cohort studies d. Well-designed case-control studies

Systematic review with meta-analysis

Each of the following is described in the text as a model of communication for cross-cultural encounters EXCEPT one. Which one is the EXCEPTION? a. L.E.A.R.N. Model b. R.E.S.P.E.C.T. Model c. ETHNIC Model d. T.O.L.E.R.A.T.E. Model

T.O.L.E.R.A.T.E. Model

T/F The Basic Screening Survey (BSS) developed by the Association of State and Territorial Dental Directors (ASTDD) includes the measurement of sealants in preschool children. The National Health and Nutrition Examination Survey (NHANES) from the CDC has added the measurement of dental sealants on primary molars in this age group

The first statement is false, the second statement is true *Healthy People 2020 dental sealant objective includes a target for sealants in primary molars of children aged 3 to 5. As a result, the NHANES has added the measurement of dental sealants on primary molars in this age group as a means of tracking progress on this objective

T/F Oral health professionals are in a unique position to identify the signs and symptoms of domestic violence. Dental professionals report the majority of domestic violence cases.

The first statement is true, the second is false. Given that approximately 65% to 75% of physical injuries from domestic violence are inflicted to the head, face, mouth, and neck, oral health professionals are in a unique position to identify the signs and symptoms of domestic violence. However, even with this large percentage of domestic violence injuries to the head and neck area, dental professionals report less than 1% of domestic violence cases.

It is easy to completely understand a culture that is not one's own, because you cannot personally identify with the culture. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

The statement is NOT correct, but the reason is correct. *It is difficult to completely understand another culture. You cannot personally identify with the culture nor share the experiences of growing up in that culture with its shared traditions, history, and issues. However, cultural competence can be achieved over time

What has been the outcome so far for the *oral health* leading health indicator (LHI) since the creation of Healthy People 2020?

There has not been any measurable progress.

Which of the following is true of a histogram? a. The bars do not touch. b. Used to depict frequencies of continuous data. c. Interact with the reader's verbal system. d. Works best when the data presentation is used to look up individual values.

Used to depict frequencies of continuous data -A histogram is similar in appearance to a bar graph, except that the *bars are adjacent* to each other to indicate that the *frequency data in the graph are on a continuum*. Graphs are perceived by the reader's visual system and work best when communicating the *shape of a distribution of values or a relationship among values*

The "A" in the L.E.A.R.N. Model of Cross-Cultural Communication stands for:

acknowledge

Cultural Competence Education Model

• Self-exploration: To become aware of one's own cultural heritage and increase acceptance of different values, attitudes, and beliefs. • Knowledge: To understand that one culture is not intrinsically superior to another and to recognize individual and group differences and similarities. • Skill: To master appropriate and sensitive strategies and skills in communicating and interacting with persons from different cultures and to seek information about various cultures within a society.

Which of the following is true regarding the measurement of oral and pharyngeal cancer (OPC)? a. The proportion of OPC diagnosed in the earliest stage dropped during 2000-2010. b. OPC primarily affects children and teenagers. c. There is no racial disparity in relation to the burden and outcomes of OPC. d. The worldwide survival rate of OPC is less than 10%.

a. The proportion of OPC diagnosed in the earliest stage dropped during 2000-2010. -OPC primarily affects older people. -A significant racial/ethnic disparity exists in relation to the burden and outcomes of OPC. -The worldwide 5-year survival rate of OPC is less than 50%.

Normally, an acceptable p value is _____ or less

0.05 *This means that results with a p value of 0.05 or less (p≤0.05) are generally considered statistically significant and provide the basis for rejection of the null hypothesis. A p of 0.05 means that the results can be caused by chance 5 times in 100. Lower p values (e.g., 0.01, 0.001, or less) are more statistically significant

What is the optimum fluoride level as recommended by the U.S. Public Health Service?

0.7 mg/L

Approximately what percentage of the adult population ages 30 to 65+ had *severe* periodontitis according to the 2009-2010 National Health and Nutrition Examination Survey (NHANES) study?

