Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

促进儿童口腔健康：确定与医疗办公室提供氟化物清漆相关的提供者、实践和社区层面的特征

基本信息

批准号：
10673452
负责人：
Ashley Kranz
金额：
$ 41.69万
依托单位：
RAND CORPORATION
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：
2022-09-15 至 2025-05-31
项目状态：
未结题

项目摘要

Project Summary Low rates of dental visits among populations that experience health disparities contribute to the substantial disparities observed in children’s oral health—with worse oral health observed among children in low-income households and Black and Hispanic children. To increase use of preventive oral health services, the US Preventive Services Task Force recommends that medical providers apply fluoride varnish to the teeth of all children aged 5 years and younger. Private health plans and all state Medicaid programs cover this primary pediatric preventive service without cost-sharing. Existing evidence indicates that delivery of fluoride varnish in medical offices increases utilization and reduces decay. Despite these benefits, few children receive it. Our parent grant (NIDCR R01-HS027994-02), funded from 08/14/20 to 05/31/24, aims to identify child, provider, practice, community-, and policy-level factors affecting delivery of fluoride varnish in medical offices in Massachusetts. In response to Notice of Special Interest: Administrative Supplements to Support Research on Preventive Interventions with Populations that Experience Health Disparities (NOT-OD-22-159), we propose to enhance the existing aims of our parent grant by examining racial and ethnic disparities in receipt of fluoride varnish. We will enhance Aim 1 to describe rates of children receiving fluoride varnish in medical settings by race/ethnicity and to determine whether differences by race/ethnicity result from where a child receives care versus children from different racial/ethnic groups receiving different care from the same provider. We will also enhance Aim 3 to examine the association between measures of structural racism (i.e., racialized economic segregation and residential segregation) and rates of children receiving fluoride varnish in medical settings. Our research team is well-suited to complete this work without 12 months because we have existing programs that can be used for the analysis of the Massachusetts Medicaid data (Aim 1) and because the dataset for Aim 3 has already been obtained and cleaned. This proposal will allow our highly successful interdisciplinary team to expand our work by examining if there is inequitable access to a primary preventive service that reduces dental caries across racial/ethnic groups and across communities impacted by racism. These are issues that we would otherwise not have the resources to address. This innovative and timely supplement has the potential to inform where to prioritize additional resources to increase receipt of preventive oral health services.

项目摘要经历健康分配的人群中牙科探访率低有助于实质性在儿童口腔健康中观察到的差异 - 低收入儿童的口腔健康状况恶化家庭，黑人和西班牙裔孩子。为了增加对预防性口腔卫生服务的使用，美国预防服务工作队建议医疗提供者将氟化物清漆涂在所有人的牙齿上 5岁及以下的儿童。私人健康计划和所有州医疗补助计划涵盖此主要小儿预防服务而无需分担成本。现有证据表明氟化物清漆在医疗办公室增加利用率并减少衰减。尽管有这些好处，但很少有孩子会收到它。我们的父母赠款（NIDCR R01-HS027994-02），资助为08/14/20至05/31/24，旨在识别儿童，提供者，练习，社区和政策级别的因素，影响在医疗办公室提供氟化物清漆的因素马萨诸塞州。响应特殊兴趣的通知：行政补品以支持研究与经历健康差异的人群的预防干预措施（NOT-OD-22-159），我们建议通过检查氟化物的种族和种族差异来增强我们父母赠款的现有目标漆。我们将增强目标1来描述通过种族/民族并确定种族/民族的差异是否从儿童获得护理的地方导致与来自不同种族/族裔的儿童相比，从同一提供商那里获得不同的护理。我们也会增强目标3来检查结构性种族主义措施之间的关联（即种族化经济隔离和居民种族隔离）和在医疗环境中接受氟化物清漆的儿童的率。我们的研究团队非常适合完成这项工作，因为我们有现有计划可以用于分析马萨诸塞州医疗补助数据（AIM 1），也可以用于AIM的数据集 3已经获得并清洗了。该建议将允许我们非常成功的跨学科团队通过检查是否无法获得减少的主要预防服务来扩大我们的工作种族/族裔以及受到种族主义影响的社区的牙齿龋齿。这些是否则，我们将没有资源可以解决。这种创新和及时的补充有可能告知在哪里确定额外资源以增加预防性口服健康服务的优先级。