Attitudes toward expanded roles for paramedical personnel.Abstract: Female students were asked to indicate willingness to consult 24 health and related professionals for smoking cessation smoking cessation Public health Temporary or permanent halting of habitual cigarette smoking; withdrawal therapies–eg, hypnosis, psychotherapy, group counseling, exposing smokers to Pts with terminal lung CA and nicotine chewing gum are often ineffective. , eating disorders eating disorders, in psychology, disorders in eating patterns that comprise four categories: anorexia nervosa, bulimia, rumination disorder, and pica. Anorexia nervosa is characterized by self-starvation to avoid obesity. or domestic abuse, as well as indicate frequency of professional contact. Subjects were most likely to consult medical/mental health professionals, relatively unwilling to consult dentists, hygienists, acupuncturists, or pharmacists about eating disorders or domestic abuse, but relatively more willing to consult them about smoking cessation. Willingness to consult nonmedical professionals was directly related to subjects' contacts with them. Although the medical training of dentists is significant, these negative patient attitudes may account for their reluctance to intrude into nondental areas of patient health without compensation. ********** As a part of an ongoing effort to expand the health care roles of dental and other paramedical par·a·med·i·cal adj. 1. Of, relating to, or being a person trained to give emergency medical treatment or assist medical professionals. 2. professionals, two types of studies have been undertaken. One series of studies (Anderson et al., 2001; Giddon and Anderson, 2002; Tran et al., 1998) focused on the knowledge and attitudes of dental health professionals towards selected expanded roles in treatment/counseling patients about smoking cessation, eating disorders, and domestic abuse. The specific aim of the present study was to complement this information about paramedical personnel by determining attitudes of potential and actual patients toward paramedical personnel in these same areas. For the purpose of this study, the term paramedical professionals refers to non-physicians who may be involved in some health related activity. A major problem of the health care system is the disparity between need for and availability of therapeutic and preventive services. One solution being evaluated in this study is the possibility of expanding the role of paramedical personnel--of which the dentists by training and experience are the most qualified health professionals to undertake some of these primary care functions (Giddon, 2004). Unfortunately, the dentists, who could soon become oral physicians, do not believe that the public wants them to provide these additional services (Giddon, 2004). Moreover, they feel, perhaps justifiably, that neither the public nor third party payers will compensate them for such expanded roles. The further irony of this impasse is that those people who engage in or are victims of behaviors such as eating disorders or domestic abuse or even tobacco use may be very reluctant to discuss the problems with physicians, family members, or athletic coaches, let alone dental health practitioners. They may, in fact, regard the involvement of dentists in the treatment or prevention of disease beyond the teeth, oral soft and hard tissues as intrusive. Such behaviors may exist even though over 100 systemic disease A systemic disease is one that affects a number of organs and tissues, or affects the body as a whole [1] Although most medical conditions will eventually involve multiple organs in advanced stage (i.e. may be manifest in the orofacial area. Moreover, oral diseases such as periodontitis periodontitis Inflammation of soft tissues around the teeth (see tooth). Poor dental hygiene leads to deposition of bacterial plaque on the teeth below the gum line, irritating and eroding nearby tissues. are suspected of having a role in cardiovascular disease Cardiovascular disease Disease that affects the heart and blood vessels. Mentioned in: Lipoproteins Test cardiovascular disease , stroke, and low birth weight (Scannapieco et al., 2003). The magnitude of some of the problems in which paramedical personnel can be of service is enormous. For example, tobacco use, eating disorders, skin cancer, hypertension, diabetes, osteoporosis and domestic abuse represent some of the most prevalent causes of disease, injury, or death. Modification of deleterious behavior related to any of these conditions, therefore, can have a significant ameliorative a·mel·io·rate tr. & intr.v. a·me·lio·rat·ed, a·me·lio·rat·ing, a·me·lio·rates To make or become better; improve. See Synonyms at improve. [Alteration of meliorate. impact. Specifically, tobacco use accounts for an estimated 450,000 deaths per year in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. (Squier, 2001). Thirty percent of all cancers and 92% of cancers of the lip, oral cavity oral cavity n. The part of the mouth behind the teeth and gums that is bounded above by the hard and soft palates and below by the tongue and the mucous membrane connecting it with the inner part of the mandible. , and pharynx pharynx (fâr`ĭngks), area of the gastrointestinal and respiratory tracts which lies between the mouth and the esophagus. In humans, the pharynx is a cone-shaped tube about 4 1-2 in. (11.43 cm) long. are attributed to tobacco use (Squier, 2001). Stomach and lung cancer lung cancer, cancer that originates in the tissues of the lungs. