Economic Evaluation of School-Based Caries Prevention Programs

项目总结/摘要 该项目的主要目标是改善口腔保健服务，减少健康不公平现象， 开展强有力的项目评估，以支持政策制定者在大流行期间的决策， 持份者为了实现这一目标，拟议研究的主要目标是评估大流行前 获得以学校为基础的龋齿预防计划（SCPP）影响儿童的牙齿和牙齿相关的护理 利用和暴露于高或非常高的COVID-19暴露风险水平的环境， 流行病这将通过以下方式实现：（1）在2010年的原始K-25补助金中引入的独特数据链接 与（2）由SCPP服务计划意外中断引起的自然实验同时进行 大流行病，近似于随机化至大流行病前SCPP访问和大流行病前无访问 在参与的学校中。这克服了先前评估学校所面临的选址偏见问题- 更普遍的是，学校选择参加校本课程， 与那些选择退出的人不同，他们选择退出的方式影响了校本课程的观察结果。 为了支持这项研究，Shulamite S。黄正申请给她行政补助 K-25奖黄博士是专门研究纽约牙科市场的健康经济学家 纽约大学牙科学院（纽约大学COD）正在建立自己作为一个年轻的口腔健康调查员 服务研究。该奖项将使黄博士能够进一步努力减少健康差距， 通过整合她在卫生经济学方面的背景和经验，改善卫生保健服务和质量 临床研究方法的政策评估和临床干预措施的评估。 在目标1中，黄博士将确定牙科和牙科相关医疗利用的趋势如何 在大流行病之前和期间，脆弱儿童的情况发生了变化。特别是，她将评估是否 与牙科相关的急诊室就诊的任何变化都表明， 在大流行期间，牙科需求得不到满足的情况日益严重。在目标2中，黄博士将量化 大流行前SCPP在大流行期间获得牙科和牙科相关医疗服务的人数 大流行前的SCPP访问。这项研究将有助于进一步建立黄博士作为口腔健康服务 从经济学领域带来因果推理方法的研究人员，以及新颖的大型数据集 联系，研究牙科保健服务的变化对大量人口的影响。 与最初的K-25奖项一样，黄博士继续得到由以下人员组成的指导团队的支持： 一位主要的导师，石楠黄金博士，在人口健康研究和经济评估的专家， 临床和行为干预和教授在纽约大学朗格尼健康和医学院;和一个共同的， 导师，理查德·尼德曼博士，牙医，教授和流行病学系主任， 纽约大学COD的健康促进，他进行了SCPP实用的临床试验，为这项研究提供了数据。

Project Summary/Abstract The primary goal of this project is to improve oral health care delivery and reduce health inequities by conducting robust program evaluations to support decision-making during the pandemic by policymakers and stakeholders. To achieve this goal, the proposed study’s primary objective is to assess how pre-pandemic access to school-based caries prevention programs (SCPPs) affect children’s dental and dental-related care utilization and exposure to environments with high or very high COVID-19 exposure risk levels during the pandemic. This will be done by leveraging (1) a unique data linkage introduced in the original K-25 grant in tandem with (2) a natural experiment caused by unexpected SCPP service schedule interruptions from the pandemic that approximates randomization to pre-pandemic SCPP access and no pre-pandemic access across participating schools. This overcomes site selection bias concerns faced by prior evaluations of school- based programs more generally, whereby schools choosing to participate in school-based programs may be different from those choosing to opt out in ways affecting the observed outcomes of school-based programs. In support of this research, Dr. Shulamite S. Huang is applying for an administrative supplement to her funded K-25 award. Dr. Huang, a health economist specializing in the study of the dental market at New York University’s College of Dentistry (NYU COD), is establishing herself as a young investigator in oral health services research. This award will allow Dr. Huang to further work towards reducing health disparities and improving health care delivery and quality by integrating her background and experience in health economics and policy evaluation with clinical research methods and evaluation of clinical interventions. In Aim 1, Dr. Huang will determine how trends in dental and dental-related medical utilization have changed among vulnerable children, before and during the pandemic. In particular, she will assess whether any changes in dental-related emergency department visits are indicative of increasing numbers and increasing severity of unmet dental needs during the pandemic. In Aim 2, Dr. Huang will quantify the impact of pre-pandemic SCPP access on dental and dental-related medical utilization during the pandemic relative to no pre-pandemic SCPP access. This research will serve to further establish Dr. Huang as a oral health services researcher that brings causal inference methods from the field of economics, as well as novel large dataset linkages, to study the impact of changes in dental care delivery on large populations. As in the original K-25 award, Dr. Huang continues to be supported by a mentoring team comprised of a primary mentor, Dr. Heather Gold, an expert in population health research and economic evaluations of clinical & behavioral interventions and Professor at NYU Langone Health and School of Medicine; and one co- mentor, Dr. Richard Niederman, a dentist and Professor and Chair of the Department of Epidemiology and Health Promotion at NYU COD, who conducts the SCPP pragmatic clinical trial providing data for this study.