PROMIS oral health toolkit-supported school-based oral health program

摘要 牙科疾病不成比例地影响低收入，服务不足和少数民族儿童。学校被 提供有效的儿童健康监测和口腔健康服务。但传统 监测方法成本高，需要使用口腔卫生专业人员，这限制了他们的筛查能力。 大量的儿童定期。类似的约束也限制了基于牙医的 学校的口腔健康计划可用于学生群体。因此，迫切需要一个更加 一种高效、可行、准确的口腔健康筛查方法，可以区分正常和异常口腔 健康状况，并将儿童分为不同的口腔健康治疗需要，以便他们可以 及时和适当的牙科治疗。建立在我们的口腔健康PROMIS（患者报告 结果测量信息系统）项目，该项目开发了全国第一个口腔健康 项目库系统和初步有效的儿童口腔健康筛查工具包，我们的目标是建立和测试一个 以学校为基础的口腔健康计划（SBOHP），包括有效的口腔健康筛查，教育，病例 管理和转介。这种新的SBOHP将（i）应用创新的口腔健康PROMIS工具包（简称 表格和计算机自适应测试），以有效和准确地识别牙齿问题，并确定 （ii）为学生提供有效及适切的口腔健康教育， 牙科治疗需求的紧迫性和家长的健康素养水平，以提高他们的认识， 口腔健康的重要性，并改善他们的口腔健康行为;及（iii）使用学校健康开始协调员 和学校护士提供病例管理，转诊和后续可用的牙科中心， 治疗来源。该SBOHP将在洛杉矶联合学校的学生中开发和测试 地区（LAUSD），在基线和12个月随访时参与SBOHP，以评估可行性， 参与率、有效率、口腔健康状况的变化、口腔卫生和饮食行为、是否拥有或使用 牙科家庭和口腔健康状况。这项研究将分两个阶段进行。第一阶段-准备阶段 将风险评估纳入我们现有的基于病例发现的治疗转介决策中; 校准口腔健康PROMIS工具包，以适应LAUSD学生群体的条件;验证 OH PROMIS工具包在识别未经治疗的龋齿和分配学生治疗转诊方面的准确性 对牙科检查的类别;并制定程序，协议和文件的测试和 对创新的SBOHP进行评估。第二阶段-测试和评估阶段将评估可行性， 支持SBOHP的口腔健康PROMIS评估工具包的可接受性和效率，以及 SBOHP对儿童口腔健康状况和护理的长期影响。这项研究有很大的潜力提供 关键的监测信息，并作为可行的，可接受的，有效的和可持续的学校模式， 为全国各地的大量儿童提供口腔健康计划。

Abstract Dental disease disproportionately affects low-income, underserved and minority children. Schools have been an effective venue for childhood health surveillance and delivery of oral health services. However, traditional surveillance methods are costly and require use of oral health professionals, which limits their ability to screen large populations of children on a periodic basis. Similar constraints also limit the extent to which dentist-based school oral health programs can be used for student populations. Thus, there is an urgent need for a more efficient, feasible and accurate oral health screening approach that can distinguish abnormal from normal oral health conditions and classify children into different levels of oral health treatment need so that they can be referred for timely and appropriate dental treatment. Building on our Oral Health PROMIS (Patient Reported Outcomes Measurement Information Systems) project, which has developed the nation’s first oral health item bank systems and initial effective oral health screening toolkits for children, we aim to establish and test a School-Based Oral Health Program (SBOHP) that includes efficient oral health screening, education, case management and referral. This novel SBOHP will (i) apply innovative Oral Health PROMIS toolkits (short form and computer adaptive testing) to efficiently and accurately identify dental problems and determine the urgency of dental treatment need; (ii) deliver effective and pertinent oral health education tailored to students’ dental treatment need urgency and parents’ health literacy levels to enhance their understanding of the importance of oral health and improve their oral health behaviors; and (iii) use school healthy start coordinators and school nurses to provide case management, referrals and follow-up with available dental hubs and treatment sources. This SBOHP will be developed and tested among students in the Los Angeles Unified School District (LAUSD), who participate in the SBOHP at baseline and 12-month follow-up, to evaluate feasibility, participation rate, efficiency, changes in oral health status, oral hygiene and diet behaviors, having or use of a dental home, and oral health status. The study will be carried out in two phases. Phase I—Preparation Phase will incorporate risk assessment into our existing case-finding-based treatment referral decision making; calibrate Oral Health PROMIS toolkits to fit conditions manifested in the LAUSD student population; validate the accuracy of OH PROMIS toolkits in identifying untreated caries and assigning students to treatment referral categories against dental examination; and develop the procedures, protocols, and documents for testing and evaluating the innovative SBOHP. Phase II—Testing and Evaluation Phase will evaluate feasibility, acceptability and efficiency of the Oral Health PROMIS assessment toolkits-supported SBOHP, and the impact of the SBOHP on children’s oral health status and care over time. The study has great potential to provide critical surveillance information and serve as a model for feasible, acceptable, efficient and sustainable school- based oral health programs for large populations of children across the country.