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell. as well is related to cigarette and cigar smoking (Chao et al., 2002). Domestic abuse affects an estimated 1.1 million women per year with significantly higher rates of abuse found in women ages 18-39 (Campbell et al., 2002). New diagnoses of skin cancer in 2002 amounted to approximately 1.3 million in the United States (Geller & Annas, 2003). The most common eating disorders are anorexia nervosa (American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential world-wide. Its some 148,000 members are mainly American but some are international. , 1994) and bulimia nervosa bulimia nervosa Eating disorder, mostly in women, in which excessive concern with weight and body shape leads to binge eating followed by compensatory behaviour such as self-induced vomiting or the excessive use of laxatives or diuretics. , affecting up to three percent of the female population and one percent of males with an even higher proportion on college campuses and among athletes (Thompson, 1996). Hypertension affected 23% of Americans ages 20-74 between 1988 and 1994, with the highest incidence in those over 75, for which there were 35 million office visits in the year 2000 for hypertension (National Center for Health Statistics National Center for Health Statistics (NCHS) is part of the Centers for Disease Control and Prevention (CDC), which is part of the United States Department of Health and Human Services. NCHS is the United States' principal health statistics agency. , 2003). For drug-related problems and alcohol in combination with other drugs, there were more than 600,000 emergency room visits in the year 2000 (National Institute on Drug Abuse The National Institute on Drug Abuse (NIDA) is a United States federal-government research institute whose mission is to "lead the Nation in bringing the power of science to bear on drug abuse and addiction. , 2003). What is the actual or potential role of paramedical providers in recognizing, treating or preventing these disorders? Many of the signs and symptoms associated with these problem areas are easily recognized by medical and paramedical professionals during patient screening or consultations for other reasons. For example, tobacco use is easily discernible to the dental health professional because of staining, breath odor, or obvious disease such as oral cancer. The behaviors of eating disordered patients may also have a profound effect on the orofacial structures. Specifically, self-induced vomiting, consuming low calorie/fat foods (e.g. fruits) and drinking large quantities of diet soda The examples and perspective in this article or section may not represent a worldwide view of the subject. Please [ improve this article] or discuss the issue on the talk page. , all of which are extremely acidic, contribute to increased rate of tooth erosion, leading to thin or discolored dis·col·or v. dis·col·ored, dis·col·or·ing, dis·col·ors v.tr. To alter or spoil the color of; stain. v.intr. To become altered or spoiled in color. enamel with sharp or notched appearance of incisal incisal /in·ci·sal/ (in-si´z'l) 1. cutting. 2. pertaining to the cutting edge of an anterior tooth. in·ci·sal adj. edges, raised amalgams, open anterior bites, and cheilosis (Bishop et al., 1994; Little, 2002; Touyz et al., 1993). In addition to recognition of oral cancer, the reporting of objective signs of skin cancer for referral to a dermatologist for evaluation and/or biopsy should be a straightforward task for dentists. For hypertension, many dental health professionals such as oral and maxillofacial surgeons Oral and maxillofacial surgeon A dentist who is trained to perform surgery to correct injuries, defects, or conditions of the mouth, teeth, jaws, and face. Mentioned in: Jaw Wiring and other paramedical professionals such as podiatrists routinely take blood pressure prior to surgical procedures Surgical procedures have long and possibly daunting names. The meaning of many surgical procedure names can often be understood if the name is broken into parts. For example in splenectomy, "ectomy" is a suffix meaning the removal of a part of the body. "Splene-" means spleen. . When the results are abnormal, may be referred to their primary care physician. Because of the covert nature of eating disorders and domestic abuse, dentists and hygienists may be the first or only health professionals (Herzog, 1982; Johnson & Rue, 1985) to have the opportunity to recognize these problem areas with highly visible oral manifestations. It is also possible that dental