Purpose: The purpose of this mixed-methods study was to examine pediatric emergency dental trends... more Purpose: The purpose of this mixed-methods study was to examine pediatric emergency dental trends in two safety net clinics and care-seeking experiences of young children's caregivers. Methods: Administrative data were used to describe and compare emergency first visits of children ages zero to six years in a community-based (CC) and a University-based (UC) safety net clinic from 2010 to 2014. In-person interviews were conducted with 11 caregivers of children ages zero to six presenting for nontrauma-related emergency visits at the UC from January to August 2016. Interviews were transcribed verbatim, coded, and analyzed inductively using Atlas. ti.7.5.9. Results: The UC experienced significantly more emergency first visits (33 percent) than the CC (five percent, P<0.001), and the majority of these UC visits were referrals. Caregivers were dissatisfied with the experienced barriers of access to care and lack of child-centeredness, specifically the referral out of the dental home for emergency dental care. Conclusions: A considerable proportion of children's first visits at dental safety net clinics was emergency related. Children's caregivers voiced issues related to access to care and lack of child-centered care. Discordance was apparent between how professional organizations define the dental home and how caregivers experience it in the context of emergency care.
177 Background: Older Black adults are disproportionately burdened by multiple myeloma (MM) yet c... more 177 Background: Older Black adults are disproportionately burdened by multiple myeloma (MM) yet continue to face significant challenges in accessing high-quality cancer care, including opportunities to engage in research. Knowledge of experiments such as the Tuskegee Study, where Black persons experienced deliberate harm from research, has created mistrust of the healthcare system, especially in the Black community. We sought to examine racial differences in dyadic (patient-informal caregiver) knowledge of the Tuskegee study and understand their perceptions of care received for MM. Methods: We conducted 21 in-depth semi-structured interviews with racially concordant patient-informal caregiver dyads living in North Carolina. Dyads were asked open-ended questions about the Tuskegee Study, mistrust, and their healthcare experiences. We used the Sort and Sift, Think and Shift approach for qualitative data analysis. Results: Between November 2021 and April 2022, we enrolled 44 participan...
This text provides comprehensive coverage of the key methods for analyzing, interpreting, and wri... more This text provides comprehensive coverage of the key methods for analyzing, interpreting, and writing up qualitative research in a single volume, and drawing on the expertise of major names in the field. Covering all the steps in the process of analyzing, interpreting, and presenting findings in qualitative research, the authors utilize a consistent chapter structure that provides novice and seasoned researchers with pragmatic, “how-to” strategies. Each chapter introduces the method; uses one of the authors\u27 own research projects as a case study of the method described; shows how the specific analytic method can be used in other types of studies; and concludes with questions and activities to prompt class discussion or personal study.https://digitalcommons.usf.edu/books/1173/thumbnail.jp
The Journal of the American Dental Association, 2021
BACKGROUND Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach... more BACKGROUND Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach to treating caries. Despite evidence supporting and potential advantages of NSCMT, dentists can be reluctant to adopt these techniques. To better understand this phenomenon, the authors interviewed dentists who primarily treat children regarding their thoughts, attitudes, and adoption of 3 NSCMT. METHODS The 3 NSCMT were fluoride varnish, silver diamine fluoride, and Hall stainless steel crowns. The authors interviewed dentists in North Carolina whose practices were restricted mostly to children. A nonprobabilistic maximum-variation design was used in the sampling. Using a semistructured interview guide, the authors recorded the interviews digitally and analyzed them thematically. The authors stratified the analysis according to years of practice, geographic location, and type of practice. Reporting was based on emerging and recurring themes and insightful quotes. RESULTS Factors most likely to promote the adoption of NSCMT were related to clinical practice, family preference, patient safety, and provider philosophy. Barriers to adoption included previous practitioner negative experiences using the techniques, high-risk caries population, and perceived likelihood of negative outcomes. Characteristics of the practice environment, patient population, communication with families, and financial considerations were influential in the clinician's determination as to whether to use these techniques. CONCLUSIONS These findings provide valuable insight into practitioners' influences, motivations, and clinical decision making in the adoption and use of management and treatment approaches for carious lesions in the pediatric population. PRACTICE IMPLICATIONS The primary factors and barriers identified in this study are possible targets for education and quality improvement programs aimed at increasing NSCMT use.
