Classification Tree Analysis of Factors Associated with Oral Cancer Exam.

In this study, we performed a classification tree analysis (CTA) to identify population subgroups that are less likely to have an oral cancer examination (OCE). We conducted telephone surveys (N = 2401) of adults residing in north Florida to collect data on OCE status and potential OCE predictors including demographics, medical and dental experience, and psychosocial factors. The CTA algorithm exhaustive chi-square automatic interaction detector (E- CHAID) was employed to determine the relationships between OCE status and the predictors.

Dental Visits Mediate the Impact of Smoking on Oral Health.

Objectives: We explored the mediational relationships among smoking, dental visits, and oral health in a longitudinal study.

Methods: We selected a sample of adult residents of rural communities of North Central Florida and followed them for 3 years (final N = 1170). We examined the impact of smoking on oral health across time and conducted mediation analysis to quantify the effect of dental visits on the relationship between smoking and poor oral health.

The reliability of psychological instruments in community samples: A cautionary note.

Although researchers norm and validate measures of psychological constructs largely on educated samples, they often use these instruments more broadly, assuming generalizability. We examined whether the assumption of generalizability is warranted. We administered three commonly used psychological measures-the Behavioral Activation/Behavioral Inhibition Scale, the Regulatory Focus Questionnaire, and the Need for Cognition Scale-to a community sample (N = 332) with limited education.

The relationships among individual and regional smoking, socioeconomic status, and oral and pharyngeal cancer survival: a mediation analysis.

Poorer survival from oral and pharyngeal cancer (OPC) has been reported for populations of lower socioeconomic status (SES), adjusting for risk factors such as patient and clinical characteristics. Beyond these risk factors, higher rates of tobacco use may be a mediator for the observed poorer OPC survival for low SES populations. In this study, we aimed to examine the impact of the relationships among SES, individual smoking status, and living in a region with a higher smoking rate on OPC survival.

Predicting Scheduling and Attending for an Oral Cancer Examination.

Background: Oral and pharyngeal cancer is highly treatable if diagnosed early, yet late diagnosis is commonplace apparently because of delays in undergoing an oral cancer examination.

Purpose: We explored predictors of scheduling and attending an oral cancer examination among a sample of Black and White men who were at high risk for oral cancer because they smoked.

Methods: During an in-person interview, participants (N = 315) from rural Florida learned about oral and pharyngeal cancer, completed survey measures, and were offered a free examination in the next week.

Determinants of First-Time Cancer Examinations in a Rural Community: A Mechanism for Behavior Change.

Objectives: After conducting a media campaign focusing on the importance of oral and pharyngeal cancer (OPC) examinations, we assessed mechanisms of behavior change among individuals receiving an OPC examination for the first time.

Methods: We used data from 2 waves of telephone surveys of individuals residing in 36 rural census tracts in northern Florida (n = 806). The second survey occurred after our media intervention.

Barriers to Medicaid participation among Florida dentists.

Background: Finding dentists who treat Medicaid-enrolled children is a struggle for many parents. The purpose of this study was to identify non-reimbursement factors that influence the decision by dentists about whether or not to participate in the Medicaid program in Florida.

Methods: Data from a mailed survey was analyzed using a logistic regression model to test the association of Medicaid participation with the Perceived Barriers and Social Responsibility variables.

Perceptions of oral health, preventive care, and care-seeking behaviors among rural adolescents.

Background: An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents.

Physical activity behavior, barriers to activity, and opinions about a smartphone-based physical activity intervention among rural residents.

Background: Rural Americans engage in less physical activity (PA) and experience higher rates of consequent health problems (i.e., obesity, cardiovascular disease) than urban Americans.

Evaluating tablet computers as a survey tool in rural communities.

Purpose: Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer.

Health literacy: a pathway to better oral health.

Objectives: We examined whether health literacy was associated with self-rated oral health status and whether the relationship was mediated by patient-dentist communication and dental care patterns.

Methods: We tested a path model with data collected from 2 waves of telephone surveys (baseline, 2009-2010; follow-up, 2011) of individuals residing in 36 rural census tracts in northern Florida (final sample size n = 1799).

Results: Higher levels of health literacy were associated with better self-rated oral health status (B = 0.

Comparative effectiveness of instructional methods: oral and pharyngeal cancer examination.

