Cunha-Cruz Joana, Milgrom Peter, Shirtcliff R Michael, Huebner Colleen E, Ludwig Sharity, Allen Gary, Scott JoAnna
Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Seattle, WA, United States.
JMIR Res Protoc. 2015 May 22;4(2):e58. doi: 10.2196/resprot.4485.
Twice daily toothbrushing with fluoridated toothpaste is the most widely advocated preventive strategy for dental caries (tooth decay) and is recommended by professional dental associations. Not all parents, children, or adolescents follow this recommendation. This protocol describes the methods for the implementation and evaluation of a quality improvement health promotion program.
The objective of the study is to show a theory-informed, evidence-based program to improve twice daily toothbrushing and oral health-related quality of life that may reduce dental caries, dental treatment need, and costs.
The design is a parallel-group, pragmatic randomized controlled trial. Families of Medicaid-insured children and adolescents within a large dental care organization in central Oregon will participate in the trial (n=21,743). Families will be assigned to one of three groups: a test intervention, an active control, or a passive control condition. The intervention aims to address barriers and support for twice-daily toothbrushing. Families in the test condition will receive toothpaste and toothbrushes by mail for all family members every three months. In addition, they will receive education and social support to encourage toothbrushing via postcards, recorded telephone messages, and an optional participant-initiated telephone helpline. Families in the active control condition will receive the kit of supplies by mail, but no additional instructional information or telephone support. Families assigned to the passive control will be on a waiting list. The primary outcomes are restorative dental care received and, only for children younger than 36 months old at baseline, the frequency of twice-daily toothbrushing. Data will be collected through dental claims records and, for children younger than 36 months old at baseline, parent interviews and clinical exams.
Enrollment of participants and baseline interviews have been completed. Final results are expected in early summer, 2017.
If proven effective, this simple intervention can be sustained by the dental care organization and replicated by other organizations and government.
ClinicalTrials.gov NCT02327507; http://clinicaltrials.gov/ct2/show/NCT02327507 (Archived by WebCite at http://www.webcitation.org/6YCIxJSor).
每天使用含氟牙膏刷牙两次是预防龋齿（蛀牙）最广泛倡导的策略，也是专业牙科协会推荐的方法。并非所有家长、儿童或青少年都遵循这一建议。本方案描述了一项质量改进健康促进项目的实施和评估方法。
本研究的目的是展示一个基于理论和证据的项目，以改善每天刷牙两次的情况以及与口腔健康相关的生活质量，从而可能减少龋齿、牙科治疗需求和成本。
该设计为平行组实用随机对照试验。俄勒冈州中部一个大型牙科护理机构中参加医疗补助保险的儿童和青少年家庭将参与试验（n = 21,743）。家庭将被分配到三个组之一：试验干预组、积极对照组或消极对照组。干预旨在解决每天刷牙两次的障碍并提供支持。试验组的家庭每三个月会收到通过邮件寄给所有家庭成员的牙膏和牙刷。此外，他们还将通过明信片、录音电话留言以及一条由参与者自主拨打的可选热线电话获得鼓励刷牙的教育和社会支持。积极对照组的家庭会收到通过邮件寄来的用品套装，但不会收到额外的指导信息或电话支持。被分配到消极对照组的家庭将被列入等候名单。主要结果是接受的修复性牙科护理，对于基线时年龄小于36个月的儿童，还包括每天刷牙两次的频率。数据将通过牙科理赔记录收集，对于基线时年龄小于36个月的儿童，还将通过家长访谈和临床检查收集。
参与者招募和基线访谈已完成。预计2017年夏初得出最终结果。
如果证明有效，这种简单的干预措施可由牙科护理机构持续实施，并由其他机构和政府进行推广。
ClinicalTrials.gov NCT02327507；http://clinicaltrials.gov/ct2/show/NCT02327507（由WebCite存档于http://www.webcitation.org/6YCIxJSor）