10%

The passage of the Affordable Care Act in 2010 decreased the number of uninsured Americans to __% in 2014

13.4 % *The ACA decreased the number of uninsured Americans from 18% in 2013 to 13.4% in 2014; yet barriers to health and oral healthcare still exist for many segments of our population. As of October 2014, the current healthcare model still left over 33 million individuals out of the system

Accountable Care Organizations (ACOs) served an estimated __% of the population in 2013.

14

In the United States, employed adults lose more than ____ million hours of work each year because of oral health problems or dental visits.

164

Each decade since ____ the U.S. Department of Health and Human Services (DHHS) has released a comprehensive set of national public health objectives. It is grounded in the notion that establishing objectives and providing benchmarks to track and monitor progress over time can motivate, guide, and focus action. Healthy People 2020 was launched in 2010 and established national objectives to be reached by the year 2020

1980

More than __% of the population in more than one fourth of the states speaks a foreign language at home

20 *Of those, 41% self-reported that they speak English "less than very well."

About what percentage of children in the United States were living in poverty in 2013?

20% (19.9%) *In 2013, the number of Americans living below the national poverty level was 45.3 million people (14.5%), a slight but insignificant decrease from the year before and the first decrease since 2006.

The American Dental Association (ADA) has estimated that approximately __% of the U.S. population has difficulty accessing dental services through the current private dental care delivery system

33%

What percentage of states have a dental professional as the state oral health program (SOHP) director?

33%

In 2013 Medicaid and CHIP provided dental coverage for more than what percentage of all children in the United States?

37%

The most recent report (2011-2012) showed that approximately what percentage of 6- to 9-year-olds had at least one dental sealant placed?

40% *22.2% of 13- to 15-year-olds had at least one dental sealant placed. Although these rates are still lower than ideal, the proportion of children with sealed permanent molars increased significantly during the previous decade by 39.1% in 6- to 9-year-olds and by 40% in 13- to 15-year-olds

More than which of the following percentages of health consumers have used social media to access health-related consumer reviews? a. 10% b. 20% c. 30% d. 40%

40% -A reported 61% of patients are likely to trust information posted online by healthcare providers. -A reported 31% of healthcare organizations have specific social media guidelines in writing

As of mid-April 2014, Medicaid enrollment grew by ______ million in the states that expanded Medicaid.

8

According to the Office of Disease Prevention and Health Promotion of the DHHS, what percentage of adults may be considered to have low health literacy in the United States?

90% *This means the vast majority of adult Americans struggle to understand fundamental health information such as health history forms, consent forms, home care and medication instructions, postoperative instructions, and drug labels

The International Caries Detection and Assessment System (ICDAS) was developed as a successor to the:

Decayed, Missing, or Filled Index

What was the most common condition of the 291 diseases studied in the international collaborative Global Burden of Disease Study in 1990-2010?

Dental caries

Which of the following components of a primary research report is the section where the author interprets the statistical results and links them to relevant literature discussed in the introduction? a. Results b. Discussion c. Methods and materials d. Abstract

Discussion -Frequently, additional literature is introduced in this section in relation to interpreting and applying the results. -The results section includes a summary of the data, a description of that statistical analysis, justification of the statistical tests used, results of the statistical analysis, and a statement of the statistical decision. -The methods and materials section describes the population, sample, and data collection methods, as well as the other methods and materials used to manipulate the independent variable. -An abstract is a brief description of the published work and appears at the beginning of a research report to provide the reader with an overview of the study.

Each of the following is a facet of the Cultural Competence Education Model EXCEPT one. Which one is the EXCEPTION? a. Knowledge b. Skill c. Ethnocentricity d. Self-exploration

Ethnocentricity

_______ is judging other cultures by one's own standards, not accepting other groups, and considering other cultures inferior.

Ethnocentrism *can lead to making false assumptions about cultural differences, forming premature judgments, and producing divisions among members of different ethnicities, races, and religious groups in society.

How many states met all of the "Eight Key Policy Benchmarks Used by PEW for Grading States' Performance"?

