Oral Health 4 Life: Promoting Oral Health among Tobacco Quitline Callers

描述（由申请人提供）： 降低口腔疾病风险和促进更好的口腔保健是公共卫生的优先事项。吸烟者由于吸烟和其他生活方式的选择（例如，低于最佳牙齿护理利用率和口腔卫生差）。因此，吸烟者是人口层面的公共口腔健康促进工作的优先目标受众。在过去的4年里，我们的项目研究已经证明了利用现有的美国戒烟热线基础设施同时促进更好的口腔健康护理和戒烟的需要和机会，从而接触到已经有动机改变行为并可能接受口腔健康干预的吸烟者。在美国，每年有超过440，000名吸烟者通过公共资助的州烟草戒烟热线获得免费戒烟治疗。这些程序中有一半以上由单一供应商（Alere Wellbeing）提供服务。Alere和购买戒烟热线服务的州的利益相关者以及我们调查的戒烟热线呼叫者支持综合口腔健康促进-戒烟计划的概念。作为回应，我们开发了一个有理论基础的，全面的，多模式的行为计划（口腔健康4生活），旨在促进更好的口腔保健与标准的戒烟咨询。这是公共卫生，不是临床牙科干预。该计划包括行为咨询，通过短信支持外展，以及其他健康教育和资源材料提供印刷和在线所有设计，以适应戒烟基础设施。通过与州戒烟热线合作，该计划将达到高风险，高需求，通常较低的社会经济地位的观众。我们现在寻求NIDCR的持续支持，以在随机试验中实施和评估该计划。在小型先锋试点（n = 10）之后，将从由Alere Wellbeing（华盛顿州西雅图）集中管理的三个州戒烟热线招募712名吸烟者。参与者将接受口腔健康4生命计划+标准戒烟护理或单独标准护理。我们假设接受增强计划的参与者更有可能去看牙医进行检查/清洁，并在6个月随访时戒烟（主要结局）。我们还假设这些人在日常口腔卫生行为（刷牙和使用牙线）方面会有更大的改善，在口腔健康知识、态度和信念方面会有更大的积极变化。对影响口腔健康但不是干预的中心目标的其他风险因素的影响（例如，饮食， 酒精使用）和潜在的变化介质将进行探讨。最后，我们将从付款人的角度计算提供口腔健康4生活计划的增量成本，并创建一个工具，让未来的购买者评估他们未来的“支付意愿”的基础上不同的定价假设的程序。如果有效，口腔健康4生命计划可以在全国范围内传播，每年接触数十万吸烟者，并可以促进更好的口腔保健，提高戒烟率，改善目标吸烟者的口腔健康结果。

DESCRIPTION (provided by applicant): Reducing oral disease risk and promoting better oral health care are public health priorities. Smokers are at high risk for oral disease as a result of their tobacco use and other lifestyle choices (e.g., less than optimal dental care utilization and poor oral hygiene). As a result, smokers are a priority target audience for population- level, public oral health promotion efforts. Over the past 4 years, our programmatic research has demonstrated a need and opportunity to leverage the existing US tobacco quitline infrastructure to promote greater oral health care and tobacco cessation concurrently, thereby reaching smokers who are already motivated for behavior change and who may be receptive to oral health intervention. Within the US, more than 440,000 smokers receive free tobacco cessation treatment annually through publically-funded state tobacco quitlines. More than half of these programs are serviced by a single vendor (Alere Wellbeing). Stakeholders at Alere and the states who purchase their quitline services, as well as quitline callers we surveyed, support the concept of an integrated oral health promotion-tobacco cessation program. In response, we developed a theoretically-grounded, comprehensive, multi-modal behavioral program (Oral Health 4 Life) which is designed to promote better oral health care in conjunction with standard tobacco quitline counseling. This is a public health, not a clinical dental intervention. The program consists of behavioral counseling, supportive outreach via text messaging, and other health education and resource materials delivered in print and online-all designed to fit within the quitline infrastructure. By partnering with state quitlines, the program will reach a high- ris, high-need, typically lower-SES audience. We now seek continued support from NIDCR to implement and evaluate this program in a randomized trial. Following a small vanguard pilot (n = 10), 712 smokers will be recruited from three state quitlines managed centrally by Alere Wellbeing in Seattle, WA. Participants will receive either the Oral Health 4 Life program + standard quitline care or standard care alone. We hypothesize participants who receive the enhanced program will be more likely to see a dentist for a check-up/cleaning and to quit smoking at 6 month follow-up (primary outcomes). We also hypothesize these individuals will have greater improvement in their routine oral hygiene behaviors (brushing and flossing), and greater positive change in their oral health knowledge, attitudes, and beliefs. Effects on other risk factors which affect oral health, but are not central targets of the intervention (e.g., diet, alcohol use) and potential mediators of change will be explored. Finally, we will calculate the incremental cost of offering the Oral Health 4 Life program from the payer perspective and create a tool to allow future purchasers to assess their future 'willingness to pay' for the progra based on different pricing assumptions. If effective, the Oral Health 4 Life program could be disseminated nationwide, reaching hundreds of thousands of smokers each year, and could promote greater oral health care, enhance abstinence rates, and improve oral health outcomes among targeted smokers.