Objectives: This mixed-methods study examined a) pediatric emergency dental care trends in two sa... more Objectives: This mixed-methods study examined a) pediatric emergency dental care trends in two safety net clinics and b) emergency dental care-related experiences of young children's caregivers. Methods: Administrative data were used to describe and compare characteristics of emergency first-visits of children ages 0-6 in a community-based (CC) and a University-based (UC) safety net clinic from 2010-2014. In-person interviews were conducted with 10 caregivers of children ages 0-6 presenting for non-trauma-related emergency visits at the UC from January-August 2016. Interviews were transcribed verbatim, coded and analyzed inductively using Atlas.ti.7.5.9. Results: Significantly more emergency first-visits were attended at the UC (33%) versus the CC (5%), and the majority of these UC visits were referrals. Caregivers were dissatisfied with the experienced barriers of access to care and lack of child-centeredness, specifically the referral out of the dental home. Conclusions: A con...
Background: Adult colorectal surgery patients continue to have high rates of readmissions, despit... more Background: Adult colorectal surgery patients continue to have high rates of readmissions, despite known risk factors for non-routine postdischarge care (emergency department (ED) visit or rehospitalization) and countless interventions to address these. It is unclear how the patient perspective frames and modifies the impact of these risk factors. This study aimed to explain why individual risk-factors led a patient to seek non-routine postdischarge care. Methods: This single institution prospective cohort study identified consecutive adult inpatient colorectal surgery patients from 2017-2018. We used a convergent parallel design to integrate electronic health record data with brief phone surveys and in-depth interviews to generate a “what, why, and so what” summary of findings. Findings: We enrolled 258 participants, surveyed 167, and interviewed 18. Overall, 20% were readmitted, 3% had an ED visit, 2% had an observation stay, and 75% had routine postdischarge care. Undergoing open...
ObjectiveGrowing evidence suggests that subjective binge eating (SBE; loss of control eating invo... more ObjectiveGrowing evidence suggests that subjective binge eating (SBE; loss of control eating involving subjectively, but not objectively, large quantities of food) is clinically concerning even though it is not currently considered a diagnostic criterion for eating disorders. However, the lived experience of SBEs has not been examined in a systematic, and data‐driven way.MethodThe current study used a qualitative, inductive interview approach to further define SBEs as described by individuals who experience them. Participants (N = 14; 11 cisgender women, Mage = 35.29, 12 White/non‐Latinx) reported SBEs that occurred at least twice per week over the prior 3 months. We completed semi‐structured qualitative phone interviews with participants regarding their most recent SBE and objective binge‐eating episode (OBE) if applicable, as well as broader experiences and attitudes regarding non‐binge eating.ResultsInductive, reflexive, thematic coding yielded descriptive and interpretive codes ...
American Journal of Orthodontics and Dentofacial Orthopedics, 2021
INTRODUCTION Referrals from general dentists are a significant source of orthodontic patients, bu... more INTRODUCTION Referrals from general dentists are a significant source of orthodontic patients, but our knowledge of factors guiding referral decisions predates recent marketplace trends of direct-to-consumer products and broad digitization. To provide orthodontists with current, nationwide data on referral values and communication preferences, a mixed-methods study was conducted. METHODS Semistructured interviews were conducted with practicing general dentists (n = 23), and interviews were analyzed to identify factors important to communication and referrals. Qualitative data provided the foundation to develop and pretest a survey distributed nationally to American Dental Association general dentists through email (n = 373). Survey results were evaluated using bivariate and descriptive statistics. RESULTS Although 42% of general dentists provide orthodontics, of those, 68% report insufficient orthodontic training in dental school, and 61% have increased orthodontic care in recent years. General dentists refer to orthodontists for complex cases and growing patients, with the orthodontist's perceived skill and proximity to the patient being important for choosing a specific orthodontic practice. Phone (70%) and email (61%) are the most used interoffice communication methods, with email (40%) and then phone (30%) being the most preferred. The most important aspects of a working relationship were patient satisfaction and final occlusal outcome, whereas the best way to boost referrals was through improving communication. CONCLUSIONS Excellent care and patient satisfaction remain primary motivators for referrals from generalists to orthodontists. An improved orthodontic curriculum is needed for general dentists. Good communication with dentists is critical for growing referral streams and enhancing patient care.
1. Qual Health Res. 2010 Dec 7. [Epub ahead of print] Considering the Qualitative-Quantitative La... more 1. Qual Health Res. 2010 Dec 7. [Epub ahead of print] Considering the Qualitative-Quantitative Language Divide. Morse JM, Dimitroff LJ, Harper R, Koontz A, Kumra S, Matthew-Maich N, Mihas P, Murphey C. University of Utah. ...
