Predicting Non-Attendance: A Model of the Complex Relationships in Dental Care Non-Attendance among Adolescents in Örebro County, Sweden — Oak Academic Publishing
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Predicting Non-Attendance: A Model of the Complex Relationships in Dental Care Non-Attendance among Adolescents in Örebro County, Sweden
Department of Pedodontics, Postgraduate Dental Education Center, Örebro County Council, Örebro, Sweden
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Department for Sustainable Development, Region Örebro County, Örebro, Sweden
,
Department of Dental Research, Public Dental Service, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
,
Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
1 Department of Pedodontics, Postgraduate Dental Education Center, Örebro County Council, Örebro, Sweden
2 Department for Sustainable Development, Region Örebro County, Örebro, Sweden
3 Department of Dental Research, Public Dental Service, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
4 Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
Background: Understanding why adolescents miss dental appointments is central to promoting people’s oral health into adulthood. Studies on non-attendant adolescents are rare. Method: In our previous study using data from the 2014 population-based cross-sectional survey of schoolchildren in ?rebro County, Sweden we suggested a risk-factor model for non-attendance with five components (sociodemographic factors, self-rated health, perceived life events, health behaviour, social cohesion and social capital). The present study tested the external validity of the multivariate model for all components simultaneously developed from the 2014 study using a new population-based cross- sectional survey (n = 7576) of schoolchildren in ?rebro County, Sweden 2017. Using the predicted values from the 2014-logistic regression, we computed ROC-curves for the 2014 and 2017 study populations, respectively. Results: Of the 6 304 adolescents who answered the question of attendance to dental health care and all eleven independent items in 2017, 324 (5.1%) reported that they sought dental care only for acute pain or not at all, thus regarded as non-attendant. When using the risk model based on the 2014 data for the 2017 data, the area under the receiver operating curve (AUC) for non-attendance adolescents was 0.74 (95% CI 0.71 - 0.76). Conclusion: The present study shows that the model created from the 2014 population-based survey has excellent discriminative performance (AUC) in the 2017 population-based survey predicting non-attending adolescents. The methodology applied in this study may be useful to other health care services to develop predictive non-attending models based on their specific population.
KeywordsAdolescentsDental AttendanceBroken Dental AppointmentsROCPartial Area under the Receiver Operating CharacteristicsPredicting Non-Attending Behaviour
Annerback, E. M., Wingren, G., Svedin, C. G., & Gustafsson, P. A. (2010). Prevalence and Characteristics of Child Physical Abuse in Sweden—Findings from a Population-Based Youth Survey. Acta Paediatrica, 99, 1229-1236. https://doi.org/10.1111/j.1651-2227.2010.01792.x
Appleton, J., Powell, C., & Coombes, L. (2016). Children’s Missed Healthcare Appointments: Professional and Organisational Responses. Archives of Disease in Childhood, 101, 814-818. https://doi.org/10.1136/archdischild-2015-309621
Blomqvist, M., Holmberg, K., Fernell, E., Ek, U., & Dahllof, G. (2006). Oral Health, Dental Anxiety, and Behavior Management Problems in Children with Attention Deficit Hyperactivity Disorder. European Journal of Oral Sciences, 114, 385-390. https://doi.org/10.1111/j.1600-0722.2006.00393.x
Bronfenbrenner, U. (2005). The Bioecological Theory of Human Development. In U. Bronfenbrenner (Ed.), Making Human Beings Human (pp. 3-15). Thousand Oaks, CA: SAGE Publications.
