title: Health literacy environmental scans of community-based dental clinics in Maryland.
abstract: OBJECTIVE
  We conducted health literacy environmental scans in 26 Maryland community-based dental clinics to identify institutional characteristics and provider practices that affect dental services access and dental caries education.
  
  
  METHODS
  In 2011-2012 we assessed user friendliness of the clinics including accessibility, signage, facility navigation, educational materials, and patient forms. We interviewed patients and surveyed dental providers about their knowledge and use of communication techniques.
  
  
  RESULTS
  Of 32 clinics, 26 participated. Implementation of the health literacy environmental scan tools was acceptable to the dental directors and provided clinic directors with information to enhance care and outreach. We found considerable variation among clinic facilities, operations, and content of educational materials. There was less variation in types of insurance accepted, no-show rates, methods of communicating with patients, and electronic health records use. Providers who had taken a communication skills course were more likely than those who had not to use recommended communication techniques.
  
  
  CONCLUSIONS
  Our findings provide insight into the use of health literacy environmental scan tools to identify clinic and provider characteristics and practices that can be used to make dental environments more user friendly and health literate.
authors.affiliation: Alice M. Horowitz and Min Qi Wang are with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Dushanka V. Kleinman is with the Department of Epidemiology and Biostatics, School of Public Health, University of Maryland, College Park. Catherine Maybury and Sarah D. Radice are with the Office of the Dean, School of Public Health, University of Maryland, College Park. Wendy Child is an independent consultant, College Park, MD. Rima E. Rudd is with the Department of Social and Behavioral Science, Harvard School of Public Health, Harvard University, Boston, MA.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Horowitz
authors.forename: Catherine
authors.initials: C
authors.lastname: Maybury
authors.forename: Dushanka V
authors.initials: DV
authors.lastname: Kleinman
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Radice
authors.forename: Min Qi
authors.initials: MQ
authors.lastname: Wang
authors.forename: Wendy
authors.initials: W
authors.lastname: Child
authors.forename: Rima E
authors.initials: RE
authors.lastname: Rudd
mesh_terms: D003149:Community Dentistry / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data; D003731:Dental Caries / Q000517:prevention & control; D003740:Dental Clinics / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000379:methods / Q000706:statistics & numerical data; D006272:Health Facility Environment / Q000379:methods / Q000706:statistics & numerical data*; D057220:Health Literacy / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008123:Location Directories and Signs; D008297:Male; D008396:Maryland / Q000453:epidemiology; D009909:Oral Health