hygienists, who are predominantly female, may be more accepted and supportive than male dentists for female patients who suffer disproportionately from eating disorders or domestic abuse. Recognition and reporting of domestic abuse of at least children is now mandated in 48 of states for most health care providers (National Clearinghouse on Child Abuse and Neglect Information, 2003). Moreover, because of their continued contact across the life span of patients, dentists and related health professionals are in a unique position to recognize the early signs and symptoms of tobacco use, eating disorders, or domestic abuse, as well as hypertension and skin cancer. Early recognition and intervention in any of these problem areas may result in a more positive prognosis for recovery of physical and mental health. Some questions relating to relating to relate prep → concernant relating to relate prep → bezüglich +gen, mit Bezug auf +acc expanding the role of dental health personnel have been explored previously. The American Dental Association American Dental Association (ADA), n.pr a nonprofit professional association whose membership is dental professionals in the United States. Its purpose is to assist its members in providing the highest professional and ethical care to the citizens of the (ADA Ada, city, United States Ada (ā`ə), city (1990 pop. 15,820), seat of Pontotoc co., S central Okla.; inc. 1904. It is a large cattle market and the center of a rich oil and ranch area. ) surveyed the roles of dentists in tobacco cessation efforts and identification of child abuse (ADA, 1995a) and hypertension (ADA, 1995b). Cohen cohen or kohen (Hebrew: “priest”) Jewish priest descended from Zadok (a descendant of Aaron), priest at the First Temple of Jerusalem. The biblical priesthood was hereditary and male. et al. (1996) conducted a national survey of endodontists and patients for determination of incidence and attitudes towards infectious diseases infectious diseases: see communicable diseases. such as hepatitis, herpes, and HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome , and found an increase in the last decade in dental health professionals' willingness to treat patients with transmissible transmissible /trans·mis·si·ble/ (trans-mis´i-b'l) capable of being transmitted. trans·mis·si·ble adj. Capable of being conveyed from one person to another. diseases. In addition to the studies of Giddon, Anderson et al. (Anderson et al., 2002; Giddon and Anderson, 2002; Tran et al., 1998) and others indicating that dentists are willing but reluctant to become involved in other than smoking cessation and treatment of the dental aspects of eating disorders, there are several studies suggesting that physicians have reservations as well. Bursten et al. (1996), assessed family physicians' knowledge of bulimia nervosa using a mailed survey and found that despite an overall prevalence of one percent for bulimia bulimia: see eating disorders. , nearly one third of those surveyed had never diagnosed bulimia and two thirds are not currently providing care for bulimic bu·li·mi·a n. 1. An eating disorder, common especially among young women of normal or nearly normal weight, that is characterized by episodic binge eating and followed by feelings of guilt, depression, and self-condemnation. patients. Morgan (1999) found that only 20 percent of gynecologists were confident in their ability to diagnose eating disorders. METHOD From a list of possible problem areas for potential patients that could be discussed or recognized by paramedical personnel, the following were selected because they were primarily volitional vo·li·tion n. 1. The act or an instance of making a conscious choice or decision. 2. A conscious choice or decision. 3. The power or faculty of choosing; the will. and amenable to behavior modification behavior modification n. 1. The use of basic learning techniques, such as conditioning, biofeedback, reinforcement, or aversion therapy, to teach simple skills or alter undesirable behavior. 2. See behavior therapy. : smoking cessation, eating disorders, and domestic abuse. To determine attitudes towards selected expanded roles and experience with paramedical professionals, four samples of approximately 30 to 40 each for a total of 130 female volunteer undergraduates (Ss) attending a New England New England, name applied to the region comprising six states of the NE United States—Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut. The region is thought to have been so named by Capt. college collected over a four-year period were asked to: 1.) provide demographic information including age, weight, gender, ethnicity, participation in athletic teams, frequency of exercise, and whether they thought they had an eating disorder or had been told that they had an eating disorder; 2.) indicate their attitudes or feelings about 24 medical and paramedical professionals using a Likert format scale (very willing, willing, unwilling, very unwilling); and 3) experience with these professionals (none, some, or many contacts) (Table 