Publications by authors named "Sergio Chrisopoulos"

11 Publications

  • Page 1 of 1

Are trust and satisfaction similar in dental care settings?

Community Dent Oral Epidemiol 2020 12 26;48(6):480-486. Epub 2020 Jun 26.

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.

Objectives: Trust and satisfaction in dental care settings are salient constructs to operationalize the concept of dentist-patient relationships (DPR). This study aimed to compare the similarity of both constructs with regard to factor structure and revise the scales for better psychometric properties.

Methods: Data analysed in the study were collected in self-complete questionnaires from a random sample of 4011 adults living in South Australia. Trust and satisfaction were assessed using the Dentist Trust Scale and the Dental Care Satisfaction scale. Items in the scales were initially examined with a split-half sample in exploratory factor analysis and cluster analysis. Factor structures of different model designs were tested on the other half sample in confirmatory factor analysis. The final model was cross-validated on the first half sample for structural invariance.

Results: Exploratory factor analysis revealed a three-factor structure consisting of 'trust', 'satisfaction' and 'distrust/dissatisfaction' (60.2% of the variance explained; Cronbach's α = 0.94, 0.81, 0.73, respectively). Cluster analysis supported the factor solution with the same three major clusters except for a single-item independent branch of the 'cost' domain from the satisfaction scale. The final model was designed with two correlated but distinct factors, 'trust' and 'satisfaction', with the modification of one inter-item covariance and deleting the least associated item (GFI = 0.96, CFI = 0.98, RMSEA = 0.06). The stability of the final model was achieved through cross-validation (P = .143, ∆CFI < 0.001).

Conclusions: Trust and satisfaction in dental care settings are unidimensionally different yet highly correlated factors concurrently. Demonstrating the discriminant and complementary functions of both constructs can justify the rationale to apply them together in further studies for DPR.
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http://dx.doi.org/10.1111/cdoe.12559DOI Listing
December 2020

Oral hygiene behaviours among Australian adults in the National Study of Adult Oral Health (NSAOH) 2017-18.

Aust Dent J 2020 06;65 Suppl 1:S79-S84

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, SA, Australia.

Background: This paper examines oral hygiene behaviours (tooth brushing, mouthwash use and dental floss) by a range of explanatory variables.

Methods: Explanatory variables included age, sex, region, income, area-based SES, dental insurance and visiting pattern. The data reported were collected in the interview survey in NSAOH 2017-18.

Results: A higher percentage of females brushed with toothpaste at least daily (98.0%) and used floss in the last week (62.6%) than males (94.6% and 48.5% respectively). There was an income gradient in tooth brushing. Higher percentages brushed in the high income (96.8%) than middle (96.2%) and low-income tertiles (93.6%). A higher percentage of the high-income tertile (58.2%) flossed than the lower tertile (53.3%). Those with unfavourable visit patterns had lower percentages who brushed daily (92.7%) than the intermediate (96.7%) or favourable (98.2%) groups. There was a gradient in flossing by visiting, with a lower percentage flossing for the unfavourable visiting group (38.5%) than for the intermediate (52.8%) or favourable groups (67.6%).

Conclusions: Oral hygiene behaviours were associated with gender, socioeconomic status and dental visiting. A higher percentage of women brushed and flossed than men. Lower socioeconomic status and those with unfavourable visiting patterns had lower frequencies of brushing and flossing.
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http://dx.doi.org/10.1111/adj.12769DOI Listing
June 2020

National Study of Adult Oral Health 2017-18: Study design and methods.

Aust Dent J 2020 06;65 Suppl 1:S5-S10

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.

The National Study of Adult Oral Health (NSAOH) is Australia's third national oral examination survey of a representative sample of Australian adults. The study was undertaken primarily to describe levels of oral health in the population and to describe trends since the first survey, conducted in 1987-88. The aim of the study was to complete 7,200 examinations, necessitating approximately 15,200 completed interviews. Survey participants were selected using a multi-stage probability sampling design that began with the sampling of postcodes within states/territories in Australia. Individuals within selected postcodes were then selected by the Australian Government Department of Human Services (DHS) from the Medicare database. Following an initial opt-out period, participants were given the option to either complete the questionnaire online or to complete the questionnaire via a computer-assisted telephone interview. Participants were asked a series of questions about their oral health and dental service use and those who reported having one or more of their own natural teeth were invited to undergo a standardised oral examination. Examinations were conducted by state/territory dental practitioners who underwent prior training and calibration in survey procedures by the Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide.
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http://dx.doi.org/10.1111/adj.12758DOI Listing
June 2020

National Study of Adult Oral Health 2017-18: participation and representativeness.

Aust Dent J 2020 06;65 Suppl 1:S11-S17

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.

