Broader connections for border care
By Kristen Zapata
For over 50 years, the School of Dentistry has been a critical player in community outreach in San Antonio and South Texas. Every year, the school weaves community engagement opportunities into its academic and patient care curriculums.
A new grant from the Valley Baptist Legacy Foundation made one new opportunity possible in fall 2022: a program to expand the school’s reach into vulnerable patient populations in the Rio Grande Valley of South Texas by partnering with community health workers, also known as promotoras. Certified by the State of Texas, the community health workers in the program will share specially tailored oral health information for the clients they serve.
A significant population of adults residing in the Rio Grande Valley region are uninsured and living at or under the poverty threshold. As part of their mission, community health workers — including nurses and social workers — root themselves within the communities, establishing personal relationships to earn their clients’ trust and foster a positive health care experience. Workers partner with their clients to identify health needs and provide guidance and resources for their care.
According to the United States Census Bureau, the average rate of poverty is 38% in the Rio Grande Valley, with 37.5% of adults lacking medical insurance. Greater still is a lack of dental insurance, which severely impacts access to oral health care.
“Most oral disease is preventable,” said Juanita Lozano-Pineda, DDS, MPH, associate dean for external affairs and associate professor of comprehensive dentistry. “If we can educate non-dental health professionals to conduct oral health screenings, provide them materials to educate their clients on oral health and connect them with local dentists, we can improve clients’ overall health outcomes.”
To accomplish this, the program, directed by Lozano-Pineda, will roll out a three-phase approach over the next two years. Phase one, taking place this winter, establishes a new relationship with community health agencies in the Rio Grande Valley to discover what educational information would best suit health workers’ clients. For example, residents who are pregnant, have diabetes or chronic asthma would receive specialized oral health information referencing their respective conditions.
Understanding the health issues facing each health agency will enable the program to customize educational information for each group, such as brochures, flip charts and other visual aids, which will help clients to better understand the relationship between their oral health and overall health. The program will also create educational tools in English and Spanish, since 78.4% of residents in the area speak a language other than English at home and 92% of the population is Hispanic, according to the Census Bureau.
In spring 2023, phase two of the program will take dental faculty and students to the South Texas region to teach health workers how to conduct an oral health screening and how to calculate a client’s risk for urgent care. Predental students attending The University of Texas Rio Grande Valley will volunteer alongside UT Health San Antonio dental faculty and students to provide oral health instruction to agency workers. The oral screening data collected will be evaluated to better assess the health needs of the communities served and tailor long-term program goals.
“It is very important for us to train community health providers to recognize oral disease,” said Peter M. Loomer, DDS, PhD, professor and dean of the School of Dentistry. “They have access to people who do not have dental insurance or have never seen a dentist. With their help, we will have a greater impact, improving oral health in the Valley.”
The School of Dentistry’s mobile dental clinic will be used to kick off the third and final phase of the program, which will address the immediate needs of clients who require urgent care. The mobile clinic will travel from San Antonio to the Rio Grande Valley with the school’s dental team ready to provide services. Partnerships with local dental professionals through professional dental organizations will be sought for follow-up and routine care.
Lozano-Pineda said she is confident that making these important interprofessional connections will make a lasting difference.
“We hope to provide nurses, social workers and community health professionals a better awareness of oral health and when and how to refer their clients to local dentists,” she said. “In turn, we will be better able to understand the unmet oral health needs of the population to make sure we can support their continued work.”
Although the School of Dentistry currently conducts clinical rotations and mission trips in South Texas to provide clinical services and preventive oral health education materials, this new initiative will allow for greater access to the region’s non-dental professionals.
“All health workers play a critical role in improving oral health,” Lozano-Pineda said.