Purpose: The purpose of this mixed-methods study was to examine pediatric emergency dental trends... more Purpose: The purpose of this mixed-methods study was to examine pediatric emergency dental trends in two safety net clinics and care-seeking experiences of young children's caregivers. Methods: Administrative data were used to describe and compare emergency first visits of children ages zero to six years in a community-based (CC) and a University-based (UC) safety net clinic from 2010 to 2014. In-person interviews were conducted with 11 caregivers of children ages zero to six presenting for nontrauma-related emergency visits at the UC from January to August 2016. Interviews were transcribed verbatim, coded, and analyzed inductively using Atlas. ti.7.5.9. Results: The UC experienced significantly more emergency first visits (33 percent) than the CC (five percent, P<0.001), and the majority of these UC visits were referrals. Caregivers were dissatisfied with the experienced barriers of access to care and lack of child-centeredness, specifically the referral out of the dental home for emergency dental care. Conclusions: A considerable proportion of children's first visits at dental safety net clinics was emergency related. Children's caregivers voiced issues related to access to care and lack of child-centered care. Discordance was apparent between how professional organizations define the dental home and how caregivers experience it in the context of emergency care.
177 Background: Older Black adults are disproportionately burdened by multiple myeloma (MM) yet c... more 177 Background: Older Black adults are disproportionately burdened by multiple myeloma (MM) yet continue to face significant challenges in accessing high-quality cancer care, including opportunities to engage in research. Knowledge of experiments such as the Tuskegee Study, where Black persons experienced deliberate harm from research, has created mistrust of the healthcare system, especially in the Black community. We sought to examine racial differences in dyadic (patient-informal caregiver) knowledge of the Tuskegee study and understand their perceptions of care received for MM. Methods: We conducted 21 in-depth semi-structured interviews with racially concordant patient-informal caregiver dyads living in North Carolina. Dyads were asked open-ended questions about the Tuskegee Study, mistrust, and their healthcare experiences. We used the Sort and Sift, Think and Shift approach for qualitative data analysis. Results: Between November 2021 and April 2022, we enrolled 44 participan...
This text provides comprehensive coverage of the key methods for analyzing, interpreting, and wri... more This text provides comprehensive coverage of the key methods for analyzing, interpreting, and writing up qualitative research in a single volume, and drawing on the expertise of major names in the field. Covering all the steps in the process of analyzing, interpreting, and presenting findings in qualitative research, the authors utilize a consistent chapter structure that provides novice and seasoned researchers with pragmatic, “how-to” strategies. Each chapter introduces the method; uses one of the authors\u27 own research projects as a case study of the method described; shows how the specific analytic method can be used in other types of studies; and concludes with questions and activities to prompt class discussion or personal study.https://digitalcommons.usf.edu/books/1173/thumbnail.jp
The Journal of the American Dental Association, 2021
BACKGROUND Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach... more BACKGROUND Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach to treating caries. Despite evidence supporting and potential advantages of NSCMT, dentists can be reluctant to adopt these techniques. To better understand this phenomenon, the authors interviewed dentists who primarily treat children regarding their thoughts, attitudes, and adoption of 3 NSCMT. METHODS The 3 NSCMT were fluoride varnish, silver diamine fluoride, and Hall stainless steel crowns. The authors interviewed dentists in North Carolina whose practices were restricted mostly to children. A nonprobabilistic maximum-variation design was used in the sampling. Using a semistructured interview guide, the authors recorded the interviews digitally and analyzed them thematically. The authors stratified the analysis according to years of practice, geographic location, and type of practice. Reporting was based on emerging and recurring themes and insightful quotes. RESULTS Factors most likely to promote the adoption of NSCMT were related to clinical practice, family preference, patient safety, and provider philosophy. Barriers to adoption included previous practitioner negative experiences using the techniques, high-risk caries population, and perceived likelihood of negative outcomes. Characteristics of the practice environment, patient population, communication with families, and financial considerations were influential in the clinician's determination as to whether to use these techniques. CONCLUSIONS These findings provide valuable insight into practitioners' influences, motivations, and clinical decision making in the adoption and use of management and treatment approaches for carious lesions in the pediatric population. PRACTICE IMPLICATIONS The primary factors and barriers identified in this study are possible targets for education and quality improvement programs aimed at increasing NSCMT use.
