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Factors associated with dentists’ intent to stay at current community health center long-term
Thesis   Open access

Factors associated with dentists’ intent to stay at current community health center long-term

McAllister Castelaz
University of Iowa
Master of Science (MS), University of Iowa
Spring 2024
DOI: 10.25820/etd.007440
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Abstract

Disparities in access to dental care persist in the United States. Community health centers (CHCs) are a part of the dental safety net that provides care to those who face significant access barriers. Increasing reports of dentist burnout and declining interest in public health careers raise concerns regarding clinician shortages in CHCs. The purpose of this research project is to identify factors related to dentists’ intent to continue working in their current CHC long-term. The data source was a 2021 workforce survey conducted by the National Network for Oral Health Access (NNOHA). This online survey was distributed to NNOHA listerserv subscribers, NNOHA members, as well as promoted during the 2021 Annual NNOHA Conference. The study sample included dentists currently employed in a CHC. The dependent variable was dentists’ intent to stay at their current CHC long-term, which was categorized as more than seven years or less than or equal to seven years. A set of 48 independent variables of interest were categorized into four domains: organizational aspects, individual perceptions, individual motivators, and individual characteristics. Descriptive and bivariate analyses were performed, and a final multivariable model was developed. The final study sample included 248 dentists. In the final multivariable model, dentists in a leadership position had 3.7 times the odds of intending to stay at their current CHC compared to staff dentists. Additionally, dentists with a high level of professional autonomy had over 2.5 times the odds to intend to stay compared to those who reported low to moderate level of professional autonomy. While not statistically significant, dentists who reported good or excellent support of the dental team during the COVID-19 pandemic demonstrated a positive association with intent to stay compared to those who had less than good support, and those who did not consider a change in employment due to COVID-19 demonstrated a positive association with the intention to stay compared to those who did consider a change. Dentists’ autonomy and role were significantly associated with intent to stay at their community health centers. However, length of time in clinical practice was not found to be significantly associated with intent to stay. Additionally, factors often associated with recruiting mechanisms, such as identifying individuals interested in providing care in a community-based environment, loan repayment opportunities, or benefits packages were not associated with an intent to stay at their health center long-term. Understanding the difference between recruitment strategies and retention strategies is important for health centers as the work to fulfill their organizational mission to provide equitable access to dental care in their communities.

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