PREVENTION OF EARLY CHILDHOOD CARIES IN MEDICAL PRACTICE

在医疗实践中预防幼儿龋齿

基本信息

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
项目类别：
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

项目摘要

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.

本研究的目的是评估一项已经获得资助且正在进行的干预措施，以预防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，包括为 36 个月以下的婴儿和幼儿进行筛查和涂氟化物清漆，并为其主要护理人员提供健康教育。社区协调员帮助确保在 9 个月大时进行第一次检查，此后每六个月一次。准实验设计将使用10个匹配县的信息进行比较。该评估由三项独立的研究组成，旨在确定干预措施对 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（从 9 个月大开始干预）与对照组儿童的非空洞性和空洞性龋齿病变的患病率和严重程度来确定。团体。干预县和比较县的历史控制将解释 ECC 的长期趋势。对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措施对 5 岁儿童（即干预结束两年后）的 ECC 的延续影响。其理由是需要知道在儿童不再符合资格之后以及在他们参加学校预防性牙科项目之前，早期基于医疗的干预措施的结果是否继续有效。将对幼儿园学生（包括 20 个研究县的 8,000 名学生中的 95%）进行公共卫生监测得出的龋齿增量，将与第一项研究中观察到的干预儿童和对照儿童以及同期对照儿童和历史对照儿童进行比较。 4年前。将使用 Medicaid 和 CHIP 牙科索赔来测试基于医疗的干预措施和牙医提供的预防服务之间的相互作用。第三项研究将确定针对 1 岁和 2 岁儿童的 ECC 干预措施对 3 岁和 4 岁儿童累积龋齿相关 (CR) 治疗以及医疗补助和 CHIP 计划提供的牙科服务费用的影响。由于费用昂贵，医院使用的可能性将与总 CR 治疗和费用分开分析。大多数分析将重点关注净干预成本（社区外展和提供者报销）是否可以通过 CR 治疗成本的减少来抵消。我们将对与口腔健康相关的生活质量的成本进行有限的评估。