Objectives: This mixed-methods study examined a) pediatric emergency dental care trends in two sa... more Objectives: This mixed-methods study examined a) pediatric emergency dental care trends in two safety net clinics and b) emergency dental care-related experiences of young children's caregivers. Methods: Administrative data were used to describe and compare characteristics of emergency first-visits of children ages 0-6 in a community-based (CC) and a University-based (UC) safety net clinic from 2010-2014. In-person interviews were conducted with 10 caregivers of children ages 0-6 presenting for non-trauma-related emergency visits at the UC from January-August 2016. Interviews were transcribed verbatim, coded and analyzed inductively using Atlas.ti.7.5.9. Results: Significantly more emergency first-visits were attended at the UC (33%) versus the CC (5%), and the majority of these UC visits were referrals. Caregivers were dissatisfied with the experienced barriers of access to care and lack of child-centeredness, specifically the referral out of the dental home. Conclusions: A con...
Background: Adult colorectal surgery patients continue to have high rates of readmissions, despit... more Background: Adult colorectal surgery patients continue to have high rates of readmissions, despite known risk factors for non-routine postdischarge care (emergency department (ED) visit or rehospitalization) and countless interventions to address these. It is unclear how the patient perspective frames and modifies the impact of these risk factors. This study aimed to explain why individual risk-factors led a patient to seek non-routine postdischarge care. Methods: This single institution prospective cohort study identified consecutive adult inpatient colorectal surgery patients from 2017-2018. We used a convergent parallel design to integrate electronic health record data with brief phone surveys and in-depth interviews to generate a “what, why, and so what” summary of findings. Findings: We enrolled 258 participants, surveyed 167, and interviewed 18. Overall, 20% were readmitted, 3% had an ED visit, 2% had an observation stay, and 75% had routine postdischarge care. Undergoing open...
ObjectiveGrowing evidence suggests that subjective binge eating (SBE; loss of control eating invo... more ObjectiveGrowing evidence suggests that subjective binge eating (SBE; loss of control eating involving subjectively, but not objectively, large quantities of food) is clinically concerning even though it is not currently considered a diagnostic criterion for eating disorders. However, the lived experience of SBEs has not been examined in a systematic, and data‐driven way.MethodThe current study used a qualitative, inductive interview approach to further define SBEs as described by individuals who experience them. Participants (N = 14; 11 cisgender women, Mage = 35.29, 12 White/non‐Latinx) reported SBEs that occurred at least twice per week over the prior 3 months. We completed semi‐structured qualitative phone interviews with participants regarding their most recent SBE and objective binge‐eating episode (OBE) if applicable, as well as broader experiences and attitudes regarding non‐binge eating.ResultsInductive, reflexive, thematic coding yielded descriptive and interpretive codes ...
American Journal of Orthodontics and Dentofacial Orthopedics, 2021
INTRODUCTION Referrals from general dentists are a significant source of orthodontic patients, bu... more INTRODUCTION Referrals from general dentists are a significant source of orthodontic patients, but our knowledge of factors guiding referral decisions predates recent marketplace trends of direct-to-consumer products and broad digitization. To provide orthodontists with current, nationwide data on referral values and communication preferences, a mixed-methods study was conducted. METHODS Semistructured interviews were conducted with practicing general dentists (n = 23), and interviews were analyzed to identify factors important to communication and referrals. Qualitative data provided the foundation to develop and pretest a survey distributed nationally to American Dental Association general dentists through email (n = 373). Survey results were evaluated using bivariate and descriptive statistics. RESULTS Although 42% of general dentists provide orthodontics, of those, 68% report insufficient orthodontic training in dental school, and 61% have increased orthodontic care in recent years. General dentists refer to orthodontists for complex cases and growing patients, with the orthodontist's perceived skill and proximity to the patient being important for choosing a specific orthodontic practice. Phone (70%) and email (61%) are the most used interoffice communication methods, with email (40%) and then phone (30%) being the most preferred. The most important aspects of a working relationship were patient satisfaction and final occlusal outcome, whereas the best way to boost referrals was through improving communication. CONCLUSIONS Excellent care and patient satisfaction remain primary motivators for referrals from generalists to orthodontists. An improved orthodontic curriculum is needed for general dentists. Good communication with dentists is critical for growing referral streams and enhancing patient care.
1. Qual Health Res. 2010 Dec 7. [Epub ahead of print] Considering the Qualitative-Quantitative La... more 1. Qual Health Res. 2010 Dec 7. [Epub ahead of print] Considering the Qualitative-Quantitative Language Divide. Morse JM, Dimitroff LJ, Harper R, Koontz A, Kumra S, Matthew-Maich N, Mihas P, Murphey C. University of Utah. ...
Uploads
Papers by Paul Mihas