The National Study of Adult Oral Health (NSAOH) 2017-18 collected information from a sample of the Australian population aged 15 years and over. The Study comprised an interview questionnaire, completed by telephone or online, and an oral epidemiological examination among dentate participants. Participation in the Study was voluntary and therefore relied on the goodwill of selected participants. This paper provides a summary of participation rates for the Interview and Examination phases of the study. The potential for biased population estimates due to variation in participation rates is explored. The weighting procedure implemented to ensure the sample is representative of the target population is described and a comparison of the estimated population distributions derived from the weighted sample and the actual population distributions is provided for a range of socioeconomic characteristics. In summary, it can be concluded that estimates derived from the weighted Interview and Examination samples are valid estimates of the Australian population aged 15 years and over.
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http://dx.doi.org/10.1111/adj.12759DOI Listing
June 2020

Oral health impacts among Australian adults in the National Study of Adult Oral Health (NSAOH) 2017-18.

Aust Dent J 2020 06;65 Suppl 1:S59-S66

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.

Background: This paper examines oral health impacts of toothache experience, self-rated oral health (SROH), being uncomfortable with dental appearance, and avoiding foods in the Australian adult population.

Methods: The explanatory variables include age, sex, region, income, area-based SES, dental insurance and visiting pattern. The data were collected in the interview in NSAOH 2017-18.

Results: There were lower percentages with: toothache in the highest (14.8%) than middle (21.2%) and lower income tertiles (25.2%); fair/poor SROH in the highest (15.8%) than middle (24.1%) and lower tertiles (34.8%); uncomfortable with appearance in the highest (29.1%) than middle (35.3%) and lower tertiles (42.2%); and food avoidance in the higher (15.3%) than middle (22.9%) and lower tertiles (34.4%). There were higher percentages with: toothache in the unfavourable (32.2%) than intermediate (23.1%) and favourable (11.7%) visiting groups; fair/poor SROH in the unfavourable (44.0%) than intermediate (27.4%) or favourable (10.2%) groups; being uncomfortable about appearance in the unfavourable (47.6%) than intermediate (39.5%) or favourable (25.8%) groups; and avoiding foods in the unfavourable (34.8%) than intermediate (26.0%) or favourable (14.5%) groups.

Conclusions: Socioeconomic status and dental visiting were associated with oral health impacts. Oral health impacts were worse for those with lower income and unfavourable visiting patterns.
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http://dx.doi.org/10.1111/adj.12766DOI Listing
June 2020

Use of dental services among Australian adults in the National Study of Adult Oral Health (NSAOH) 2017-18.

Aust Dent J 2020 06;65 Suppl 1:S71-S78

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.

Background: This study examines last dental visit (visiting within the last 12 months, having a last visit 5 or more years ago, attending a private dental practice) and usual visit (usually visiting for a check-up, having a dentist they usually attend).

Methods: Explanatory variables include age, gender, region, income, area-based SES and dental insurance. The data were collected in the Interview in NSAOH 2017-18.

Results: There was a dental visiting gradient by region, with lower percentages visiting in the last 12 months in remote (44.9%) and regional areas (50.8%) than major cities (58.7%). A higher percentage of the higher-income tertile made visits (63.8%) than the middle (53.7%) and lower tertiles (49.9%). There was a visiting gradient by area-based SES, with higher percentages in the higher (63.8%) and middle SES tertiles (55.2%) than the lower tertile (50.2%). Uninsured persons had lower percentages visiting (43.3%) than insured (69.7%).

Conclusions: Persons in remote locations, those with low socioeconomic status and those uninsured were disadvantaged in terms of access. They had lower percentages visiting in the last 12 months, usually visiting for a check-up, having a dentist they usually attend and higher percentages visiting 5 or more years ago.
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http://dx.doi.org/10.1111/adj.12768DOI Listing
June 2020

Dentist-patient relationships and oral health impact in Australian adults.

Community Dent Oral Epidemiol 2020 08 13;48(4):309-316. Epub 2020 Apr 13.

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.

Objectives: Dentist-patient relationships (DPRs) are a key component in clinical encounters with potential benefits for oral health outcomes. This study aimed to investigate whether better DPR variables are associated with higher oral health-related quality of life (OHRQoL).

Methods: A total of 12 245 adults aged 18 years or over were randomly sampled from South Australia in 2015-2016. Data were collected from self-complete questionnaires and analysed as a cross-sectional design. The outcome variable was the Oral Health Impact Profile (OHIP-14). Explanatory DPR variables included trust in dentists, satisfaction with dental care, and dental fear. Covariates comprising oral health behaviours, dental services, demographics, and socioeconomic status were included as potential confounding variables. Bivariate correlation analyses and multivariable linear regression were performed for the associations among explanatory, outcome variables and other covariates.