1). RESULTS The demographic information across all samples is shown in Table 2. As shown in Table 1, the Likert type willingness responses were converted to numerical scores; viz: very willing = 1, willing = 2, unwilling = 3, very unwilling = 4. Similarly the contacts with paramedical personnel were converted to none = 0, 12 = 1, *3 = 2. Using ANOVA anova see analysis of variance. ANOVA Analysis of variance, see there , there were no overall differences among the responses across the four samples, nor was there any difference in the rank orders of the means across the four years as demonstrated by the highly significant correlations which ranged from rhos of .867 to .972 or median rho of .910 (p<.01). In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke" put differently , the relative position of the professions did not change from one sample year to the next. The results across all four sample years were therefore combined and analyzed for convenience as parametric data See parametric symbol. except for the correlations. Standard errors rather then standard deviations were presented to simplify inter-item comparisons. The mean attitude/feeling score towards each of the medical and paramedical professionals for smoking cessation, eating disorder, and domestic abuse problem areas is shown in Table 3. A comparison of the means of the most consulted with the least consulted Likert scores indicated that medical and mental health professionals, with the exception of plastic surgeons and dermatologists, were most likely to be consulted, regardless of frequency of contact (p<.01). As expected, rank ordering of the magnitude of the responses verified that Ss were most willing to consult their primary care physician, psychologist, nurse, psychiatrist, mental health practitioner, and nutritionist nu·tri·tion·ist n. One who is trained or is an expert in the field of nutrition. nutritionist Dietitian, see there , respectively, and relatively unwilling to consult podiatrists, plastic surgeons, opticians, chiropractors, dentists, or orthodontists. Similar to the results across years, the Years, The the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109] See : Time relative order of the professions did not change, as shown in Table 3, from one problem area to another; that is, the rhos ranged from .804 to .943 among smoking cessation, eating disorders, and domestic abuse. Moreover, only 33 (26%) of Ss were very willing or willing to discuss eating disorders with their dentist compared with 114 (89%) who were willing to discuss them with their primary care physician, which was significantly different by [Chi.sup.2] = 115.6 p<.00. Hair stylists would be consulted almost as often as dentists or pharmacists. There was a trend in the data suggesting a negative relationship between frequency of contact and willingness to discuss problem areas with the professionals noted here; that is, the greater the numbers of contacts the more willing Ss were to discuss problem areas. DISCUSSION The results of this survey of female college students indicate that potential patients on a relative basis are not willing to discuss smoking cessation, eating disorders, or domestic abuse with podiatrists, dental health practitioners, or plastic surgeons, but are relatively willing to consult their primary care physicians, psychologists, and other mental health specialists and nutritionists. These results are more disappointing than surprising, especially for the dental health professionals. Given that enhancing physical attractiveness Physical attractiveness is the perception of the physical traits of an individual human person as pleasing or beautiful. It can include various implications, such as sexual attractiveness, cuteness, and physique. is a major motive for engaging in disordered eating Disordered Eating is a term that is used by some people to describe a wide variety of irregularities in eating behavior that do not warrant a diagnosis of a specific eating disorder such as anorexia nervosa or bulimia nervosa. behaviors, it is ironic that such patients may actually decrease their attractiveness to others by having to hide their smiles (Eder, 1995). Thus, for eating disorders, dental health professionals have a unique opportunity for early intervention ear·ly intervention n. Abbr. EI A process of assessment and therapy provided to children, especially those younger than age 6, to facilitate normal cognitive and emotional development and to prevent developmental disability or delay. by alerting patients to and treating their dental manifestations. Unfortunately, however, based upon these survey results, patients are unwilling to consult them. The possibility that this survey was biased in favor of or against dental health professionals was minimized because none of the respondents had any knowledge that the survey was associated with a dental research institution. Whatever the patterns of likely consultation, the responses were remarkably consistent across the results obtained from four independent samples and the three problem areas