DENTAL ADOPTION OF CARIES CONTROL SERVICES

虽然已经出现了新的有效的技术来控制儿童的变化，但只有少数牙医采用了它们。为了提高对牙医的接受程度，华盛顿牙科服务中心（WD）制定了一项由两部分组成的干预措施，包括提供者教育和按服务收费的报销，为有头戴福利的高危儿童提供一揽子控制哭闹服务。研究的目的是：1)确定干预措施对牙科医生接受儿童龋齿防治服务的影响；2)在高危儿童中，确定控制龋齿服务对龋齿发病率和使用修复服务的影响；3)确定干预措施的成本效益。这一人口包括16404名受波音员工抚养的子女，他们都在WDS人头计划的覆盖范围内。有30名或以上儿童的牙医（N=91）将被邀请参加研究，预计至少有50名牙医参加。同意的牙医将被随机分为干预组和对照组。干预组的牙医将为900名高危儿童提供aries控制服务，并收集dmfs/ dmfs基线评分和1年和2年随访（n=900）。对照组牙医将报销在相同时期为有风险的儿童（n=900）收集dmfs/ dmfs评分的费用，这些儿童将接受常规护理。牙医和儿童对防治龋齿服务的使用情况将通过《世界龋齿普查》记录进行为期两年的衡量。目的1将部分通过牙医参与研究来评估，并通过比较各组之间牙医对龋齿控制服务的使用。目的2比较两组龋病发生率和龋病恢复率。目的2比较两组龋病发生率和龋病恢复率。如果检测到有益效果，将在目标3中进行成本效益分析。这项研究补充了中心申请的其他要素。正如确定最易患口腔疾病的儿童很重要一样，提供者采用最能发现和预防疾病的具有成本效益的新技术也同样重要。通过实现这一目标，本研究在日常实践中促进了综合行为、社会科学和卫生服务研究，并直接促进了本中心应用的目标5和6。

Although new, effective technologies have emerged for controlling varies in children, only a minority of dentists have adopted them. To increase dentist adoption, Washington Dental Service (WD) has developed a 2-part intervention composed of provider education and fee-for-service reimbursement for providing a package of cries-control services to at risk children with capitation benefits. Study aims are: 1) to determine the effect of the intervention on dentist adoption of caries-control services for children; 2) among at risk children, to determine the effect of caries-control services on the incidence of dental caries and use of restorative services; and 3) to determine the cost effectiveness of the intervention. The population consists of 16,404 children dependents of Boeing employees covered by the (WDS) capitation program. Dentists with 30 or more capitation children (N=91) will be invited to participate in the study, and at least 50 dentists are expected to participate. Consenting dentists will be randomized into intervention and control groups. Dentists in the intervention group will provide aries control services to 900 at risk children and collect dmfs/DMFS scores at baseline and 1- and 2-year follow-ups (n=900). Control group dentists will be reimbursed for collecting dmfs/DMFS scores at identical periods for at risk children (n=900), who will receive usual care. Dentist and child use of caries-control services will be measured through WDS records for 2 years. Aim 1 will be assessed partly by dentist participation in the study, and by comparing dentist use of caries-control services between groups. Aim 2 will compare caries incidence and restorative between groups. Aim 2 will compare caries incidence and restorative between groups. If beneficial effects are detected, a cost-effectiveness analysis will be performed in Aim 3. The study complements other elements of the Center application. Just as it is important to identify children most susceptible to oral disease, so it is equally important for providers to adopt new, cost-effective technologies that can best detect and prevent disease. By addressing this purpose, the study fosters integrated behavioral, social science and health services research in daily practice, and contributes directly to Aims 5 and 6 of the Center application.