The ADHA proposed the ADHP model as a cost-effective response to help address the lack of access to dental care of many Americans. Development of this model has paralleled features in the nursing profession with its successful implementation of the nurse practitioner. The opportunity for nurses to obtain this advanced degree has been available for over forty years. During this time, roles of nurse practitioners have included care to underserved populations and have gained acceptance by the public. Programs for “school dental nurses” date back to 1921 and have undergone several transitions. Currently, The Bachelor of Oral Health degree, offered by two universities in New Zealand, prepares graduates with expanded duties of both a dental hygienist and dental therapist. Meanwhile, other allied dental workforce models, such as Community Dental Health Coordinator, are being proposed as alternative solutions to address the underserved populations.
The purpose of this pilot study was to examine the factors of support/interest, level of practice, and socio-demographics associated with the proposed ADHP. A random
sample of active registered dental hygienists was selected in Colorado, Kentucky, and North Carolina. The low response rate (29%) was inadequate to support any significant
differences among the three states and limited any generalizations to the population. However, the descriptive data yielded points of interest in comparing responses among the three states and contributed to the suggested recommendations.
The ADHA initiated curriculum development three years prior to the administration of this survey and almost 50% of the respondents had not heard of the proposed ADHP. Therefore, the ADHA should develop alternative strategies to improve the flow of
remains a low representation to the total number of dental hygienists. The ADHA should creatively market and promote the advantages of membership. Efforts are being made to encourage the transition of membership from SADHA to ADHA; however, post-graduates with years of practicing experience need to be contacted. Membership in the ADHA would likely increase the awareness and knowledge of pertinent issues like the ADHP model. Members would hopefully become more engaged in advocacy efforts and legislative issues.
ADHA’s report, Dental Hygiene: Focus on Advancing the Profession, states the goal of advancing the baccalaureate degree in dental hygiene as entry-level in the next five years. Achievement of this goal would better prepare graduates for alternative career opportunities and would enhance the number of qualified applicants who are interested in becoming an ADHP. Sixty-five percent of the respondents in this study held an Associate Degree in Dental Hygiene. Respondents in this group who are interested in obtaining the proposed AHDP credential need to first complete a Bachelors Degree. Community/ technical colleges need to encourage more graduates to pursue a baccalaureate degree. Likewise, dental hygiene degree completion programs need to modify their recruitment efforts to include recent graduates and non-traditional students. Furthermore, to increase enrollment, these programs should consider changes with course scheduling and online teaching methods to accommodate the various needs of students.
A significant difference was observed among the states of those interested in becoming an ADHP and those who were not interested. Of those interested, a majority of the respondents (mean 56%) indicated that they would be willing to spend two years or less to obtain the proposed ADHP credential. Many indicated that they would be willing to enroll as a part-time student and take courses online with the preferred teaching format of “in class lectures supplemented with online material.” The results may suggest that practicing dental hygienists with years of experience will make up a large percentage of the applicant pool. A profile of these interested respondents reveals similar trends with other students who
pursued advanced degrees. Assessment of this data should be beneficial to ADHP
programs with regards to planning school locations, recruitment efforts, course scheduling, delivery methods, and teaching formats. Programs will need to develop strategies to overcome challenges and best meet the needs of a varied applicant pool of recent graduates and non-traditional students.
Self-administered surveys require much preparation and attention to receive a good response rate. Both design and wording of questions contribute to the reliability and validity of a survey. Pilot testing questions can support these factors and provide guidance in survey revisions. The results of this pilot study denote that certain questions could be modified to improve measurement of the specific aims. Recommendations found in the literature would aid in the development of a revised survey.
Among the three states, a higher overall level of support for the proposed ADHP was indicated as compared to the overall level of interest. However, the 302 respondents
interested in obtaining the proposed ADHP credential indicated specific preferences to support their interest. Although this pilot study is limited with generalizations to the
population, these characteristics may be beneficial in the progress of the ADHP. Utilization of this pilot study along with the recommendations for a revised survey may help future researchers find additional trends and characteristics of potential students regarding the ADHP.
APPENDIX A Cover Letter
The University of North Carolina at Chapel Hill School of Dentistry Department of Dental Ecology Graduate Dental Hygiene Education Program CB# 7450, 3320 Old Dental Building Chapel Hill, NC 27599-7450 June 19, 2007
Dear Colleague,
The American Dental Hygienists’ Association (ADHA) is proposing the concept of an Advanced Dental Hygiene Practitioner (ADHP) to help address the oral health needs of the underserved populations. The curriculum draft for this new practitioner is to prepare dental hygienists to practice at an advanced level. I am conducting a research study entitled, “Practicing Dental Hygienists’ Attitudes toward the Proposed Advanced Dental Hygiene Practitioner.” This study is using a survey instrument that will assess the support/interest of the ADHP concept and characteristics of individual dental hygienists who would be attracted to the ADHP program.
Active registered dental hygienists in Colorado, Kentucky, and North Carolina have been randomly selected to receive this survey. You are one of 1,562 dental hygienists selected out of over 10,000 to participate in this study.
This research study has been approved by the UNC-CH Institutional Review Board (IRB). Your participation is completely voluntary and will remain anonymous. You do not have to sign the survey. Each survey will have an identifying code and only the study researchers and the IRB will have access to the study information. Future reports will not contain your personal identifiers or information. There are no penalties for choosing not to participate. You will not be compensated for your participation. Completion of the survey should only take approximately 10 minutes. Please return the completed survey by June 30, 2007 in the enclosed stamped business reply envelope.
Thank you for taking the time to complete this important survey. Your participation will provide valuable insight to the support/interest of the ADHP concept and to the
understanding of the types of individuals who would be interested in this new program. Sincerely,
Douglas L. Lambert, RDH, BA
Masters of Dental Hygiene Education Degree Candidate Thesis Committee Members:
Mary George, RDH, MEd Jessica Lee, DDS, MPH, PhD
Alice Curran, DMD, MS Daniel Shugars, DDS, MPH, PhD
Enclosures: Survey
APPENDIX B Questionnaire
Box for Internal Use “Practicing Dental Hygienists’ Attitudes toward the
Proposed Advanced Dental Hygiene Practitioner”
Thank you for participating in this research study by completing this survey regarding the proposed Advanced Dental Hygiene Practitioner (ADHP). Please read each question carefully and record your
most appropriate response directly on the survey. Your Support and Interest in ADHP
1. Which one of the following BEST describes how you initially heard about the proposed ADHP?
1. Work 4. Professional journal
2. Friend 5. Other source _______________ 3. Internet 6. Do not know about the proposed ADHP The ADHP curriculum draft from ADHA lists five general themes with specific descriptions. For questions 2–6, please rate both your level of support AND your level of interest regarding the proposed professional responsibilities, knowledge, and skills of an ADHP. For example, for Theme I, how would you describe your level of support for an ADHP performing these advanced skills (left column), and how would you describe your own level of interest performing such advanced skills (right column)?
Your Level of Support Please use this scale as reference Your Level of Interest
5 Very Supportive 5 Very Interested
4 Somewhat Supportive 4 Somewhat Interested
3 Neutral 3 Neutral
2 Not Supportive 2 Slightly Interested
1 Strongly Against 1 Not Interested Your
Level of Support
Proposed Professional Responsibilities, Knowledge,
and Skills of an ADHP
Your Level of Interest 2. 5 4 3 2 1