over a four-year period--suggesting a stereotypical unchanging response pattern for young adult females. In summary, there are significant consumer/patient and practitioner barriers to expanding the roles of paramedical personnel in general, with a surprising antipathy toward potential involvement of some professions. In addition to the reluctance of patients, the work of Anderson et al., 2001; Giddon and Anderson, 2002; Squier, 2001; and Tran et al., 1998 has demonstrated that dental and possibly other health professionals also appear to be resistant to assuming a significant role in recognition or prevention of eating disorders and domestic abuse. At the very least, increased public and professional awareness would seem to be the next step. With increased knowledge and skills, paramedical professionals may become less concerned about losing patients because of unsolicited intrusiveness. Further studies of consumer attitudes and experience may help identify barriers to utilizing these personnel. Strategies for implementation of prevention programs can then be developed, such as health promotional material for use by schools, clinics, private offices, and dental and other health professional organizations. New curricula for paramedical personnel and community-wide educational programs can then be created to encourage increased utilization of paramedical health care. REFERENCES American Dental Association. (1994). The 1994 survey of current issues in dentistry: Tobacco use cessation efforts among private practitioners. Chicago: American Dental Association. American Dental Association (1995a). The 1995 survey of dental practice Noun 1. dental practice - the practice of dentistry practice - the exercise of a profession; "the practice of the law"; "I took over his practice when he retired" : characteristics of dentists in private practice and their patients. Chicago: American Dental Association. American Dental Association (1995b). Dentists able to treat patients with chronic diseases. ADA News Releases, October 10, 1995. American Psychiatric Association (1994). Quick reference to the diagnostic criteria from DSM-IV DSM-IV Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). This reference book, published by the American Psychiatric Association, is the diagnostic standard for most mental health professionals in the United States. . Washington, DC: American Psychiatric Association, 251-4. Anderson, N.K., Weber, H.P., & Giddon, D.B. (2001). Attitudes toward eating disorders and expanded dental roles. Journal of Dental Research, 80, 1795. Bishop, K., Briggs, P., & Schmidt, E. (1994). Identification and immediate management of the oral changes associated with eating disorders. British Journal of Hospital Medicine, 52(7), 326-34. Bursten, M.S., Gabel, L.L., Brose n. 1. Pottage made by pouring some boiling liquid on meal (esp. oatmeal), and stirring it. It is called beef brose, water brose, etc., according to the name of the liquid (beef broth, hot water, etc.) used. , J.A., & Monk, J.S. (1996). Detecting and treating bulimia nervosa: How involved are family physicians? The Journal of the American Board of Family Practice, 9, 241-8. Campbell, J., Jones, A.S., Dienemann, J.K, Schollenberger, J., O'Campo, P., Gielen, A.C., & Wynne, C. (2002). Intimate partner violence and physical health consequences. Archives of Internal Medicine The Archives of Internal Medicine is a bi-monthly international peer-reviewed professional medical journal published by the American Medical Association. Archives of Internal Medicine , 27;162(10):1157-63. Chao, A., Thun, M.K., Henley, S.J., Jacobs, E.J., McCullough, M.L., & Calle, E.E. (2002). Cigarette smoking, use of other tobacco products and stomach cancer mortality in US adults: The cancer prevention study II. International Journal of Cancer, 101(4), 380-9. Cohen, A.S., Jacobsen, E.L., & BeGole, E.A. (1997). National survey of endodontists and selected patient samples. Oral Surgery, Oral Medicine, Oral Pathology oral pathology n. The branch of dentistry concerned with the diseases of oral and paraoral structures, including oral soft tissues and mucous membranes and the teeth, jaws, and salivary glands. , Oral Radiology, and Endodontics endodontics: see dentistry. , 83, 696-702. Eder, R.A., Ed. Craniofacial anomalies craniofacial anomalies (  nom´lēs),n. : Psychological Perspectives. New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , NY: Springer Verlag, 1995. Giddon, D.B., & Anderson, N.K. (2002). Attitudes toward expanded roles for paramedical personnel. Society of Behavioral Medicine behavioral medicine n. The application of behavior therapy techniques, such as biofeedback and relaxation training, to the prevention and treatment of medical and psychosomatic disorders and to the treatment of undesirable behaviors, such as overeating. , 2002 Final Program, Washington, DC, p.82, #5-70, April 6, 2002. Geller, A.C., & Annas, G.D. (2003). Epidemiology of melanoma and nonmelanoma skin cancer nonmelanoma skin cancer 1 Basal cell carcinoma, see there 2 Squamous cell cancer, see