None of the states met all eight benchmarks -Only 7 states merited a grade of A, which reflected meeting at least six of the eight benchmarks. -22 states received a B by meeting five benchmarks. -18 states and D.C. received a grade of C or D, meeting just three or four of the policy goals. -5 states received an F, meeting two or fewer benchmarks.

In 2000 the _________ established guidelines for state and territorial oral public health programs to ensure that they reflect the necessary infrastructure and capacity to be able to meet adequately the needs of the populations served.

Association of State and Territorial Dental Directors (ASTDD)

Descriptive Statistics

• Describe and summarize data in sample • Not generalized to another group • Show relationships among variables (correlation) *Examples* • Measures of central tendency (mean, median, mode) • Measures of dispersion (range, variance, standard deviation) • Frequency counts and percentages • Tables and graphs • Percentiles • Correlation

L.E.A.R.N. Model of Cross-Cultural Communication

-*Listen*: with sympathy and understanding to the patient's perception of the problem -*Explain*: your perceptions of the problem and your strategy for treatment -*Acknowledge*: and discuss the differences and similarities between these perceptions. -*Recommend*: treatment while remembering the patient's cultural parameters -*Negotiate*: agreement; strive to understand the patient's explanatory model so the treatment fits into his or her cultural framework.

R.E.S.P.E.C.T Model of Cross-Cultural Communication

-*Rapport* • Connect on a social level. • Seek the patient's point of view. -*Empathy* • Remember that the patient has come to you for help. • Seek out and understand the patient's rationale for his or her behaviors or illness. • Verbally acknowledge and legitimize the patient's feelings. -*Support* • Help the patient overcome barriers. • Involve family members if appropriate. -*Partnership* • Negotiate roles when necessary. • Stress that you will be working together to address medical problems. -*Explanations* -*Cultural Competence* • Respect the patient and his or her culture and beliefs. • Understand that the patient's view of you may be identified by ethnic or cultural stereotypes. • Be aware of your own biases and preconceptions. -*Trust*

Cultural Competence Continuum

-Cultural proficiency -Cultural competence -Cultural pre-competence -Cultural blindness -Cultural incapacity -Cultural destructiveness

Ranking of evidence for evidence-based decision making

-Systematic reviews with metaanalysis: Cochrane reviews -Systematic review without meta analysis -One or more randomized controlled trials -well-designed cohort studies -well-designed case control studies -Case series -Opinions of respected authorities; reports of experts; case reports -animal research

a "provider-run organization in which participating providers are collectively responsible for the care of the enrolled population, and may share in any savings associated with improvements in the quality and efficiency of care."

Accountable Care Organizations (ACOs)

Which of the following is an example of external validity rather than internal validity? a. Use of appropriate statistical procedures b. Control of variables c. Accurate generalization of results to other people d. Careful planning and supervision of study procedures

Accurate generalization of results to other people *External validity refers to the extent to which study results can be generalized accurately to other situations and people. External validity is affected by how well the sample represents the population. When a sample is strongly representative of the population, the results can be generalized to other members of the population. This denotes high external validity.

The ________ expansion of Medicaid and CHIP enables more children to be eligible for dental benefits because dental benefits are considered essential health benefits by _________

Affordable Care Act (ACA)

The ADHA will be challenged to develop the next generation of leaders, prepare adequate numbers of qualified dental hygiene faculty, and create new forms of volunteerism and community engagement for retirement because of which of the following change-drivers impacting the dental hygiene profession?

Aging workforce

Which ethnic group experienced the greatest percentage increase in population between 2000 and 2010?

Asian American -Asian American population increased by 43.3% -Hispanic/Latino population increased by 43.0%, -Pacific Islander population increased by 35.4% -Black/African American increased by 12.3%.

T/F . The United States spends more on health care than any other nation in the world, yet ranks poorly on nearly every measure of health status. Behavioral causes account for nearly 40% of all deaths in the United States

Both statements are true

T/F Correlation communicates only association of variables, which indicates risk. Correlation cannot be used to indicate cause and effect without follow-up longitudinal studies.

