DENTAL ADOPTION OF CARIES CONTROL SERVICES

尽管出现了新的、有效的技术来控制儿童的差异，但只有少数牙医采用了这些技术。为了增加牙医的采用率，华盛顿牙科服务(WD)开发了一项由提供者教育和服务费补偿组成的两部分干预措施，为高危儿童提供一整套哭声控制服务，并提供按人头计算的福利。研究的目的是：1)确定干预对牙医采用儿童防龋服务的效果；2)在高危儿童中，确定防龋服务对龋病发病率和修复服务使用的影响；3)确定干预措施的成本效益。人口由波音员工的16,404名儿童组成，他们是波音公司员工(WDS)的随行人员。有30名或更多儿童(N=91)的牙医将被邀请参加这项研究，预计至少有50名牙医参与。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，并收集基线和1年和2年随访(n=900)的DMFS/DMFS评分。对照组牙医将报销在相同时期为高危儿童(n=900)收集DMFS/DMFS分数，这些儿童将接受常规护理。牙医和儿童对龋齿控制服务的使用情况将通过WDS记录进行衡量，为期两年。目标1将通过牙医参与这项研究以及比较牙医在不同组别中对龋病控制服务的使用情况来进行部分评估。目标2将比较不同组间的龋患率和修复效果。目标2将比较不同组间的龋患率和修复效果。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应用的其他要素。正如确定最容易患口腔疾病的儿童很重要一样，提供者采用能够最好地检测和预防疾病的新的、成本效益高的技术也同样重要。通过解决这一目的，这项研究在日常实践中促进了行为、社会科学和卫生服务的综合研究，并直接促进了中心应用的目标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.