title: Nurse Practitioners' Use of Communication Techniques: Results of a Maryland Oral Health Literacy Survey.
abstract: OBJECTIVE
  We examined nurse practitioners' use and opinions of recommended communication techniques for the promotion of oral health as part of a Maryland state-wide oral health literacy assessment. Use of recommended health-literate and patient-centered communication techniques have demonstrated improved health outcomes.
  
  
  METHODS
  A 27-item self-report survey, containing 17 communication technique items, across 5 domains, was mailed to 1,410 licensed nurse practitioners (NPs) in Maryland in 2010. Use of communication techniques and opinions about their effectiveness were analyzed using descriptive statistics. General linear models explored provider and practice characteristics to predict differences in the total number and the mean number of communication techniques routinely used in a week.
  
  
  RESULTS
  More than 80% of NPs (N = 194) routinely used 3 of the 7 basic communication techniques: simple language, limiting teaching to 2-3 concepts, and speaking slowly. More than 75% of respondents believed that 6 of the 7 basic communication techniques are effective. Sociodemographic provider characteristics and practice characteristics were not significant predictors of the mean number or the total number of communication techniques routinely used by NPs in a week. Potential predictors for using more of the 7 basic communication techniques, demonstrating significance in one general linear model each, were: assessing the office for user-friendliness and ever taking a communication course in addition to nursing school.
  
  
  CONCLUSIONS
  NPs in Maryland self-reported routinely using some recommended health-literate communication techniques, with belief in their effectiveness. Our findings suggest that NPs who had assessed the office for patient-friendliness or who had taken a communication course beyond their initial education may be predictors for using more of the 7 basic communication techniques. These self-reported findings should be validated with observational studies. Graduate and continuing education for NPs should increase emphasis on health-literate and patient-centered communication techniques to increase patient understanding of dental caries prevention. Non-dental healthcare providers, such as NPs, are uniquely positioned to contribute to preventing early childhood dental caries through health-literate and patient-centered communication.
authors.affiliation: Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States of America.
authors.forename: Laura W
authors.initials: LW
authors.lastname: Koo
authors.affiliation: Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, MD, United States of America.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Horowitz
authors.affiliation: Office of the Dean, School of Public Health, University of Maryland College Park, College Park, MD, United States of America.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Radice
authors.affiliation: Department of Behavioral and Community Health, School of Public Health, University of Maryland College Park, College Park, MD, United States of America.
authors.forename: Min Q
authors.initials: MQ
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland College Park, College Park, MD, United States of America.
authors.forename: Dushanka V
authors.initials: DV
authors.lastname: Kleinman
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D057220:Health Literacy / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009722:Nurse Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D009909:Oral Health