Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

项目摘要 在经历健康差异的人群中，牙科就诊率低导致了严重的 在儿童口腔健康方面观察到的差异-在低收入儿童中观察到的口腔健康较差 黑人和西班牙裔儿童。为了增加预防性口腔保健服务的使用， 预防服务工作组建议，医疗提供者适用于所有的牙齿氟化物清漆 5岁及以下儿童。私人健康计划和所有州医疗补助计划都覆盖了这一主要领域。 儿科预防性服务，不分摊费用。现有的证据表明， 医务室提高了利用率并减少了腐烂。尽管有这些好处，但很少有儿童能享受到。 父母补助金（NIDCR R 01-HS 027994 -02），从20年8月14日至24年5月31日资助，旨在确定儿童，提供者， 实践、社区和政策层面的因素影响了美国医疗办公室氟涂料的使用， 马萨诸塞州。回应特别关注通知：支持研究的行政补充 对经历健康差异的人群进行预防性干预（NOT-OD-22-159），我们建议 通过审查接受氟化物的种族和民族差异，加强我们父母补助金的现有目标 清漆我们将加强目标1，以描述儿童在医疗环境中接受氟化物保护漆的比率， 种族/族裔的差异，并确定种族/族裔的差异是否因儿童接受照料的地点而产生 与来自不同种族/族裔群体的儿童从同一提供者获得不同的照顾相比。我们还将 加强目标3，审查结构性种族主义措施（即，种族化经济 隔离和居住隔离）以及儿童在医疗环境中接受氟化物保护漆的比例。 我们的研究团队非常适合在没有12个月的情况下完成这项工作，因为我们有现有的计划 可用于分析马萨诸塞州医疗补助数据（Aim 1），因为Aim的数据集 3已被获取并清理。这项提议将使我们非常成功的跨学科团队 扩大我们的工作，审查是否存在获得初级预防服务的不公平现象， 不同种族/族裔群体和受种族主义影响的社区的龋齿情况。这些问题 否则我们就没有资源来解决这个问题。这一创新和及时的补充， 潜在的信息，以优先增加资源，以增加预防性口腔保健服务的接收。

Project Summary Low rates of dental visits among populations that experience health disparities contribute to the substantial disparities observed in children’s oral health—with worse oral health observed among children in low-income households and Black and Hispanic children. To increase use of preventive oral health services, the US Preventive Services Task Force recommends that medical providers apply fluoride varnish to the teeth of all children aged 5 years and younger. Private health plans and all state Medicaid programs cover this primary pediatric preventive service without cost-sharing. Existing evidence indicates that delivery of fluoride varnish in medical offices increases utilization and reduces decay. Despite these benefits, few children receive it. Our parent grant (NIDCR R01-HS027994-02), funded from 08/14/20 to 05/31/24, aims to identify child, provider, practice, community-, and policy-level factors affecting delivery of fluoride varnish in medical offices in Massachusetts. In response to Notice of Special Interest: Administrative Supplements to Support Research on Preventive Interventions with Populations that Experience Health Disparities (NOT-OD-22-159), we propose to enhance the existing aims of our parent grant by examining racial and ethnic disparities in receipt of fluoride varnish. We will enhance Aim 1 to describe rates of children receiving fluoride varnish in medical settings by race/ethnicity and to determine whether differences by race/ethnicity result from where a child receives care versus children from different racial/ethnic groups receiving different care from the same provider. We will also enhance Aim 3 to examine the association between measures of structural racism (i.e., racialized economic segregation and residential segregation) and rates of children receiving fluoride varnish in medical settings. Our research team is well-suited to complete this work without 12 months because we have existing programs that can be used for the analysis of the Massachusetts Medicaid data (Aim 1) and because the dataset for Aim 3 has already been obtained and cleaned. This proposal will allow our highly successful interdisciplinary team to expand our work by examining if there is inequitable access to a primary preventive service that reduces dental caries across racial/ethnic groups and across communities impacted by racism. These are issues that we would otherwise not have the resources to address. This innovative and timely supplement has the potential to inform where to prioritize additional resources to increase receipt of preventive oral health services.