A qualitative description of a pilot project to improve access to care in one Den

对旨在改善在一个 Den 中获得护理的机会的试点项目的定性描述

• 批准号: 8119844
• 负责人: Sarah Elaine Raskin
• 金额: $ 4.05万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-06 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8119844
• 关键词: qualitative; description; pilot; project; improve

DESCRIPTION (provided by applicant): Residents of rural central Appalachia, an area characterized by poverty, low dental insurance coverage, and health professional shortages, bear a disproportionate burden of oral disease. Reports document adult loss of most or all teeth and children's dental decay in the region at rates 7 times that of the nation. To improve southwest Virginians' access to oral healthcare, in February 2009 Governor Tim Kaine approved an unfunded pilot project allowing public health dental hygienists to provide basic services in the region. Because no evaluation resources were committed for this pilot project, district health directors must use rudimentary measures, such as number of sealants provided, to fulfill the project's mandatory reporting requirements. This community-based dissertation proposal was developed with the input of district health directors to improve evaluation efforts by using a range of qualitative methods to describe the project in more detail. I will draw on multiple ethnographic methods, including semi-structured interviews, focus group discussions, and participant observation research, to document the experiences of adult patients, parents of child patients, and dental hygienists and the dentists who supervise them remotely, as well as stakeholders, and patients and providers who chose not to participate in the project. Consistent with AHRQ's strategic goals of fostering research that investigates health care Efficiency and Effectiveness, this proposal aims to determine how the pilot project to expand access to dental care fared. Following data collection and analysis, I will develop recommendations for how subsequent iterations could be improved to deliver better oral healthcare to one AHRQ priority population, low-income rural residents. This proposal is particularly timely given current debates, nationally, about the possibility of establishing a mid-level dental provider classification in order to increase access to affordable, culturally appropriate dental care in Dental Health Professional Shortage Areas. Finally, this project aims to point toward longitudinal studies of treatment narratives as a novel evaluation methodology. PUBLIC HEALTH RELEVANCE: The proposed research stands to impact state and possibly national policy on intra- and inter- professional jurisdictions of dental health care provision, and attendant practices by providers working in community-based and other public dental health clinics. In order to disseminate results to a wide audience of scholars, policy makers, dental health providers, and other stakeholders, I will produce (1) a dissertation manuscript, (2) a report to stakeholders which will contain recommendations for improving interventions which use task-sharing to increase access to oral health care among low- income rural residents, and (3) articles for publication and papers for presentation in a variety of journals. I will also impact practice by giving lectures to students of dental hygiene, public policy, and other fields at community colleges and 4-year institutions in central Appalachia, while I am in the field. Page 1 of 1 Qualitative description of a dental health pilot project

描述(申请人提供)：阿巴拉契亚中部农村地区的居民，这个地区的特点是贫困，牙科保险覆盖率低，卫生专业人员短缺，背负着不成比例的口腔疾病负担。报告记录了该地区成年人大部分或全部牙齿的脱落和儿童龋齿的比率是全国的7倍。为了改善西南部弗吉尼亚州人获得口腔保健的机会，2009年2月，州长蒂姆·凯恩批准了一项没有资金的试点项目，允许公共卫生牙科卫生员在该地区提供基本服务。由于没有为这一试点项目提供评估资源，地区卫生总监必须使用基本措施，如提供的密封剂数量，以满足该项目的强制性报告要求。这项以社区为基础的论文提案是在地区卫生主任的参与下制定的，目的是通过使用一系列定性方法更详细地描述项目来改进评估工作。我将利用多种人种学方法，包括半结构化访谈、焦点小组讨论和参与者观察研究，记录成人患者、儿童患者的父母、牙齿卫生师和远程监督他们的牙医，以及利益相关者，以及选择不参与该项目的患者和提供者的经历。与AHRQ促进调查卫生保健效率和有效性的研究的战略目标一致，这项提案旨在确定扩大获得牙科保健的试点项目的进展情况。在数据收集和分析之后，我将就如何改进后续迭代以向AHRQ重点人群-低收入农村居民提供更好的口腔保健提出建议。考虑到目前在全国范围内关于建立中级牙科提供者分类的可能性的辩论，这项建议尤其及时，以便在牙科保健专业人员短缺的地区增加获得负担得起的、文化上合适的牙科护理的机会。最后，本项目旨在将治疗叙述作为一种新的评估方法进行纵向研究。 公共卫生相关性：拟议的研究将影响国家甚至可能是国家关于牙科保健提供的专业内和专业间司法管辖区的政策，以及在社区和其他公共牙科保健诊所工作的提供者的随行做法。为了将成果传播给广大学者、政策制定者、牙科保健提供者和其他利益攸关方，我将制作(1)论文手稿，(2)向利益攸关方提交一份报告，其中将包含改进干预措施的建议，这些干预措施利用任务分担来增加低收入农村居民获得口腔保健的机会，以及(3)发表文章和在各种期刊上发表的论文。我还将在阿巴拉契亚中部的社区大学和四年制机构为口腔卫生、公共政策和其他领域的学生讲课，这也会影响实践。第1页(共1页)牙科健康试点项目的定性描述