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

• 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
• 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
• 来源: https://reporter.nih.gov/project-details/10673452
• 关键词: 5 year old; Address; Administrative Supplement; Advisory Committees; Affect; American; Asian; Black race; Caring; Cessation of life; Characteristics; Child; Childhood; Communities; Cost Sharing; Data; Data Set; Data Sources; Dental; Dental Care; Dental caries; Dentists; Economics; Empirical Research; Ethnic Origin; Ethnic group; Exposure to; Fluoride Varnishes; Funding; Health; Health Services; Health Services Accessibility; Hispanic; Household; Individual; Insurance Carriers; Insurance Coverage; Link; Low income; Massachusetts; Measures; Medicaid; Medical; National Institute of Dental and Craniofacial Research; Oral health; Pain; Performance; Physicians; Policies; Population; Preventive; Preventive service; Primary Health Care; Privatization; Provider; Quality of life; Race; Recommendation; Research; Research Support; Resources; Schools; Structural Racism; Time; Tooth structure; Visit; Work; aged; care delivery; care providers; experience; federal policy; health disparity; health inequalities; health plan; health professional shortage areas; innovation; interest; pandemic disease; parent grant; population health; preventive intervention; programs; racial and ethnic; racial and ethnic disparities; racial difference; racism; residential segregation; response; segregation; social disparities

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.

项目概要 经历健康差异的人群中牙科就诊率低导致了巨大的差异 儿童口腔健康状况存在差异——低收入儿童口腔健康状况较差 家庭以及黑人和西班牙裔儿童为了增加预防性口腔保健服务的使用，美国 预防服务工作组建议医疗服务提供者在所有牙齿上涂上氟化物清漆 5 岁及以下的儿童 私人健康计划和所有州医疗补助计划均涵盖此主要项目。 现有证据表明，提供氟化物清漆是不需分摊费用的儿科预防服务。 尽管有这些好处，但很少有孩子能接受它。 家长补助金 (NIDCR R01-HS027994-02)，资助时间为 2020 年 8 月 14 日至 24 年 5 月 31 日，旨在识别儿童、提供者、 影响医疗办公室提供氟化漆的实践、社区和政策层面的因素 马萨诸塞州响应特别关注通知：支持研究的行政补充。 对经历健康差异的人群进行预防性干预（NOT-OD-22-159），我们建议 通过审查接受氟化物方面的种族和民族差异，加强我们家长补助金的现有目标 我们将增强目标 1，以描述在医疗环境中接受氟化物清漆的儿童的比例。 种族/民族，并确定种族/民族差异是否由儿童接受护理的地点造成 与来自同一提供者接受不同护理的不同种族/族裔群体的儿童相比，我们也会这样做。 加强目标 3，审查结构性种族主义措施之间的关联（即种族化的经济 隔离和居住隔离）以及儿童在医疗环境中接受氟化漆的比率。 我们的研究团队非常适合在 12 个月内完成这项工作，因为我们有现有的计划 可用于分析马萨诸塞州医疗补助数据（目标 1），并且因为目标的数据集 3 已经获得并清理完毕，该提案将使我们的跨学科团队取得巨大成功。 扩大我们的工作，检查是否存在不平等获得初级预防服务的情况，从而减少 跨种族/族裔群体和受种族主义影响的社区的牙科职业。 否则我们就没有资源来解决这个创新且及时的补充。 可能告知在哪里优先考虑额外资源以增加预防性口腔保健服务的接受率。

项目成果

Variation in Current Guidelines for Fluoride Varnish Application for Young Children in Medical Settings in the United States.

美国医疗环境中幼儿氟化物清漆应用现行指南的变化。

• 发表时间: 2022
• 作者: Goff, Sarah L;Gahlon, Grace;Geissler, Kimberley H;Dick, Andrew W;Kranz, Ashley M
• 通讯作者: Kranz, Ashley M

Dental Fluoride Varnish Application During Medical Visits Among Children Who Are Privately Insured.

私人保险儿童就诊期间使用牙科氟化漆。

• 发表时间: 2021
• 影响因子: 13.8
• 作者: Geissler, Kimberley H;Dick, Andrew W;Goff, Sarah L;Whaley, Christopher;Kranz, Ashley M
• 通讯作者: Kranz, Ashley M

The Patient Protection and Affordable Care Act and Pediatric Medical Clinicians' Application of Fluoride Varnish.

《患者保护和平价医疗法案》和儿科临床医生对氟化物清漆的应用。

• 发表时间: 2023-11-01
• 影响因子: 13.8
• 作者: Gracner, Tadeja;Kranz, Ashley M;Li, Kun;Dick, Andrew W;Geissler, Kimberley
• 通讯作者: Geissler, Kimberley

Variation in prices for an evidence-based pediatric preventive service.

循证儿科预防服务的价格变化。

• 发表时间: 2022-10
• 影响因子: 3.4
• 作者: Kranz, Ashley M;Gahlon, Grace;Dick, Andrew W;Goff, Sarah L;Whaley, Christopher;Geissler, Kimberley H
• 通讯作者: Geissler, Kimberley H

Pediatric oral health services in Medicaid managed care and fee for service.

医疗补助管理护理中的儿科口腔健康服务和服务费。

• 发表时间: 2023-02
• 作者: Chen, Annie Yu;Opper, Isaac M;Dick, Andrew W;Stein, Bradley D;Kranz, Ashley M
• 通讯作者: Kranz, Ashley M