Date of Award


Document Type

Campus Access Dissertation


Health Services and Policy Management

First Advisor

Saundra H Glover


Researchers have documented the unmet need of oral health services for persons living with HIV/AIDS (PLWHA), especially in those that are African American. Untreated oral conditions can lead to systemic complications which may further compound the problems experienced by this vulnerable population. Given the lack of treatment of oral conditions in this population, it is necessary to know what health service organizations are doing to meet this need. However, the procedures that an organization uses to engage this population while addressing oral health needs has not been documented. The purpose of this study is to identify organizational characteristics that facilitate or prevent continuous patient engagement in oral health services.

DISS_para>The health services program that was evaluated in this study utilized a fully staffed mobile dental unit to provide services to PLWHA at a primary medical service organization in South Carolina. The patients who used the oral health services were concurrently engaged in regular medical care where they sought dental services. The priority population in this study is African Americans, as they have been reported to seek routine dental care less frequently as other subpopulations.

A case study analysis format was used, where data was collected using qualitative interviews (8 staff interviews, 16 patient interviews).The interviews were transcribed verbatim and analyzed using QSR NVivo software. An adapted version of the Systems Model for Clinical Preventive Care and published literature were used to guide the development of interview questions and categorization of responses. There were 17 themes that emerged as facilitators to continuous engagement in oral health services and nine themes emerged as barriers. Themes were categorized as system characteristics, service characteristics, reinforcing, and clinical staff characteristics or non-clinical staff characteristics.

Several suggestions to reduce or eliminate the organizational barriers have been made; additionally, an expansion of existing policies and programs to provide financial coverage for dental services is recommended. Health service professionals can use the findings of this study to develop and implement organization-wide strategies that will encourage continued engagement of PLWHA in oral health services.