Effectiveness and improvement of rural, school-based, caries prevention programs

我们希望改善口腔健康，降低农村校本龋齿预防项目的成本 使用比较有效和质量改进的方法。我们将检验这一假设 综合防龋法比增量防龋法更有效。 意义重大。龋病是一种可以预防的细菌感染，但25%的美国学童没有得到治疗 腐烂--比哮喘多五倍。农村、种族和少数民族的患病率翻了一番 人口。有效的预防干预措施，由疾病控制和预防中心建议 预防，都是可用的。然而，它们往往没有得到充分利用，很少对临床效果进行评估。 接近。使用队列设计，我们将纵向评估和比较全面和 在农村小学逐步开展龋病预防工作。使用这些比较数据，我们将 为临床和成本效益制定、实施和测试口腔健康改善模式。 明确的目标。1)。制定程序手册，使用以下工具标准化和校准龋齿诊断 NHANES诊断标准，实施用于记录、提交和分析的电子可读表格。 2)。比较评估临床和成本效益、最佳护理和时机模式以及指导地点 改进计划。3)。创建数据库以生成龋齿预防和开放的替代模型 该数据库用于临床和研究用途。 影响和创新。据我们所知，这将是第一次比较有效性研究(包括 经济评估)具有广度和深度，以确定和传播有效的预防方案。 一个额外的好处将是创建一个丰富的数据库，用于在其他地点建立预防模型。 环境和调查人员。福赛斯已经有百年历史了。哈佛大学附属口腔健康研究所。 我们将把这一人才与波士顿大学数据协调中心和学校龋齿结合起来 预防方案服务于4个州10个农村县的67所学校的约10,000名儿童。

We popose to improve oral health and reduce costs of rural school-based caries prevention programs using comparative effectiveness and quality improvement methods. We will test the hypothesis that comprehensive caries prevention is more effective than incremental prevention. Significance. Caries is a preventable bacterial infection, yet 25% of U.S. school children have untreated decay - five-times more than asthma. The prevalence doubles for rural, racial and ethnic minority populations. Effective preventive interventions, recommended by the Centers for Disease Control and Prevention, are available. However, they are often underused and rarely evaluated for clinical effectiveness. Approach. Using a cohort design, we will longitudinally evaluate and compare comprehensive and incremental caries prevention programs in rural elementary schools. Using this comparative data we will generate, implement and test oral health improvement models for clinical and cost-effectiveness. Specific Aims. 1). Develop a manual of procedures, standardize and calibrate caries diagnosis using NHANES diagnostic criteria, implement electronic readable forms for recording, submission, and analysis. 2). Comparatively evaluate clinical and cost-effectiveness, model optimal care and timing, and mentor site improvement programs. 3). Create a database to generate alternate models for caries prevention and open this database for clinical and research use. Impact and Innovation. To our knowledge, this will be the first comparative effectiveness study (including economic assessment) with the breadth and depth to identify and disseminate effective prevention protocols. An added benefit will be the creation of a rich database for modeling prevention in other locations. Environment and Investigators. Forsyth is a century old. Harvard affiliated, oral health research institute. We will marry this talent with the Boston University Data Coordinating Center and school-based caries prevention programs serving ~10,000 children in 67 school, in 10 rural counties, in 4 states.