Both statements are true

T/F Eliminating health disparities and promoting health equity are embedded in Healthy People 2020. The concepts of health equity and health disparity are inseparable in their practical application

Both statements are true

T/F In the past societies primarily functioned with a monocultural and monolingual perspective. Cultural diversity in American society is more realistically an intricate mosaic, consisting of numerous racial and ethnic groups.

Both statements are true

T/F The Department of Health and Human Services (DHHS) predicts a significant shortage of dentists in the United States by 2025. There is expected to be a surplus of dental hygienists by 2025

Both statements are true

T/F The main goal of patient-centered care has been to provide individualized care with an emphasis on personal relationships. The primary aim of striving for cultural competency has been to increase health equity and reduce disparities.

Both statements are true

T/F The prevalence of dental caries among school-age children declined within the U.S. in the 1980s and 1990s. These improvements for children appear to have stalled and, for some indicators, actually regressed in the 2000s

Both statements are true

T/F With the private practice delivery model, there are more dentists practicing in high-income areas than in low-income areas. This practice pattern limits access to oral care to those few Americans who can afford to pay for it.

Both statements are true

T/F Formative evaluation involves examining the service-learning project while it is ongoing. Summative evaluation involves a formal end-product review of the service-learning project

Both statements are true *Making concrete plans to use both methods helps to ensure permanence or institutionalization of the service-learning project

T/F Society faces a crisis of enormous inequality in the distribution of health and oral healthcare services. Health reforms have been recommended for several decades with little success.

Both statements are true *The inequality exists despite societal goals, poverty initiatives, and viable common-ground solutions. It is apparent also that the healthcare crisis has been recognized, reported, discussed, and debated for more than 50 years. In most cases, oral healthcare services have been excluded from healthcare reforms until 2010 with the passage of the Patient Protection and Affordable Care Act (ACA).

T/F Public health officials recommended that surveillance tools were needed to monitor multiple sources of fluoride, because the prevalence of dental fluorosis in the United States has increased in the milder categories.

Both the statement and reason are correct and related

Which of the following is a form of contracted care in which a provider receives a fixed payment from a third-party payer in exchange for all or most care needed by a group of patients during the contract period? a. Fee schedule b. Table of allowances c. Capitation d. Direct reimbursement

Capitation *Capitation is the method used by HMOs; payment is made to the provider regardless of use by enrollees. It is designed to increase preventive care, but effectiveness is in question and is uncommon

Which of the following statistical techniques is a characteristic of inferential rather than descriptive statistics? a. Chi-square test b. Percentiles c. Measures of central tendency d. Measure of dispersion

Chi-square test All of the other choices are examples of techniques used with descriptive statistics.

A person in which of the following age groups is most likely to visit the dentist according to the Centers for Disease Control and Prevention (CDC) in 2012? a. Children ages 2 to 17 b. Adults ages 18 to 64 c. Adults ages 65 and older d. None of the above

Children ages 2 to 17 *The CDC reports that in 2012 the percentage of individuals with a dental visit varied by age: -82.3% of children ages 2 to 17, -61.6% of adults ages 18 to 64, and -61.8% of adults ages 65 and older.

Which of the following steps in the service-learning process is illustrated by the process of mutual objective formation?

Collaboration

Steps in the service-learning process

Collaboration, orientation, preparation, reflection, evaluation

Measuring millimeter probe depths with a periodontal probe is an example of collection of which of the following types of data? a. Categorical b. Dichotomous c. Discrete d. Continuous

Continuous *Continuous data are numeric data that can be expressed by a large or infinite number of measures along a continuum. Continuous data have real value when expressed as fractions, and are considered to be quantitative in nature.

Which of the following represents the top stage of cultural-competency development on the "Cultural Competence Continuum"? a. Cultural competence b. Cultural blindness c. Cultural proficiency d. Cultural incapacity

Cultural proficiency

Which of the following is the outermost circle of the action model to achieve Healthy People 2020 overarching goals? a. Living and working conditions b. Individual behavior c. Social, family, and community networks d. Innate individual traits: age, sex, race, and biologic factors related to the biology of health and disease

Living and working conditions

Which measure of central tendency is the arithmetic average of the data distribution?