Results: Response data were analysed from 4220 participants (response rate = 41.9%). Unadjusted mean total scores of DPR variables and OHIP-14 were associated with most of the study participants' characteristics (P < .05). Bivariate correlations among DPR variables and OHIP-14 showed a diverse range of coefficients (|r| or |ρ|=0.22-0.67). Multivariable regression analyses in both individual/clustered block entry and full model indicated that higher satisfaction and less dental fear (B = -0.039 and 0.316, respectively in the full model) were associated with lower OHIP-14 after adjusting for possible confounders (P < .01).

Conclusions: This study found that favourable DPR variables, mainly greater satisfaction and less dental fear are positively associated with better OHRQoL. Further studies are warranted to investigate the causality and mediation/moderation of DPR variables on oral health outcomes.
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http://dx.doi.org/10.1111/cdoe.12534DOI Listing
August 2020

The Life Story Experience of "Migrant Dentists" in Australia: Potential Implications for Health Workforce Governance and International Cooperation.

Int J Health Policy Manag 2017 06 1;6(6):317-326. Epub 2017 Jun 1.

Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia.

Background: The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration.

Methods: A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale.

Results: A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years.

Conclusion: Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward.
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http://dx.doi.org/10.15171/ijhpm.2016.135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5458793PMC
June 2017

Characteristics and practice profiles of migrant dentist groups in Australia: implications for dental workforce policy and planning.

Int Dent J 2015 Jun 11;65(3):146-55. Epub 2015 Feb 11.

Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia.

Introduction: Migrants comprise a growing proportion of the dental workforce in Australia. To date, research on migrant dentists is limited, raising policy questions regarding the motivations for migration, demographic profiles and work patterns. The purpose of this paper was to present findings from the first national survey of migrant dentists in Australia.

Methods: All dentists with a primary dental qualification from an overseas institution and registered with the Australian Dental Association (n=1,872) or enrolled as a graduate student in any of the nine dental schools in Australia (n=105) were surveyed between January and May 2013.

Results: A total of 1,022 participants (response rate=54.5%) were classifiable into three migrant dentist groups: direct recognition (n=491); Australian Dental Council (ADC) (n=411); and alternative pathway (n=120). Overall, 41.8% of migrant dentists were female. More than half of the ADC group (54.1%) were from lower middle income countries. The most frequent motivation for migration according to the direct recognition group (21.1%) was 'adventure', whereas other groups migrated for 'better opportunity'. The majority of ADC respondents (65%) were under 45 years of age, and a larger proportion worked in the most disadvantaged areas (12.4%), compared with other groups. Gender, marital status, years since arrival in Australia and having children varied between the groups (chi square; P<0.05).

Conclusion: Dentist groups migrate to Australia for different reasons. The large proportion of the migrant dentist workforce sourced from lower middle income countries points towards deficiencies in oral health systems both for these countries and for Australia. The feminisation of the migrant dentist profile could in future affect dentist-practice activity patterns in Australia. Further research, especially on the settlement experiences of these dentists, can provide better insights into issues faced by these dentists, the nature of support that migrant dentists receive in Australia, the probable future patterns of work and potential impact on the dental workforce and dental service provision.
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http://dx.doi.org/10.1111/idj.12154DOI Listing
June 2015

Trends in dental visiting avoidance due to cost in Australia, 1994 to 2010: an age-period-cohort analysis.

BMC Health Serv Res 2013 Oct 3;13:381. Epub 2013 Oct 3.

Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, 5005 Adelaide, South Australia, Australia.

Background: The cost of dental care may be a barrier to regular dental attendance with the proportion of the Australian population avoiding or delaying care due to cost increasing since 1994. This paper explores the extent to which age, period and cohort factors have contributed to the variation in avoiding or delaying visiting a dentist because of cost.

Methods: Data were obtained from four national dental telephone interview surveys of Australian residents aged five years and over conducted in 1994, 1999, 2004 and 2010 (response rates 48%-72%). The trend in the percentage of persons avoiding or delaying visiting a dentist because of cost was analysed by means of a standard cohort table and more formal age-period-cohort analyses using a nested models framework.

Results: There was an overall increase in the proportion of people avoiding or delaying visiting a dentist indicating the presence of period effects. Financial barriers were also associated with age such that the likelihood of avoiding because of cost was highest for those in their mid-late twenties and lowest in both children and older adults. Cohort effects were also present although the pattern of effects differed between cohorts.

Conclusion: The findings of this study suggest that, in addition to the increase in costs associated with dental care, policies targeting specific age groups and income levels may be contributing to the inequality in access to dental care.
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http://dx.doi.org/10.1186/1472-6963-13-381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3851774PMC
October 2013

Productivity losses from dental problems.

Aust Dent J 2012 Sep;57(3):393-7

Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide SA 5005, Australia.

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http://dx.doi.org/10.1111/j.1834-7819.2012.01718.xDOI Listing
September 2012