Carlsson, V., Hakeberg, M., Blomkvist, K., & Wide Boman, U. (2013). Attention Deficit Hyperactivity Disorder and Dental Anxiety in Adults: Relationship with Oral Health. European Journal of Oral Sciences, 121, 258-263. https://doi.org/10.1111/eos.12016
Chariatte, V., Berchtold, A., Akre, C., Michaud, P. A., & Suris, J. C. (2008). Missed Appointments in an Outpatient Clinic for Adolescents, an Approach to Predict the Risk of Missing. Journal of Adolescent Health, 43, 38-45. https://doi.org/10.1016/j.jadohealth.2007.12.017
Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. (2015). Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD): The TRIPOD Statement. BMJ, 350, g7594. https://doi.org/10.1136/bmj.g7594
Conover, W. J. (1999). Practical Nonparametric Statistics (3rd ed.). New York: Wiley.
Davoglio, R. S., Abegg, C., & Aerts, D. R. (2013). Factors Related to the Use of Dental Services among Adolescents from Gravatai, RS, Brazil, in 2005. Revista Brasileira de Epidemiologia, 16, 546-554. https://doi.org/10.1590/S1415-790X2013000200028
Duijster, D., Verrips, G. H., & van Loveren, C. (2014). The Role of Family Functioning in Childhood Dental Caries. Community Dentistry and Oral Epidemiology, 42, 193-205. https://doi.org/10.1111/cdoe.12079
Fägerstad, A., Windahl, J., & Arnrup, K. (2016). Understanding Avoidance and Non-Attendance among Adolescents in Dental Care—An Integrative Review. Community Dental Health, 33, 195-207.
Fisher-Owens, S. A., Gansky, S. A., Platt, L. J., Weintraub, J. A., Soobader, M. J., Bramlett, M. D., & Newacheck, P. W. (2007). Influences on Children’s Oral Health: A Conceptual Model. Pediatrics, 120, e510-e520. https://doi.org/10.1542/peds.2006-3084
Freire, M. C., Sheiham, A., & Hardy, R. (2001). Adolescents’ Sense of Coherence, Oral Health Status, and Oral Health-Related Behaviours. Community Dentistry and Oral Epidemiology, 29, 204-212. https://doi.org/10.1034/j.1600-0528.2001.290306.x
Gustafsson, A., Arnrup, K., Broberg, A. G., Bodin, L., & Berggren, U. (2007). Psychosocial Concomitants to Dental Fear and Behaviour Management Problems. International Journal of Paediatric Dentistry, 17, 449-459. https://doi.org/10.1111/j.1365-263X.2007.00883.x
Gustafsson, A., Broberg, A. G., Bodin, L., Berggren, U., & Arnrup, K. (2010). Possible Predictors of Discontinuation of Specialized Dental Treatment among Children and Adolescents with Dental Behaviour Management Problems. European Journal of Oral Sciences, 118, 270-277. https://doi.org/10.1111/j.1600-0722.2010.00734.x
Gustafsson, A., Persson, C., & Källestål, C (2018). Factors Associated to Non-Attendance to Dental Care among Adolescents—Suggesting a Model. Psychology, 9, 2731-2751. https://doi.org/10.4236/psych.2018.913157
Hanley, J. A., & McNeil, B. J. (1982). The Meaning and Use of the Area under a Receiver Operating Characteristic (ROC) Curve. Radiology, 143, 29-36. https://doi.org/10.1148/radiology.143.1.7063747
Haugejorden, O., Klock, K. S., Astrom, A. N., Skaret, E., & Trovik, T. A. (2008). Socio-Economic Inequality in the Self-Reported Number of Natural Teeth among Norwegian Adults—An Analytical Study. Community Dentistry and Oral Epidemiology, 36, 269-278. https://doi.org/10.1111/j.1600-0528.2007.00367.x
Khan, S., Barrington, G., Bettiol, S., Barnett, T., & Crocombe, L. (2018). Is Overweight/Obesity a Risk Factor for Periodontitis in Young Adults and Adolescents?: A Systematic Review. Obesity Reviews, 19, 852-883. https://doi.org/10.1111/obr.12668
