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.

在初级保健设置中删除氟化物清漆的障碍 项目摘要/摘要： 牙齿衰减是一个重要的，持续的公共卫生问题，影响儿童 低收入家庭以及从一般居民和少数民族的少数族裔和少数民族的家庭 人口。因为幼儿比初级保健提供者更有可能 牙医，包括儿科的适当有效的预防口腔健康服务（POHS） 孩子的访问有可能显着改善儿童的口腔健康。氟化物清漆 （fv）应用程序是由主要计划中的保险计划偿还的一种POH 幼儿的护理设置，但只有一小部分医生应用FV。 该项目的目的是评估和减少目前劝阻PCP的障碍 在孩子访问期间提供FV。 第一个目的是收集和分析有关时间，成本和工作流程的详细数据 与初级保健环境中的FV交付相关。实现此目标的关键组成部分意志 包括时间研究和通过各种实践的合作伙伴诊所的数据分析 特征。第二个目的是评估障碍和促进者，以便在 初级保健设置。将合并框架应用于实施研究 （CFIR）收集和分析主要线人访谈，利益相关者的数据 将对干预气候的观点进行分析，以更好地了解理由 POH交付的明显障碍的根本障碍，重点是消除过程流动障碍。 最终目的是优化夫妇访问工作流程中的FV应用程序。统计分析， 模拟和数学建模将被用来确定如何最小化时间和 在环境因素不同组合的变异性影响下的成本。最好的 实施实践将进行整理和传播。虽然FV应用程序没有 这些模型隔离其他活动，还可以帮助确定是否是否 报销将资助额外的资源以添加FV应用程序而无需牺牲其他资源 预防保健。 研究贡献将是特定的工作流程建议和结果资源 和成本数据，以及对实施障碍和促进者的更好理解， 这将使医生的办公室可以决定如何将FV整合到其儿科井中 儿童根据自己独特的实践特征来拜访。这些改进的框架， 广泛传播，将促进在孩子访问期间更广泛地分娩的POH。