Mean *The positive aspect of the mean is that it includes the value of each score; the negative aspect is that it can be distorted by extreme scores in the distribution and thus may not give a true picture of the central tendency.

Which of the following is true regarding the use of plain language for the improvement of health literacy?

Plain language is clear writing without unnecessary words or expressions.

Brainstorming activities are part of which of the following steps in the service-learning process? a. Evaluation b. Collaboration c. Preparation d. Orientation

Preparation *Preparation involves brainstorming activities, identifying roles, developing action plans and contingency plans, and setting time lines. Diligent skill sets, including leadership, listening skills, and the assessment of community needs, are essential

_____________ is the code by which the profession regulates actions and sets standards for its members

Professional Ethics

What is the most cost-effective method of providing fluoride to the community?

Public water supply

What are the three essential aspects of the iron triangle of health care?

Quality, cost, and access

Which of the following types of scales of measurement is considered to be the most complex? a. Interval scale b. Ordinal scale c. Ratio scale d. Nominal scale

Ratio scale -Each scale of measurement takes on the characteristics of the previous one, building up to the ratio scale, which is the most complex. -Ratio scale data are considered most powerful and are preferred whenever possible to provide stronger research results

Inferential Statistics

• Generalize or apply information from the sample to the population • Includes categories of parametric and nonparametric *Examples* • Parametric: t-test, analysis of variance (ANOVA) • Nonparametric: chi-square, Wilcoxon signed-rank test, Mann-Whitney U test • Confidence intervals

Which of the following is the only Healthy People 2020 Leading Health Indicator (LHI) that represents oral health? a. Increase proportion of children, adolescents, and adults who used the oral healthcare system in the past year. b. Dental insurance coverage. c. Receipt of oral cancer screening. d. Access to oral health care.

a. Increase proportion of children, adolescents, and adults who used the oral healthcare system in the past year.

Mixed-methods research uses ________ research methods to answer the research question. a. both quantitative and qualitative b. quantitative but not qualitative c. qualitative but not quantitative d. neither quantitative nor qualitative

a. both quantitative and qualitative

Which of the following DMF survey results indicates the need for education and earlier intervention to avoid additional extractions in the future? a. A high D b. A high M c. A high F d. A low F

b. A high M -A high M indicates the need for education and earlier intervention to avoid additional extractions. -A high D demonstrates the need for dental treatment. -A high F indicates that the population is receiving treatment -A low F means the population is not receiving treatment.

The Centers for Disease Control and Prevention (CDC) recommends a public health surveillance system for each of the following health-related events EXCEPT one. Which one is the EXCEPTION? a. It is of public health importance. b. It is not preventable. c. It affects many people. d. It requires large expenditures of resources

b. It is not preventable. *The CDC recommends surveillance if a health-related event, such as an oral disease or condition, affects many people, requires large expenditures of resources, is largely preventable, and is of public health importance.

The dental hygienist's social or civic responsibility includes knowing __________ legislators. a. both his or her individual state and congressional b. his or her individual state but not congressional c. his or her individual congressional but not state d. neither his or her individual state nor congressional

both his or her individual state and congressional

Each of the following is true EXCEPT one. Which one is the EXCEPTION? a. Composite indices that score gingivitis and periodontitis on the same scale are now considered invalid. b. Clinical attachment loss (CAL) remains the diagnostic "gold standard" for periodontitis. c. The Healthy People 2020 periodontal disease objective relates to periodontitis in adults (35- to 44-year-olds). d. The Periodontal Disease Index (PDI) is no longer considered useful because it no longer reflects contemporary theories of periodontal disease

c. The Healthy People 2020 periodontal disease objective relates to periodontitis in adults (35- to 44-year-olds). *Healthy People 2020 periodontal disease objective has been focused on a more representative age range of adults (46- to 74-year-olds)