there 3. Skin adnexal carcinoma 4. Cutaneous lymphoma . Seminars in Oncology Nursing  The perspective and/or examples in this article do not represent a world-wide view. Please [ edit] this page to improve its geographical balance. , 19(1), 2-11.Giddon, D.B. (2004). Should dentists become 'oral physicians'? Journal of the American Dental Association The Journal of the American Dental Association, or JADA, is a monthly journal of reliable, peer-reviewed information on dentistry, and is published by the American Dental Association (ADA). The current editor is Dr. , 135, 438-446. Herzog, D.B. (1982). Bulimia: the secretive syndrome. Psychosomatics, 23, 481-3. Johnson, D.L., & Rue, V.M. (1985). The bulimic dental patient: Recognition and recommendations. Dental Hygiene dental hygiene n. The practice of keeping the mouth, teeth, and gums clean and healthy to prevent disease. Also called oral hygiene. , (August), 372-7. Little, J.W. (2002). Eating disorders: Dental implications. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endododontics, 93, 138-43. Morgan, J.F. (1999). Eating disorders and gynecology: knowledge and attitudes among clinicians. Acta Obstetricia et Gynecologica Scandinavica, Mar 78(3), 233-9. National Center for Health Statistics: Illegal Drug Use. Available at: http://www.cdc.gov/nchs/fastats/ hyprtens.htm, accessed 9/18/2003. National Clearinghouse on Child Abuse and Neglect Information. Statutes at-a-glance. Available at: http:// www.calib.com/nccanch/pubs/sag/manda.pdf, accessed 9/25/03 National Institute on Drug Abuse: NIDA NIDA National Institute on Drug Abuse NIDA National Institute of Dramatic Arts (Australia) NIDA Northern Ireland Development Agency (UK) NIDA Northern Ireland Dairy Association InfoFacts. Available at: http://www.nida.nih.gov/Infofax/HospitalVisits.html, accessed 9/18/2003. Nunn, J.H. (1996). Prevalence of dental erosion and the implications for oral health. European Journal European Journal is a weekly Deutsche Welle (DW) news program produced in English. It is broadcast from Brussels, Belgium and primarily covers political and economic developments across the European Union and the rest of Europe, as well as issues of particular concern to of Oral Science, 104, 156-61. Olivardia, R., Pope, H.G., Jr., Mangweth, B., & Hudson, J.I. (1995). Eating disorders in college men. American Journal of Psychiatry The American Journal of Psychiatry (AJP) is the most widely read psychiatric journal in the world. It covers topics on biological psychiatry, treatment innovations, forensic, ethical, economic, and social issues. , 152(9), 1279-85. Scannapieco, F.A., Bush, R.B., & Paju, S. (2003). Associations between periodontal disease Periodontal Disease Definition Periodontal diseases are a group of diseases that affect the tissues that support and anchor the teeth. Left untreated, periodontal disease results in the destruction of the gums, alveolar bone (the part of the jaws where and risk for atherosclorosis, cardiovascular disease and stroke. A systematic review. Annals of Periodontology periodontology, n See periodontics. , 8(1), 38-53. Squier, C. (2001). Introduction: Tobacco, human disease, and the role of the dental profession. Journal of Dental Education, 65(4), 303-305. Thompson, J.K., ed. (1996). Body image, eating disorders, and obesity: An integrative guide for assessment and treatment. Washington, DC: American Psychological Association The American Psychological Association (APA) is a professional organization representing psychology in the US. Description and history The association has around 150,000 members and an annual budget of around $70m. . Touyz, S.W., Liew, V.P., Tseng, P., Frisken, K., Williams, H., & Beumont, P.J. V. (1993). Oral and dental complications in dieting disorders. International Journal of Eating Disorders, 14(3), 341-8. Tran, C., Anderson, N.K., & Giddon, D.B. (1998). Dental health professionals' knowledge and attitudes about eating disorders. Journal of Dental Education, 62(1), 84. Donald B. Giddon, DMD (1) (Digital Micromirror Device) See DLP. (2) (Digital Multi-layer Disk) See high-def DVD formats. , PhD Nina K. Anderson, PhD Donald B. Giddon, DMD, PhD is a Clinical Professor of Community Health at Brown University School of Medicine. Nina K. Anderson, PhD is a Clinical Instructor with the Harvard University Harvard University, mainly at Cambridge, Mass., including Harvard College, the oldest American college. Harvard College Harvard College, originally for men, was founded in 1636 with a grant from the General Court of the Massachusetts Bay Colony. School of Dental Medicine. Address all correspondence to Donald B. Giddon, DMD, PhD, 277 Linden Street, Suite 208, Wellesley, MA 02482, PHONE: 781.235.2995, FAX: 781.235.2996, E-MAIL e-mail: see electronic mail. in full electronic mail Messages and other data exchanged between individuals using computers in a network. : Donald_Giddon@brown.edu
Table 1. Questionnaire
1. For columns A, B and C, please circle the number which best
indicates your willingness to consult the professionals listed
below.
