Reducing oral health disparities in children using predictive analytics and mathematical modeling
使用预测分析和数学模型减少儿童口腔健康差异
基本信息
- 批准号:10548840
- 负责人:
- 金额:$ 12.68万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-01-10 至 2023-11-30
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Project Summary
Tooth decay is the most common chronic disease among U.S. children.2,3 Despite efforts to increase utilization
among minority populations by improving coverage for dental insurance via Medicaid and Children’s Health
Insurance Program (CHIP), large oral health disparities remain with Black and Hispanic children having the
poorest oral health of any racial groups in the US.5-8 In addition to lack of access to recommended care, individual
health behaviors (e.g., poor dietary and oral hygiene) and community- and provider-related structural factors
also contribute to the high risk of severe dental caries in minority populations.6,9 State Medicaid and CHIP dental
programs are encouraged to consider strategies to reduce oral health disparities in their delivery system
improvement efforts,6 however, they are challenged with improving quality and reducing quality disparities among
high-need beneficiaries in a cost-effective way.6 Steps toward successful program improvements include the
ability to validly measure the value of care (defined by both health outcomes and costs) delivered to their
beneficiaries, as well as incorporating racial/ethnic disparities in the assessment. There is a critical gap in our
understanding of the influence of race/ethnicity and its interaction with multilevel risk factors on disparities in
quality and oral health outcomes. The scientific objective of this research plan is to study multilevel determinants
of oral health and disparities in quality of dental care and assess the value of improving care and eliminating
racial/ethnic disparities in quality. In Aim 1, we will develop a risk prediction model of severe dental caries by
applying machine-learning based survival analysis4,10 on electronic health record (EHR) data to understand the
influence of race/ethnicity on progression of severe caries and explore heterogenous treatment effects of dental
care. In Aim 2, we will analyze individual-level claims in Medicaid Analytic eXtract (MAX) data combined with
multiple data sources to comprehensively measure racial/ethnic disparities in overall quality of dental care, using
evidence-based quality indicators, and identify modifiable structural risk factors creating disparities. In Aim 3,
incorporating results from Aims 1 and 2, a microsimulation model of severe caries, integrating individual-level
data with data on key contextual factors, will be developed and used to assess the cost-effectiveness and value
of improvements in care stemming from dental quality measures and eliminating racial/ethnic disparities in
quality. Findings from this study will support decision-making by policymakers and stakeholders, and will form
the basis of an R01 application to study novel strategies that target underserved and vulnerable populations.
This research plan is complemented by a career development plan that builds on the applicant’s background in
health policy and decision science. Specifically, this career development plan outlines new training in three
areas: (1) oral health epidemiology, (2) health disparities research, and (3) advanced analytics methods. The
combined research and training plan will prepare the applicant for a successful independent research career
identifying, evaluating, and implementing multilevel interventions to reduce racial/ethnic disparities in oral health.
项目摘要
蛀牙是美国儿童中最常见的慢性疾病。2,3尽管努力增加利用率
通过医疗补助和儿童健康改善牙科保险的承保范围,在少数群体中
保险计划(CHIP),大口腔健康差异仍然存在,黑人和西班牙裔儿童
美国任何种族群体的口腔健康状况最差。5-8除了无法获得推荐护理,个人
健康行为(例如,饮食和口腔卫生差)以及社区以及与提供者相关的结构因素
也有助于少数族裔的高风险。6,9州医疗补助和芯片牙齿
鼓励计划考虑减少其交付系统中口腔健康分布的策略
改进工作,6然而,他们面临着提高质量和降低质量差异的挑战
以具有成本效益的方式进行高层受益人。6成功的计划改进的步骤包括
能够有效衡量提供给他们的护理价值(由健康成果和成本定义)
受益人以及评估中的种族/种族差异。我们有关键的差距
了解种族/种族的影响及其与多层次风险因素对分布的相互作用
质量和口腔健康结果。该研究计划的科学目标是研究多级决定者
口腔健康和牙科护理质量差异和评估改善护理和消除的价值
种族/种族质量差异。在AIM 1中,我们将通过
在电子健康记录(EHR)数据上应用基于机器学习的生存分析4,10了解
种族/民族对严重龋齿进展的影响并探索牙齿的异源治疗效果
关心。在AIM 2中,我们将分析医疗补助分析提取物(MAX)数据中的个人级别主张
多种数据源可全面衡量牙科护理总体质量的种族/种族分布,使用
基于证据的质量指标,并确定可修改的结构性风险因素造成差异。在AIM 3中,
合并AIM 1和2的结果,这是严重携带的微仿真模型,整合了个体级别
与关键上下文因素有关的数据,将开发并用于评估成本效益和价值
牙科质量措施的改善,并消除种族/种族差异
质量。这项研究的结果将支持决策者和利益相关者的决策,并将形成
R01应用于研究针对服务不足和脆弱人群的新型策略的基础。
该研究计划由一项职业发展计划完成,该计划以申请人的背景为基础
卫生政策和决策科学。具体而言,该职业发展计划概述了三个新培训
区域:(1)口腔健康流行病学,(2)健康差异研究和(3)高级分析方法。
联合研究和培训计划将使申请人为成功的独立研究职业做好准备
识别,评估和实施多层次干预措施,以减少口腔健康中的种族/种族差异。
项目成果
期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Analysis of Race and Ethnicity, Socioeconomic Factors, and Tooth Decay Among US Children.
- DOI:10.1001/jamanetworkopen.2023.18425
- 发表时间:2023-06-01
- 期刊:
- 影响因子:13.8
- 作者:Choi, Sung Eun;White, Joel;Mertz, Elizabeth;Normand, Sharon-Lise
- 通讯作者:Normand, Sharon-Lise
共 1 条
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Sung Eun Choi的其他基金
Reducing oral health disparities in children using predictive analytics and mathematical modeling
使用预测分析和数学模型减少儿童口腔健康差异
- 批准号:1034514010345140
- 财政年份:2022
- 资助金额:$ 12.68万$ 12.68万
- 项目类别:
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