Kheirkhah, P., Feng, Q., Travis, L. M., Tavakoli-Tabasi, S., & Sharafkhaneh, A. (2016). Prevalence, Predictors and Economic Consequences of No-Shows. BMC Health Services Research, 16, Article No. 13. https://doi.org/10.1186/s12913-015-1243-z
Kvist, T., Annerback, E. M., Sahlqvist, L., Flodmark, O., & Dahllof, G. (2013). Association between Adolescents’ Self-Perceived Oral Health and Self-Reported Experiences of Abuse. European Journal of Oral Sciences, 121, 594-599. https://doi.org/10.1111/eos.12084
Lopez, R., & Baelum, V. (2007). Factors Associated with Dental Attendance among Adolescents in Santiago, Chile. BMC Oral Health, 7, Article No. 4. https://doi.org/10.1186/1472-6831-7-4
Lu, H. X., Wong, M. C., Lo, E. C., & McGrath, C. (2011). Trends in Oral Health from Childhood to Early Adulthood: A Life Course Approach. Community Dentistry and Oral Epidemiology, 39, 352-360. https://doi.org/10.1111/j.1600-0528.2011.00611.x
Milgrom, P., Fiset, L., Melnick, S., & Weinstein, P. (1988). The Prevalence and Practice Management Consequences of Dental Fear in a Major US City. Journal of the American Dental Association, 116, 641-647. https://doi.org/10.14219/jada.archive.1988.0030
NCD Risk Factor Collaboration (NCD-RisC) (2017). Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128.9 Million Children, Adolescents, and Adults. The Lancet, 390, 2627-2642.
Neal, R. D., Hussain-Gambles, M., Allgar, V. L., Lawlor, D. A., & Dempsey, O. (2005). Reasons for and Consequences of Missed Appointments in General Practice in the UK: Questionnaire Survey and Prospective Review of Medical Records. BMC Family Practice, 6, Article No. 47. https://doi.org/10.1186/1471-2296-6-47
Neovius, M., & Rasmussen, F. (2011). Alarmerande siffror för övervikt och fetma i Sverige och världen. Lakartidningen, 108, 2566-2568.
Okullo, I., Astrom, A. N., & Haugejorden, O. (2004). Social Inequalities in Oral Health and in Use of Oral Health Care Services among Adolescents in Uganda. International Journal of Paediatric Dentistry, 14, 326-335. https://doi.org/10.1111/j.1365-263X.2004.00568.x
Ostberg, A. L., Ericsson, J. S., Wennstrom, J. L., & Abrahamsson, K. H. (2010). Socio-Economic and Lifestyle Factors in Relation to Priority of Dental Care in a Swedish Adolescent Population. Swedish Dental Journal, 34, 87-94.
Ostberg, A. L., Lindblad, U., & Halling, A. (2003). Self-Perceived Oral Health in Adolescents Associated with Family Characteristics and Parental Employment Status. Community Dental Health, 20, 159-164.
Pais, M. S., & Bissell, S. (2006). Overview and Implementation of the UN Convention on the Rights of the Child. The Lancet, 367, 689-690. https://doi.org/10.1016/S0140-6736(06)68267-6
Patton, G. C., Sawyer, S. M., Santelli, J. S., Ross, D. A., Afifi, R., Allen, N. B. et al. (2016). Our Future: A Lancet Commission on Adolescent Health and Wellbeing. The Lancet, 387, 2423-2478. https://doi.org/10.1016/S0140-6736(16)00579-1
Reilly, B. M., & Evans, A. T. (2006). Translating Clinical Research into Clinical Practice: Impact of Using Prediction Rules to Make Decisions. Annals of Internal Medicine, 144, 201-209. https://doi.org/10.7326/0003-4819-144-3-200602070-00009
Ridell, K., Matsson, L., & Mejare, I. (2007). Background Factors Associated with Endodontic Treatment Due to Caries in Young Permanent Teeth. Acta Odontologica Scandinavica, 65, 219-223. https://doi.org/10.1080/00016350701364904