1 = Very Willing
2 = Willing
3 = Unwilling
4 = Very unwilling
2. For column D, please circle the number which best indicates your
experience with the professional listed:
None = 0 visits per year
Some = 1-2 visits per year
Many = 3 or more visits per year
Professional A. Smoking Cessation B. Eating Disorder
ACUPUNCTURIST 1 2 3 4 1 2 3 4
ATHLETIC COACH/TRAINER 1 2 3 4 1 2 3 4
CLERGYMAN 1 2 3 4 1 2 3 4
CHIROPRACTOR 1 2 3 4 1 2 3 4
DENTAL HYGIENIST 1 2 3 4 1 2 3 4
DENTIST 1 2 3 4 1 2 3 4
DERMATOLOGIST 1 2 3 4 1 2 3 4
FAMILY/PRIMARY CARE PHYSICIAN 1 2 3 4 1 2 3 4
GYNECOLOGIST 1 2 3 4 1 2 3 4
HAIR STYLIST 1 2 3 4 1 2 3 4
MENTAL HEALTH THERAPIST 1 2 3 4 1 2 3 4
NURSE 1 2 3 4 1 2 3 4
NUTRITIONIST/ DIETITIAN 1 2 3 4 1 2 3 4
OPTOMETRIST/ OPTICIAN 1 2 3 4 1 2 3 4
ORTHODONTIST 1 2 3 4 1 2 3 4
PEDIATRICIAN 1 2 3 4 1 2 3 4
PHARMACIST 1 2 3 4 1 2 3 4
PHYSICAL THERAPIST 1 2 3 4 1 2 3 4
PLASTIC SURGEON 1 2 3 4 1 2 3 4
PODIATRIST 1 2 3 4 1 2 3 4
PSYCHIATRIST 1 2 3 4 1 2 3 4
PSYCHOLOGIST 1 2 3 4 1 2 3 4
SCHOOL COUNSELOR 1 2 3 4 1 2 3 4
SOCIAL WORKER 1 2 3 4 1 2 3 4
Professional C. Domestic Abuse
ACUPUNCTURIST 1 2 3 4
ATHLETIC COACH/TRAINER 1 2 3 4
CLERGYMAN 1 2 3 4
CHIROPRACTOR 1 2 3 4
DENTAL HYGIENIST 1 2 3 4
DENTIST 1 2 3 4
DERMATOLOGIST 1 2 3 4
FAMILY/PRIMARY CARE PHYSICIAN 1 2 3 4
GYNECOLOGIST 1 2 3 4
HAIR STYLIST 1 2 3 4
MENTAL HEALTH THERAPIST 1 2 3 4
NURSE 1 2 3 4
NUTRITIONIST/ DIETITIAN 1 2 3 4
OPTOMETRIST/ OPTICIAN 1 2 3 4
ORTHODONTIST 1 2 3 4
PEDIATRICIAN 1 2 3 4
PHARMACIST 1 2 3 4
PHYSICAL THERAPIST 1 2 3 4
PLASTIC SURGEON 1 2 3 4
PODIATRIST 1 2 3 4
PSYCHIATRIST 1 2 3 4
PSYCHOLOGIST 1 2 3 4
SCHOOL COUNSELOR 1 2 3 4
SOCIAL WORKER 1 2 3 4
Professional D. Contacts with
Professional
ACUPUNCTURIST None Some Many
ATHLETIC COACH/TRAINER None Some Many
CLERGYMAN None Some Many
CHIROPRACTOR None Some Many
DENTAL HYGIENIST None Some Many
DENTIST None Some Many
DERMATOLOGIST None Some Many
FAMILY/PRIMARY CARE PHYSICIAN None Some Many
GYNECOLOGIST None Some Many
HAIR STYLIST None Some Many
MENTAL HEALTH THERAPIST None Some Many
NURSE None Some Many
NUTRITIONIST/ DIETITIAN None Some Many
OPTOMETRIST/ OPTICIAN None Some Many
ORTHODONTIST None Some Many
PEDIATRICIAN None Some Many
PHARMACIST None Some Many
PHYSICAL THERAPIST None Some Many
PLASTIC SURGEON None Some Many
PODIATRIST None Some Many
PSYCHIATRIST None Some Many
PSYCHOLOGIST None Some Many
SCHOOL COUNSELOR None Some Many
SOCIAL WORKER None Some Many
Table 2. Demographic Information (N=130).
Mean SD [+ or -]
Age 20.1 [+ or -] 2.01 years
Weight 131.1 [+ or -] 21.32 pounds
Height 65.0 [+ or -] 2.79 inches
BMI 21.8 [+ or -] 2.97
Table 3: Rank Order of Mean [+ or -] S.E. of Willingness
Scores (N=130).
