PREVENTION OF EARLY CHILDHOOD CARIES IN MEDICAL PRACTICE

在医疗实践中预防幼儿龋齿

• 批准号: 6516640
• 负责人: RICHARD GARY ROZIER
• 金额: $ 51.7万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-15 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6516640
• 关键词: dental caries; health education; human data; human subject; human therapy evaluation; interview; low socioeconomic status; oral health; patient oriented research; preschool child (1-5); preventive dentistry; quality of life

The purpose of this research is to evaluate an already funded and ongoing intervention to prevent early childhood caries (ECC) in children of low-income families. The intervention began in 10 North Carolina counties in Jan 2000. Pediatricians and nurses are providing preventive dental services, including screening and fluoride varnish applications for infants and toddlers up to 36 months of age, and health education for their primary caregivers. Community coordinators help ensure the fist visit at 9 months of age and at six-month intervals thereafter. The quasi-experimental design will use information from 10 matched counties for comparison. The evaluation consists of three separate studies designed to determine the impact of the intervention on ECC outcomes. In the first study, short-term effectiveness of the intervention will be determined by comparing the prevalence and severity of noncavitated and cavitated carious lesions in 900 3-year-olds, who began the intervention at 9 months of age, with children from the control group. Historical controls from the intervention and comparison counties will account for secular trends in ECC. An interview of caregivers will provide control variables and secondary outcomes, including knowledge, behaviors and quality of life. The second study will determine carryover effects of the intervention on ECC in children 5 years of age, two years after their participation in the intervention ends. Its justification is the need to know if results from early, medical-based interventions continue after children are no longer eligible and before they enroll in school-based preventive dentistry programs. Caries increments derived from public health surveillance of kindergarten students, which includes 95 percent of the 8,000 students in the 20 study counties, will be compared for intervention and control children who were observed in the first study, as well as concurrent controls and historical controls from 4 years before. Interactions between the medical-based interventions and preventive services provided by dentists will be tested using Medicaid and CHIP dental claims. The third study will determine the effects of the ECC interventions for 1- and 2- year-olds on cumulative caries-related (CR) treatment and costs of dental services provided by the Medicaid and CHIP programs through 3 and 4 years of age. The likelihood of hospital use will be analyzed separately from total CR treatment and costs because of its expense. Most analyses will focus on whether net intervention costs (community outreach and provider reimbursements) are offset by reductions in CR treatment costs. We will do a limited assessment of the cost pe oral health- related quality of life.

这项研究的目的是评估已经有资助且持续的干预措施，以防止低收入家庭儿童的幼儿龋齿（ECC）。 干预措施于2000年1月在北卡罗来纳州的10个县开始。儿科医生和护士正在提供预防性牙科服务，包括针对婴儿和幼儿的筛查和氟化物清漆，最高36个月，以及对其初级护理人员的健康教育。 社区协调员有助于确保拳头在9个月大时及以后的六个月间隔。准实验设计将使用10个匹配县的信息进行比较。评估由三项独立的研究组成，旨在确定干预对ECC结果的影响。 在第一项研究中，干预措施的短期有效性将通过比较900名3岁儿童的未储存和闲置性瘤病变的患病率和严重程度，他们从9个月大开始进行干预，并与对照组的儿童进行干预。 干预和比较县的历史控制将解释ECC的世俗趋势。 护理人员的访谈将提供控制变量和次要结果，包括知识，行为和生活质量。 第二项研究将确定干预对ECC参加干预措施两年结束两年后对ECC的结转影响。 它的理由是需要知道在儿童不再符合条件之后以及他们参加以学校为基础的预防牙科计划之前，基于早期的医学干预措施的结果是否继续。幼儿园学生的公共卫生监视得出的龋齿增加，其中包括20个研究县的8,000名学生中的95％，将在第一项研究中观察到的干预和对照儿童，以及4年前的同时控制和历史控制。 将使用Medicaid和ChIP Dental索赔来测试牙医提供的基于医学的干预措施与预防服务之间的相互作用。 第三项研究将确定1岁和2岁儿童对龋齿相关（CR）治疗（CR）治疗的影响以及医疗补助计划和芯片计划在3岁和4岁之间提供的牙科服务的影响。 由于费用，医院使用的可能性将与总CR治疗和成本分开分析。 大多数分析将集中于净干预成本（社区外展和提供商的报销）是否被CR治疗成本降低所抵消。我们将对PE口腔健康相关的生活质量的成本进行有限的评估。