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MOLAR: Mapping Oral health and Local Area Resources

MOLAR：绘制口腔健康和当地资源图

基本信息

批准号：
10445530
负责人：
Margaret Emily Samuels-Kalow
金额：
$ 51.96万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-15 至 2023-04-14
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10445530
关键词：
Accident and Emergency department Address Antibiotics Area Caring Color Communities Dental Dental Clinics Dental Insurance Dentists Development Diagnostic Procedure Diagnostic tests Disease Effectiveness of Interventions Emergency Care Emergency Department patient Emergency department visit Enrollment Ensure Frequencies Geographic Distribution Geography Goals Grant Health Health Personnel Health Resources Health Services Health Services Accessibility Health system Healthcare Healthcare Systems High Prevalence Homelessness Improve Access Individual Inequality Insurance Interdisciplinary Study Intervention Intervention Trial Low income Medicaid Mission Modeling Morbidity - disease rate Mouth Diseases National Institute of Dental and Craniofacial Research Neighborhoods Oral health Outcome Paper Patients Policies Population Populations at Risk Primary Health Care Process Proctor framework Provider Public Health Randomized Randomized Controlled Trials Research Resources Risk Risk Factors Role Schools Screening procedure Site Strategic Planning Technology Telephone Testing Text Messaging Time Tooth Diseases Toothache Treatment Efficacy Visit Vulnerable Populations Work adverse outcome base comorbidity density dental infection effectiveness implementation study ethnic minority food insecurity health disparity health goals health inequalities health related quality of life implementation framework implementation strategy improved improved outcome opioid use disorder patient oriented patient population prescription opioid primary outcome racial minority safety net satisfaction screening secondary outcome social social health determinants standard care standard of care success successful intervention

项目摘要

Abstract Despite the importance of optimizing oral health as a public health goal, there remain significant disparities in access to oral health care and in health outcomes. Although there have been multiple studies showing similar risk factors for unmet oral health needs and emergency department (ED) utilization, and a high frequency of ED utilization for oral health conditions, the optimal strategy for leveraging an ED visit to connect patients to oral health care remains to be defined. Previous efforts to reduce ED utilization for oral health problems have focused on improving access to insurance and have not been successful in reducing ED visits. This project would use a hybrid effectiveness-implementation study to perform a randomized controlled trial of an intervention to reduce unmet oral health and social needs in the ED, while collecting information to inform subsequent implementation strategies. We will assess individual, health system and community level impacts of an intervention to identify and address adverse social determinants of health (aSDoH) along with unmet oral health needs among ED patients. ED patients randomized to (1) standard of care handout of regional dental clinics, (2) geographically-matched Medicaid-accepting dental clinics or (3) aSDoH screening + geographically- matched resources for oral health and aSDoH and phone navigation as necessary to access resources. For Aim 1, the primary outcome will be individual successful linkage to oral health care at 1 month; for Aim 2, the primary outcome will be return visits for oral health concerns. In Aim 3, we assess the spatial association of (a) dental clinics and (b) social resources with intervention efficacy to understand the community and policy needs underlying successful intervention of linkage interventions. The proposed work builds on our team’s strong track record in development of ED-based screening, with feasibility demonstrated by our pilot work and successful enrollment. This work provides the baseline information to develop a patient-centered, technology- driven strategy to integrate oral health and aSDoH into the emergency care workflow in a sustainable and scalable way. In doing so, we fulfill two of the primary goals of the NIDCR Strategic Plan: (1) Enabling “precise and personalized oral health care” by developing a model to identify patients at risk in the ED and facilitating their connection to local, accessible, community oral health care; and (2) Using “multidisciplinary research approaches to overcome disparities and inequalities” by using the ED to enroll patients who do not otherwise have access to oral health care and ensure that they are connected to appropriate community resources for their social needs and oral health care. By doing so, we address the potential drivers of poor oral health and the challenges around accessibility of oral health care. Our long-term goal is to reduce the burden of untreated oral disease in vulnerable populations by integrating screening and referral for oral health and aSDoH into ED care, and thereby reduce potentially preventable ED visits, particularly for oral health conditions.

摘要