Smoking Cessation
FAMILY/PRIMARY CARE PHYSICIAN 1.6 [+ or -] 0.08
PSYCHOLOGIST 1.8 [+ or -] 0.09
NURSE 1.9 [+ or -] 0.08
PSYCHIATRIST 1.9 [+ or -] 0.09
MENTAL HEALTH THERAPIST 2.0 [+ or -] 0.10
NUTRITIONIST/ DIETITIAN 2.3 [+ or -] 0.10
SCHOOL COUNSELOR 2.3 [+ or -] 0.10
SOCIAL WORKER 2.5 [+ or -] 0.11
ATHLETIC COACH/TRAINER 2.6 [+ or -] 0.10
PEDIATRICIAN 2.6 [+ or -] 0.11
PHARMACIST 2.7 [+ or -] 0.09
ACUPUNCTURIST 2.7 [+ or -] 0.10
DENTIST 2.8 [+ or -] 0.10
GYNECOLOGIST 2.8 [+ or -] 0.10
DENTAL HYGIENIST 2.9 [+ or -] 0.10
CLERGYMAN 3.0 [+ or -] 0.09
DERMATOLOGIST 3.0 [+ or -] 0.10
PHYSICAL THERAPIST 3.1 [+ or -] 0.09
CHIROPRACTOR 3.3 [+ or -] 0.08
HAIR STYLIST 3.3 [+ or -] 0.09
ORTHODONTIST 3.3 [+ or -] 0.09
OPTOMETRIST/ OPTICIAN 3.4 [+ or -] 0.08
PLASTIC SURGEON 3.5 [+ or -] 0.08
PODIATRIST 3.6 [+ or -] 0.07
Eating Disorders
FAMILY/PRIMARY CARE PHYSICIAN 1.6 [+ or -] 0.08
MENTAL HEALTH THERAPIST 1.6 [+ or -] 0.08
PSYCHIATRIST 1.6 [+ or -] 0.08
PSYCHOLOGIST 1.6 [+ or -] 0.08
NUTRITIONIST/ DIETITIAN 1.6 [+ or -] 0.09
NURSE 1.9 [+ or -] 0.09
SCHOOL COUNSELOR 2.0 [+ or -] 0.08
ATHLETIC COACH/TRAINER 2.4 [+ or -] 0.09
SOCIAL WORKER 2.4 [+ or -] 0.10
GYNECOLOGIST 2.5 [+ or -] 0.10
PEDIATRICIAN 2.5 [+ or -] 0.11
CLERGYMAN 2.9 [+ or -] 0.09
ACUPUNCTURIST 3.0 [+ or -] 0.09
PHYSICAL THERAPIST 3.1 [+ or -] 0.09
PHARMACIST 3.2 [+ or -] 0.08
DENTAL HYGIENIST 3.2 [+ or -] 0.09
DENTIST 3.2 [+ or -] 0.09
DERMATOLOGIST 3.2 [+ or -] 0.09
CHIROPRACTOR 3.4 [+ or -] 0.07
ORTHODONTIST 3.4 [+ or -] 0.08
PLASTIC SURGEON 3.4 [+ or -] 0.08
HAIR STYLIST 3.5 [+ or -] 0.07
OPTOMETRIST/ OPTICIAN 3.5 [+ or -] 0.07
PODIATRIST 3.6 [+ or -] 0.07
Domestic Abuse
MENTAL HEALTH THERAPIST 1.6 [+ or -] 0.08
PSYCHOLOGIST 1.6 [+ or -] 0.08
PSYCHIATRIST 1.6 [+ or -] 0.09
SOCIAL WORKER 1.9 [+ or -] 0.09
FAMILY/PRIMARY CARE PHYSICIAN 2.0 [+ or -] 0.09
SCHOOL COUNSELOR 2.0 [+ or -] 0.09
NURSE 2.1 [+ or -] 0.09
CLERGYMAN 2.4 [+ or -] 0.10
GYNECOLOGIST 2.5 [+ or -] 0.10
PEDIATRICIAN 2.6 [+ or -] 0.11
ATHLETIC COACH/TRAINER 3.0 [+ or -] 0.09
NUTRITIONIST/ DIETITIAN 3.2 [+ or -] 0.08
ACUPUNCTURIST 3.2 [+ or -] 0.09
PHYSICAL THERAPIST 3.2 [+ or -] 0.09
CHIROPRACTOR 3.3 [+ or -] 0.08
DERMATOLOGIST 3.3 [+ or -] 0.08
PLASTIC SURGEON 3.4 [+ or -] 0.08
DENTAL HYGIENIST 3.5 [+ or -] 0.07
DENTIST 3.5 [+ or -] 0.07
HAIR STYLIST 3.5 [+ or -] 0.07
OPTOMETRIST/OPTICIAN 3.5 [+ or -] 0.07
ORTHODONTIST 3.5 [+ or -] 0.07
PHARMACIST 3.5 [+ or -] 0.07
PODIATRIST 3.6 [+ or -] 0.07
Smoking: Eating rho=.943 (p<.01)
Smoking: Abuse rho=.804 (p<.01)
Eating Disorder: Abuse rho=.892 (p<.01)
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