Removing Barriers to Fluoride Varnish Application in Primary Care Settings

消除初级保健机构中氟化物清漆应用的障碍

• 批准号: 10359596
• 负责人: Christina Scherrer
• 金额: $ 42.36万
• 依托单位: KENNESAW STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2025-02-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10359596
• 关键词: 5 year old; 9 year old; Address; Aerosols; Age; Characteristics; Child; Childhood; Climate; Clinic; Clinical; Collection; Consolidated Framework for Implementation Research; Data; Data Analyses; Decision Making; Dental; Dental Care Delivery; Dental caries; Dentists; Effectiveness; Engineering; Environmental Risk Factor; Fluoride Varnishes; Funding; General Population; Goals; Grant; Health; Health Services; Household; Insurance; Intervention; Interview; Lead; Low income; Medicaid; Modeling; Oral health; Outcome Study; Patients; Physicians; Physicians' Offices; Pit and Fissure Sealants; Prevalence; Preventive; Preventive care; Primary Health Care; Procedures; Process; Provider; Public Health; Reporting; Research; Resources; Sampling; Statistical Data Interpretation; Students; Suggestion; Time; Time Study; Training; Universities; Variant; Virginia; Visit; Vulnerable Populations; Well Child Visits; Work; base; care providers; cost; cost estimate; disadvantaged population; disparity reduction; economic disparity; ethnic minority; federal poverty level; flexibility; health care delivery; health disparity; implementation facilitators; improved; informant; interest; mathematical model; outreach; pandemic disease; primary care setting; programs; racial disparity; racial minority; simulation; stakeholder perspectives; undergraduate student

Removing Barriers to Fluoride Varnish Application in Primary Care Settings Project Summary/Abstract: Dental decay is an important, ongoing public health concern that impacts children from low-income households and from racial and ethnic minorities at higher rates than the general population. Because young children are much more likely to visit a primary care provider than a dentist, including appropriate and effective preventive oral health services (POHS) at pediatric well-child visits has the potential to dramatically improve children’s oral health. Fluoride varnish (FV) application is one such POHS that is reimbursed by insurance programs in the primary care setting for younger children, yet only a small proportion of physicians apply FV. The objective of this project is to assess and reduce barriers currently dissuading PCPs from providing FV during well-child visits. The first aim is to collect and analyze detailed data on time, costs and workflow associated with FV delivery in primary care settings. Key components to achieve this aim will include time study and bottleneck analysis of data from partner clinics with a variety of practice characteristics. The second aim is to assess barriers and facilitators to POHS delivery in primary care settings. Applying the Consolidated Framework for Implementation Research (CFIR) to the collection and analysis of data from key informant interviews, stakeholders’ perspectives on intervention climates will be analyzed to better understand the rationale underlying apparent barriers to POHS delivery, with a focus on process flow barrier elimination. The final aim is to optimize FV application in the well-child visit workflow. Statistical analysis, simulation, and mathematical modeling will be utilized to establish how to minimize time and costs under the influence of variability for different combinations of environmental factors. Best practices for implementation will be collated and disseminated. While FV application does not operate in isolation of other activities, these models can also help determine whether reimbursements would fund additional resources to add FV application without sacrificing other preventive care. The research contribution will be specific workflow suggestions and resulting resource and cost data, as well as a better understanding of barriers and facilitators to implementation, that will allow physicians’ offices to make decisions on how to integrate FV in their pediatric well- child visits based on their own unique practice characteristics. These improved frameworks, widely disseminated, will faciliate more widespread delivery of POHS during well-child visits.

消除基层医疗机构中氟化物保护漆应用的障碍 项目概要/摘要： 蛀牙是一个重要的，持续的公共卫生问题，影响儿童从 低收入家庭和少数种族和族裔家庭的比例高于一般家庭， 人口因为幼儿更有可能去看初级保健提供者，而不是 牙医，包括适当和有效的预防性口腔健康服务（POHS）在儿科 健康儿童访视有可能极大地改善儿童的口腔健康。氟保护漆 (FV)应用程序是一个这样的POHS是由保险计划报销的主要 在幼儿护理环境中，只有一小部分医生应用FV。的 该项目的目标是评估和减少目前阻碍PCP从 在健康儿童访问期间提供FV。 第一个目标是收集和分析关于时间、成本和工作流程的详细数据 与初级保健环境中FV交付相关。实现这一目标的关键组成部分将 包括时间研究和对来自具有各种实践伙伴诊所的数据的瓶颈分析 特色第二个目标是评估在以下方面提供POHS的障碍和促进因素： 初级保健机构。实施研究综合框架的应用 （CFIR）收集和分析来自关键知情人访谈的数据，利益相关者 将对干预气候的观点进行分析，以更好地理解其基本原理 潜在的明显障碍，以POHS交付，重点是工艺流程障碍消除。 最后的目的是优化FV在儿童健康访视工作流程中的应用。统计分析， 模拟和数学建模将被用来建立如何最大限度地减少时间和 在不同环境因素组合的可变性影响下的成本。最好 将整理和传播实施做法。虽然FV应用程序不 与其他活动相隔离，这些模型还可以帮助确定 报销将为增加FV应用程序提供额外资源，而不会牺牲其他 预防保健。 研究的贡献将是具体的工作流程建议和由此产生的资源 以及更好地了解执行工作的障碍和促进因素， 这将使医生办公室能够决定如何将FV整合到他们的儿科井中- 儿童访视根据自身独特的实践特点。这些改进的框架， 广泛传播，将有助于在健康儿童访问期间更广泛地提供职业健康和安全服务。