Abstract
Due to the complexity of women's health issues that involve the interplay between oral and systemic health, a multidisciplinary approach to research and practice is critical to ensure health and quality of life among women across the lifespan. The 2nd Annual Conference entitled ‘Transforming Women's Health: Discovery, Development and Delivery of the Oral–Systemic Connection’, was held in Tampa (FL, USA) on 26–27 January 2013. The conference addressed complex oral–systemic women's health issues structured by three organizational pillars: discovery, development and delivery, with overarching topic areas of oral human papillomavirus infection, autoimmune conditions and the Affordable Care Act. This conference served as an effective method for bringing together multiple disciplines to discuss emerging women's health issues.
According to the NIH Office of Research on Women's Health (ORWH), approaches aimed at improving women's health are best served by collaborative research that facilitates the integration of clinical, translational, population, social and behavioral research [101]. With increased understanding of the complexity of diseases in women, particularly those associated with oral–systemic etiologies, the ORWH has identified oral–systemic health issues as a priority area for research [101].
In order to translate new, emerging topics from research to practice, conference organizers consulted with the Research and Practice Advisory Boards of the Center for Transdisciplinary Research on Women's Health (CTR-WH) to identify emerging issues related to women's oral–systemic health. Selection of issues was driven by epidemiologic evidence, practice-based needs and the timeliness of upcoming national health policy changes. Selected issues included:
Oral human papillomavirus (HPV);
Oral–systemic autoimmune conditions;
Impact of the Affordable Care Act (ACA) on women's oral–systemic health conditions.
Purpose of the conference
In an effort to overcome the gap between discipline-specific research and practice in women's oral–systemic health, the second annual Transforming Women's Health: Discovery, Development and Delivery conference was held in Tampa (FL, USA) on 26–27 January 2013. The conference aimed to address emerging oral–systemic health issues specific to women by assembling researchers, healthcare providers and policy experts in behavioral health, dentistry, medicine, nursing, public health and allied health professionals. The aims of the conference were to: discuss the oral–systemic connections in women's health; analyze emerging evidence-based research; incorporate or improve upon existing patient-centered care in practice; recognize barriers and potential strategies to incorporating oral–systemic health into women's health research, practice and policy; and explain the mechanisms through which they can provide collaborative care to women. Specifically, thought-provoking discussions included the following topics: the oral–systemic connection; the mechanisms through which professions can provide collaborative care to women; and future opportunities for research, policy and practice in women's health.
Conference program
The 2-day conference was organized around the three pillars of the University of South Florida's (USF; FL, USA) CTR-WH: discovery, development and delivery. The following describes conference the content organized by the program themes.
Discovery
Several national scholars presented the latest research pertaining to women's oral–systemic conditions; specific topics included oral HPV infection and oral–systemic autoimmune diseases, as identified by the CTR-WH's advisory boards. Each presentation theme was followed by question and answer sessions addressing facilitators and barriers to conducting research and practice within these content areas.
Dr Anna Giuliano, Chair of the Department of Cancer Epidemiology and Director of the Center for Infection Research in Cancer at Moffitt Cancer Center in Tampa, presented an overview of HPV-related cancers. An important aspect is that specific HPV-related cancers only or disproportionately affect women. Giuliano discussed the epidemiology of these conditions as well as the potential for prevention of HPV-related cancers among women through vaccination and screening.
Dr Bree Weaver, Assistant Research Professor of Medicine and Assistant Professor of Clinical Medicine and Pediatrics at Indiana University School of Medicine in Indianapolis (IN, USA), discussed oral HPV infections and other related noncancerous conditions, specifically among adolescents. She presented the current evidence of oral sex and other behaviors in the transmission of HPV to the oral cavity.
Dr Christine Pierce Campbell, Molecular and Genetic Epidemiology Postdoctoral Fellow at Moffitt Cancer Center in Tampa discussed the natural history of oral HPV infection and the risk of head and neck cancers. She described how understanding its history will inform cancer prevention efforts such a potential screening methods and aid in the identification of individuals with known and suspected risk factors for acquisition of oral HPV infection.
Dr Leticia Reyes, Research Assistant Professor, Department of Infectious Disease and Pathology at the University of Florida College of Veterinary Medicine in Gainesville (FL, USA) presented on the pathological processes for oral–systemic conditions and autoimmune diseases.