Roe, M. F., Appleton, J. V., & Powell, C. (2015). Why Was This Child Not Brought? Archives of Disease in Childhood, 100, 511-512. https://doi.org/10.1136/archdischild-2014-307856
Skaret, E., Berg, E., Kvale, G., & Raadal, M. (2007). Psychological Characteristics of Norwegian Adolescents Reporting No Likelihood of Visiting a Dentist in a Situation with Toothache. International Journal of Paediatric Dentistry, 17, 430-438. https://doi.org/10.1111/j.1365-263X.2007.00869.x
Skaret, E., Kvale, G., & Raadal, M. (2003). General Self-Efficacy, Dental Anxiety and Multiple Fears among 20-Year-Olds in Norway. Scandinavian Journal of Psychology, 44, 331-337. https://doi.org/10.1111/1467-9450.00352
Skaret, E., Raadal, M., Berg, E., & Kvale, G. (1999). Dental Anxiety and Dental Avoidance among 12 to 18 Year Olds in Norway. European Journal of Oral Sciences, 107, 422-428. https://doi.org/10.1046/j.0909-8836.1999.eos107602.x
Skaret, E., Raadal, M., Kvale, G., & Berg, E. (1998). Missed and Cancelled Appointments among 12 - 18-Year-Olds in the Norwegian Public Dental Service. European Journal of Oral Sciences, 106, 1006-1012. https://doi.org/10.1046/j.0909-8836.1998.eos106605.x
Skaret, E., Raadal, M., Kvale, G., & Berg, E. (2000). Factors Related to Missed and Cancelled Dental Appointments among Adolescents in Norway. European Journal of Oral Sciences, 108, 175-183. https://doi.org/10.1034/j.1600-0722.2000.108003175.x
Socialstyrelsen (2015). Karies bland barn och ungdomar—Epidemiologiska uppgifter för år 2014. https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/statistik/2015-11-36.pdf
Thomas, D. (2004). Postal Reminders Can Improve Attendance at Orthodontic Clinics. Evidence-Based Dentistry, 5, 14. https://doi.org/10.1038/sj.ebd.6400244
Trubey, R. J., Moore, S. C., & Chestnutt, I. G. (2015). Children’S Toothbrushing Frequency: The Influence of Parents’ Rationale for Brushing, Habits and Family Routines. Caries Research, 49, 157-164. https://doi.org/10.1159/000365152
Viner, R. M., Ozer, E. M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., & Currie, C. (2012). Adolescence and the Social Determinants of Health. The Lancet, 379, 1641-1652. https://doi.org/10.1016/S0140-6736(12)60149-4
Vingilis, E., Wade, T., & Seeley, J. (2007). Predictors of Adolescent Health Care Utilization. Journal of Adolescence, 30, 773-800. https://doi.org/10.1016/j.adolescence.2006.10.001
Waller, J., & Hodgkin, P. (2000). Defaulters in General Practice: Who Are They and What Can Be Done about Them? Family Practice, 17, 252-253. https://doi.org/10.1093/fampra/17.3.252
Wogelius, P., Poulsen, S., & Sorensen, H. T. (2003). Prevalence of Dental Anxiety and Behavior Management Problems among Six to Eight Years Old Danish Children. Acta Odontologica Scandinavica, 61, 178-183. https://doi.org/10.1080/00016350310003468
World Health Organisation (2014). Health for the World’s Adolescents. https://www.who.int/maternal_child_adolescent/topics/adolescence/second-decade/en/
Yu, S. M., Bellamy, H. A., Schwalberg, R. H., & Drum, M. A. (2001). Factors Associated with Use of Preventive Dental and Health Services among U.S. Adolescents. Journal of Adolescent Health, 29, 395-405. https://doi.org/10.1016/S1054-139X(01)00252-X
Zimmer-Gembeck, M. J., Alexander, T., & Nystrom, R. J. (1997). Adolescents Report Their Need for and Use of Health Care Services. Journal of Adolescent Health, 21, 388-399. https://doi.org/10.1016/S1054-139X(97)00167-5