{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:18:01Z","timestamp":1781659081252,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"crossref","award":["5R21DE024272"],"award-info":[{"award-number":["5R21DE024272"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Dental Education"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Successfully educating dental providers and patients about the link between human papillomavirus (HPV) and oropharyngeal cancer requires coordinated efforts to increase HPV\u2010related prevention practices. The aim of this study was to identify, using a systems perspective, the multi\u2010level determinants related to how dental providers can promote HPV prevention in dental practices. Data for this qualitative study were collected in 2015\u201016 from focus groups with dentists (four focus groups, n=33), focus groups with dental hygienists (four focus groups, n=48), and in\u2010depth interviews with dental opinion leaders (n=13). Results were triangulated and mapped along micro, meso, and macro system levels. At the micro level, participants identified patient characteristics and low self\u2010efficacy as influential determinants when discussing HPV prevention. At the meso level, relationships among dentists, dental hygienists, and the physical practice environment were factors affecting dental providers' HPV prevention efforts. At the macro level, professional organizations impacted how dental providers interacted with their patients on this topic. These results suggest that improving HPV prevention among dental providers requires a multi\u2010level approach that considers the distinctive context of dental settings, dental training, and perceptions of professional roles. The findings suggested that the macro\u2010 and meso\u2010level determinants may be challenging to modify due to the distinctive culture and practice models of dentistry. Nevertheless, the association between HPV and oral cancer requires an expansion of prevention strategies used in dental practices. Improving dental providers' self\u2010efficacy to communicate HPV prevention through continuing education and integration of skill\u2010guided training in dental and dental hygiene curricula could facilitate this process.<\/jats:p>","DOI":"10.21815\/jde.019.019","type":"journal-article","created":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T18:31:15Z","timestamp":1558031475000},"page":"161-172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The Role of Dental Providers in Preventing HPV\u2010Related Diseases: A Systems Perspective"],"prefix":"10.1002","volume":"83","author":[{"given":"Ellen M.","family":"Daley","sequence":"first","affiliation":[{"name":"Department of Community and Family Health"},{"name":"College of Public Health University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl A.","family":"Vamos","sequence":"additional","affiliation":[{"name":"Department of Community and Family Health College of Public Health University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Health Systems School of Public Health University of North Texas Health Science Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coralia","family":"V\u00e1zquez\u2010Otero","sequence":"additional","affiliation":[{"name":"Department of Community and Family Health College of Public Health University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey B.","family":"Griner","sequence":"additional","affiliation":[{"name":"Department of Community and Family Health College of Public Health University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Merrell","sequence":"additional","affiliation":[{"name":"Department of Health Sciences James Madison University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nolan","family":"Kline","sequence":"additional","affiliation":[{"name":"Department of Anthropology Rollins College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Walker","sequence":"additional","affiliation":[{"name":"Zimmerman School of Advertising &amp; Mass Communications University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelise","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Restorative Dental Sciences College of Dentistry University of Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Petrila","sequence":"additional","affiliation":[{"name":"Meadows Mental Health Policy Institute  Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2]]},"reference":[{"issue":"26","key":"e_1_2_8_2_1","first-page":"667","article-title":"Human papilloma\u2010virus\u2010associated cancers, United States, 2008\u201012","volume":"65","author":"Viens LJ","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2011.0298"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.6995"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv086"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.36.4596"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22963"},{"issue":"12","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1158\/0008-5472.CAN-14-2843","article-title":"NHANES 2009\u201012 findings: association of sexual behaviors with higher prevalence of oral oncogenic human papillomavirus infections in U.S. men","volume":"75","author":"Chaturvedi AK","year":"2015","journal-title":"Cancer Res"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2017.07.032"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ebd.6400252"},{"key":"e_1_2_8_11_1","first-page":"300","article-title":"Use of 9\u2010valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices","volume":"64","author":"Petrosky E.","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23764"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6533a4"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2015.1129090"},{"key":"e_1_2_8_15_1","unstructured":"National Center for Health Statistics.Health United States 2016: with chartbook on long\u2010term trends in health. 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