Each of the following Healthy People 2010 objectives experienced *regression* EXCEPT one. Which one is the EXCEPTION? a. The amount of caries and untreated decay in children. b. The proportion of oral and pharyngeal cancers detected at the earliest stage. c. The proportion of children, adolescents, and adults who used the oral healthcare system in the past year. d. The proportion of adults who have ever had a permanent tooth extracted because of dental caries or periodontal disease.

d. The proportion of adults who have ever had a permanent tooth extracted because of dental caries or periodontal disease. -There was an increase in caries and untreated decay in children. -There was an increase in untreated caries in adults. -There was a decrease in the proportion of oral and pharyngeal cancers detected at the earliest stage. -There was a decrease in the proportion of children, adolescents, and adults who used the oral healthcare system in the past year.

According to the most recent Healthy People 2020 progress report, there was (a/an) _________ in the proportion of Americans who visited the dentist during the previous year. Also, there was (a/an) ________ in dental attendance among very young children.

decrease; increase

. In 2011 the American Dental Hygienists' Association (ADHA) commissioned a comprehensive survey called (a/an) ___________ to identify opportunities and constraints that could impact the future of the profession

environmental scan

Experiential learning represents an umbrella term that refers to various models of learning in which _________ governs the educational process for the student.

experience

With service-learning the _________ can initiate the request for collaboration

faculty member, community partner, or student

The experimental treatment or intervention that is imposed on the experimental group of an experimental or quasi-experimental study is called the a. independent variable. b. dependent variable. c. relevant variable. d. extraneous variable

independent variable -The independent variable is manipulated by the researcher and is believed to cause or influence the dependent variable. -The dependent variable is the variable that is thought to depend on or to be caused by the independent variable. -A relevant variable is any variable that should be controlled because it can influence how the independent variable affects the dependent variable. -An extraneous variable is any confounding variable that is not controlled in a study

Interprofessional collaborative practice (ICP) will necessitate a shift from profession-specific education and training to educating health professions students in an interprofessional model, referred to as:

interprofessional education (IPE)

The link between Oral Health-Related Quality of Life (OHRQOL) and oral health status ______ straightforward and ______ influenced by various individual and socioenvironmental factors.

is not; is

Incrementally, the United States has made decisions that health care _____ a right of all American citizens. Society _________ universally accepted their share of the responsibilityv

is; has not

Premiums for dental plans are _____ than for health plans; enrollees of dental plans are required to pay _______ out-of-pocket individual contributions for the cost of services.

less; greater

Today's society in the United States is becoming more:

multiracial, multicultural, and multilingual *According to the 2010 U.S. Census data, every non-white group in the population except American Indian/Alaskan Native increased in numbers from 2000 to 2010. More important is the increase in members of the population who speak a language other than English at home

People in the United States without dental insurance tend to seek dental treatment: a. for children, but not for adults. b. only for emergencies. c. from large clinics rather than private dental offices. d. for major restorative rather than preventive needs.

only for emergencies.

The *research* hypothesis is stated in ______ terms that represent the researcher's prediction or question, and the null hypothesis is a ______ statement of the researcher's prediction or opinion.

positive; negative *The hypothesis is often expressed as a null hypothesis, which assumes that there is no statistically significant difference between the groups being studied. Thus, the null hypothesis is a negative statement. It is actually the null hypothesis that is tested statistically.

The future of dental hygiene is in the _________ workforce.

public health

A critical element of control in experimental studies is the ________________________ to assure the groups are equivalent.

randomization of participants

The "R" in the R.E.S.P.E.C.T. Model of Cross-Cultural Communication stands for: a. request. b. rely. c. recommend. d. rapport.

rapport

The ___________ is a uniquely expressed need that flows directly from the mission and purposes of the collaborating partner

service objective (SO)

For service-learning, what the community partner wants from the dental hygiene students is referred to as the __________. A course objective is selected as the __________ for the service-learning experience.

service objective (SO); learning objective (LO)

The service objective (SO) and the learning objective (LO) are purposefully combined to form the:

service-learning objective (S-LO) *Working together to combine the SO and LO in creating the S-LO is critical to the service-learning process because it supports the integrity of the service-learning experience and illustrates its mutually beneficial nature.