DENTAL ADOPTION OF CARIES CONTROL SERVICES

虽然已经出现了新的，有效的技术来控制儿童的变化，但只有少数牙医采用了它们。为了增加牙医的采用，华盛顿牙科服务（WD）开发了一个由提供者教育和按服务收费补偿组成的两部分干预措施，为有风险的儿童提供一揽子的哭泣控制服务。研究目的是：1）确定干预对牙医采用儿童防龋服务的影响; 2）在高危儿童中，确定防龋服务对龋齿发病率和使用修复服务的影响; 3）确定干预的成本效益。人口包括16，404名波音员工的儿童家属，这些儿童家属由（白龙会）人头计划覆盖。将邀请有30名或更多人头儿童（N=91）的牙医参加研究，预计至少有50名牙医参加。牙科医生将被随机分为干预组和对照组。干预组的牙科医生将为900名高危儿童提供防龋服务，并在基线和1年和2年随访时收集dmfs/DMFS评分（n=900）。对照组牙医将在相同的时间段内为接受常规护理的高危儿童（n=900）收集dmfs/DMFS评分。牙医和儿童使用龋齿控制服务将通过白龙会记录测量2年。目标1将部分通过牙医参与研究，并通过比较各组之间牙医使用龋齿控制服务进行评估。目的2比较两组龋病发生率和修复性。目的2比较两组龋病发生率和修复性。如果发现有益效果，将在目标3中进行成本效益分析。该研究补充了中心申请的其他要素。正如识别最易患口腔疾病的儿童非常重要一样，提供者采用能够最好地检测和预防疾病的新的、具有成本效益的技术也同样重要。通过解决这一目的，该研究促进了日常实践中的综合行为，社会科学和卫生服务研究，并直接有助于中心应用的目标5和6。

Although new, effective technologies have emerged for controlling varies in children, only a minority of dentists have adopted them. To increase dentist adoption, Washington Dental Service (WD) has developed a 2-part intervention composed of provider education and fee-for-service reimbursement for providing a package of cries-control services to at risk children with capitation benefits. Study aims are: 1) to determine the effect of the intervention on dentist adoption of caries-control services for children; 2) among at risk children, to determine the effect of caries-control services on the incidence of dental caries and use of restorative services; and 3) to determine the cost effectiveness of the intervention. The population consists of 16,404 children dependents of Boeing employees covered by the (WDS) capitation program. Dentists with 30 or more capitation children (N=91) will be invited to participate in the study, and at least 50 dentists are expected to participate. Consenting dentists will be randomized into intervention and control groups. Dentists in the intervention group will provide aries control services to 900 at risk children and collect dmfs/DMFS scores at baseline and 1- and 2-year follow-ups (n=900). Control group dentists will be reimbursed for collecting dmfs/DMFS scores at identical periods for at risk children (n=900), who will receive usual care. Dentist and child use of caries-control services will be measured through WDS records for 2 years. Aim 1 will be assessed partly by dentist participation in the study, and by comparing dentist use of caries-control services between groups. Aim 2 will compare caries incidence and restorative between groups. Aim 2 will compare caries incidence and restorative between groups. If beneficial effects are detected, a cost-effectiveness analysis will be performed in Aim 3. The study complements other elements of the Center application. Just as it is important to identify children most susceptible to oral disease, so it is equally important for providers to adopt new, cost-effective technologies that can best detect and prevent disease. By addressing this purpose, the study fosters integrated behavioral, social science and health services research in daily practice, and contributes directly to Aims 5 and 6 of the Center application.