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 在经历健康差距的人群中，牙科就诊率低是导致 观察到儿童口腔健康的差异-低收入儿童的口腔健康状况更差 家庭以及黑人和西班牙裔儿童。为了增加预防性口腔健康服务的使用，美国 预防服务工作组建议医疗提供者在所有人的牙齿上涂上含氟清漆 5岁及以下的儿童。私人健康计划和所有州医疗补助计划都涵盖了这一初选 无费用分担的儿科预防服务。现有证据表明，氟化物清漆在 医务室提高利用率，减少腐烂。尽管有这些好处，但很少有孩子能得到它。我们的 家长助学金(NIDCR R01-HS027994-02)从20年8月14日至24年5月31日期间资助，旨在识别儿童、提供者、 年影响医务室提供含氟清漆的实践、社区和政策因素 马萨诸塞州。回应特别关注的通知：支持研究的行政补编 对经历健康差异(非OD-22-159)的人群进行预防性干预，我们建议 通过检查接受氟化物方面的种族和民族差异，加强我们父母补助金的现有目标 清漆。我们将加强目标1，通过以下方式描述儿童在医疗环境中接受含氟清漆的比率 种族/民族，并确定种族/民族差异是否源于儿童接受护理的地方 与来自不同种族/民族的儿童从同一提供者那里得到不同的照顾相比。我们还将 加强目标3，以审查结构性种族主义措施(即种族主义的经济措施)之间的联系 隔离和居住隔离)和儿童在医疗环境中接受氟化物清漆的比率。 我们的研究团队非常适合在12个月内完成这项工作，因为我们有现有的计划 可用于分析马萨诸塞州的医疗补助数据(AIM 1)，因为AIM的数据集 %3已获得并已清理。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，审查是否有机会不公平地获得初级预防服务，从而减少 在种族/族裔群体和受种族主义影响的社区之间发生龋齿。这些都是 否则，我们就没有资源来解决问题。这一创新和及时的补充具有 有可能告知在哪里优先安排额外资源，以增加预防性口腔健康服务的接受。

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.