Statewide implementation and evaluation of a rural, school-based, caries prevention program

摘要/摘要 我们的长期目标是减少农村学童的口腔健康差距。 我们的近期目标是测试两个新的以证据为基础、以学校为基础的龋齿预防计划。 我们将比较两种预防方法：(1)使用更新、更简单、更便宜、更有效的治疗方法 含氟清漆+氟化银二胺；以及(2)更传统、更复杂、更昂贵、更耗时的 治疗包括简单+密封剂+临时治疗性修复。更简单的方法需要6分钟 几分钟即可交付，而更复杂的方法需要20分钟。因此，如果越简单， 更便宜的方法与更复杂、更昂贵的方法一样有效，数据可以支持临床 和政策变化。 为了比较这两种方法，我们将采用整群随机对照试验设计。我们将实施 这项计划在新罕布夏州的农村学校。在知情同意的情况下，学校的所有儿童都将获得 同样的处理(简单的或复杂的)。我们将为五年补助金每年提供两次预防性护理。 句号。 我们将对所有儿童进行为期五年的纵向跟踪，以确定每种预防措施的有效性。 方法。做出这一决定的主要结果将是未接受治疗的儿童的百分比 腐烂。这是美国健康人口腔健康的目标之一。我们还将研究成本和成本- 有效性。这将使我们能够确定效率和成本之间的平衡。 评估成效和成本对于缩小差距尤为重要。如果干预是 快速、廉价、100%有效，这是一个相对简单的选择。大多数干预措施并不是100% 有效。因此，有关时间、费用和有效性的信息将使我们能够更好地了解情况 临床和政策决策。具体地说，这将帮助我们回答这个问题：有多少是预防性的 干预将增加可获得性、改善健康并降低成本？

SUMMARY/ABSTRACT Our long term goal is to reduce oral health disparities in rural school children. Our immediate goal is to test two new evidence-based, school-based, cavity prevention programs. We will compare two preventions: (1) A newer, simpler, less expensive, efficient treatment using fluoride varnish + silver diamine fluoride; and (2) A more traditional, complex, expensive, time-intensive treatment that includes simple + sealants + interim therapeutic restorations. The simpler method takes 6 minutes to deliver, compared to the more complex method that takes 20 minutes. Therefore, if the simpler, less expensive is as effective as the more complex, more expensive method, the data could support clinical and policy change. To compare the two methods we will use a cluster randomized control trial design. We will implement this program in rural New Hampshire schools. All children in a school with informed consent will receive the same treatment (either simple or complex). We will provide preventive care twice per year for the 5 year grant period. We will follow all children longitudinally for five years to determine the effectiveness of each preventive method. The primary outcome to make this determination will be the percentage of children with untreated decay. This is one of the U.S. Healthy People oral health goals. We will also examine the cost and cost- effectiveness. This will allow us to determine the balance between effectiveness and cost. Assessing effectiveness and costs is particularly important for reducing disparities. If an intervention is quick, inexpensive, and 100% effective, that is a relatively simple choice. Most interventions are not 100% effective. Therefore, information on time, expense, and effectiveness will allow us to make better informed clinical and policy decisions. Specifically, this will help us answer the question: How much of which preventive intervention will increase access, improve health, and reduce costs?