This study compared the effectiveness of different methods of instruction for the oral and pharyngeal cancer examination. A group of thirty sophomore students at the University of Florida College of Dentistry were randomly assigned to three training groups: video instruction, a faculty-led hands-on instruction, or both video and hands-on instruction. The training intervention involved attending two sessions spaced two weeks apart.

A survey of barriers to screening for oral cancer among rural Black Americans.

Objective: Research documents a disparity between Black and White Americans in mortality for oral cancer that appears to result in part from behaviors such as lower oral cancer screening among Black Americans. We examined barriers to oral cancer screening among Black Americans.

Methods: We surveyed Black Americans (N = 366) living in rural Florida to identify barriers to getting screened for oral cancer.

Demographic and practice characteristics of Medicaid-participating dentists.

Objectives: The challenges entailed in dental Medicaid programs are well documented. To increase our understanding of Medicaid participation, we surveyed Florida dentists to determine the demographic and practice characteristics of Medicaid-participating dentists.

Methods: Our target population was practicing Florida dentists who treat children, including those who do not currently accept Medicaid as well as those who do.

The burden of chronic diseases in a rural North Florida sample.

Background: The degree of health disparities present in rural communities is of growing concern and is considered "urgent" since rural residents lag behind their urban counterparts in health status. Understanding the prevalence and type of chronic diseases in rural communities is often difficult since Americans living in rural areas are reportedly less likely to have access to quality health care, although there are some exceptions. Data suggest that rural residents are more likely to engage in higher levels of behavioral and health risk-taking than urban residents, and newer evidence suggests that there are differences in health risk behavior within rural subgroups.

The decision to counsel adolescents about HPV.

Objectives: To examine factors influencing dentists' intentions to counsel adolescents.

Methods: Florida dentists (N = 929) responded to 3 descriptions of an office visit by an adolescent patient. In the standard-of-care condition the patient consumed excessive sugar.

Selecting a sample size for studies with repeated measures.

Many researchers favor repeated measures designs because they allow the detection of within-person change over time and typically have higher statistical power than cross-sectional designs. However, the plethora of inputs needed for repeated measures designs can make sample size selection, a critical step in designing a successful study, difficult. Using a dental pain study as a driving example, we provide guidance for selecting an appropriate sample size for testing a time by treatment interaction for studies with repeated measures.

Disparities in knowledge of mouth or throat cancer among rural Floridians.

Objective: The aim of this study was to examine risk factors for reduced mouth or throat cancer (MTC) knowledge using a sample of rural North Floridian adults.

Methods: Telephone interviews were conducted across rural census tracts throughout North Florida in 2009-2010, using a survey adapted for cultural appropriateness. The sample consisted of 2,393 individuals (1,059 males and 1,334 females; 1,681 whites and 712 blacks).

Increasing screening intentions for oral and pharyngeal cancer.

Background: Oral and pharyngeal cancer is a serious health threat that goes unnoticed by most people. Increasing screenings for oral and pharyngeal cancer is essential to achieving early detection when the disease is most treatable.

Purpose: We tested the effectiveness of a media campaign designed to increase intentions to seek an oral and pharyngeal cancer screening.

Barriers to oral cancer screening: a focus group study of rural Black American adults.

Objective: Mortality from mouth and throat cancer (MTC) is higher among Black Americans than White Americans partially because of late stage detection through screening. The disparity in mortality is particularly problematic among Black Americans living in rural areas who have limited access to preventative resources. Our study explored barriers to screening for MTC among Black Americans.

Racial disparity in oral and pharyngeal cancer in Florida in 1991-2008: mixed trends in stage of diagnosis.

Objectives: To explore changes in distribution of stage at diagnosis among individuals with oral and pharyngeal cancers over the past two decades and whether the changes differ by race.

Methods: We obtained 1991-2008 cancer incidence data for nine anatomic sites of the oral and pharyngeal structure from the Florida Cancer Data System. These cancers were grouped into oral squamous cell carcinoma (SCC), pharyngeal SCC, and other head and neck cancers.

Variation in the gene TAS2R13 is associated with differences in alcohol consumption in patients with head and neck cancer.

Variation in responsiveness to bitter-tasting compounds has been associated with differences in alcohol consumption. One strong genetic determinant of variation in bitter taste sensitivity is alleles of the TAS2R gene family, which encode chemosensory receptors sensitive to a diverse array of natural and synthetic compounds. Members of the TAS2R family, when expressed in the gustatory system, function as bitter taste receptors.