Aimee Busquet, Arthritis Advocate at the Arthritis Foundation (FL, USA), presented on the patient perspective of living with an autoimmune condition and the role of advocacy. Busquet characterized many persons living with autoimmune conditions as having an ‘invisible illness’ and recognized the need for empathy among providers who treat these patients. Her personal story of her battle for self-advocacy was a unique, patient-centered perspective presented at the conference.
Lastly, Deborah Cragun, a Nationally Board Certified Genetic Counselor and Doctoral Candidate at the USF College of Public Health in Tampa, presented on the role of genetics in autoimmune conditions. She described the evidence for multifactorial causes of autoimmune conditions and the challenges to diagnosing and treating these conditions. She also emphasized that the most appropriate way to overcome these challenges in practice and in research is to promote transdisciplinarity.
Development
Another objective of the ORWH is to promote recognition and understanding of women's health among future health professionals and scientists by informing the design of curricula with up-to-date research findings for use in educational materials for medical, dental, nursing and other professional training [101]. The conference included two presentations which described approaches for innovative strategies to build a well-trained, diverse women's health research workforce through cultivation of academic infrastructure.
Dr Ellen Daley, Associate Professor and Co-Director of the CTR-WH, and Laura Merrell, Doctoral Student at the USF College of Public Health, presented an overview of the development of women's health curriculum at USF using an interdisciplinary approach.
Dr Donna Petersen, Dean of the USF College of Public Health, reflected on the need for transdisciplinary research and practice in women's health. Petersen articulated the indispensable role that transdisciplinary research in women's health has on public health.
Delivery
The third arm of the conference program addressed the need for a multidisciplinary approach to the delivery of healthcare to women. Presentations were related to the intersection of policy and oral–systemic health with specific attention to the ACA. Dr Frank Catalanotto, Chair of the Department of Community Dentistry and Behavioral Science at the University of Florida College of Dentistry (FL, USA), presented on the oral health components of the ACA and implications for this legislation. He described oral health disparities on a state and national level and provided recommendations for health professionals to be passionate advocates regarding the inaccessibility of oral healthcare to vulnerable populations. Additionally, Dr Patrick Cannon, Health Advocate and Consultant, reported on general health policy changes that are to or have taken effect as a result of the ACA. He illustrated ways that the ACA will expand insurance coverage, as well as provided information regarding the health insurance marketplace.
Furthermore, skill-based workshops were presented in order to educate the audience on potential tools for practice, including Brief motivational interviewing and Health Literacy. Dr Rita DeBate, Professor and Co-Director of the CTR-WH, presented on brief motivational interviewing as an evidence-based patient-centered approach to behavior change in a brief clinical encounter. Brief motivational interviewing is a way to leave the responsibility for behavior change and the right to decide not to change with the patient through a Stages of Change Model [1,2]. Participants learnt the conceptual model of brief motivational interviewing, strategies for implementation, and methods for incorporating brief motivational interviewing into practice with case studies.
The second workshop, facilitated by Dr Sandra Vamos, Health Education Consultant at Innovative Health, Inc. (Vancouver, Canada), focused on the relevance and role of health literacy in relation to women's health. Specifically, her presentation reframed health literacy as an asset in professional practice, rather than the typified barrier to healthcare. The workshop applied strategies and addressed building capacity to help overcome barriers for health literacy in professional settings. Conference attendees utilized the newly developed Health Literacy Community Capacity Assessment Tool [G
Conclusion
The overall goal of the conference was to have a forum supporting the discovery, development, and delivery of pertinent oral–systemic health issues affecting women's overall health and quality of life. This goal was successfully achieved and contributed to the fluidity of research by moving from research-based findings to practice-based discussions. It is critical that the research-to-practice gap is addressed by multiple stakeholders, and transdisciplinary approaches are understood and institutionalized [3]. Furthermore, this conference facilitated the establishment of partnerships among researchers and practitioners from differing disciplines in order to promote these ideals moving forward. As new oral–systemic health issues emerge, there will be a continued need to conduct this conference in order to examine these issues through a transdisciplinary lens and to established integrated efforts that translate research findings to practice.
Future perspective
It is anticipated by the conference organizers, that a transdisciplinary approach will be embraced by the women's health research and practice community in order to successfully address oral–systemic conditions that disproportionately affect women. Furthermore, continuation of this conference is essential in order to develop and reinvigorate the dialogue among stakeholders in preparation for transdisciplinary work.
Financial & competing interests disclosure
This conference was supported by the Agency for Health Care Research and Quality Small Grant Program for Conference Support R13 (grant number: 1R13HS021832), and the University of South Florida College of Public Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.