低收入妇女及其子女在接受简短动机性咨询干预后的牙科就诊情况：一项社区随机试验。

Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial.

作者信息

Riedy Christine A, Weinstein Philip, Mancl Lloyd, Garson Gayle, Huebner Colleen E, Milgrom Peter, Grembowski David, Shepherd-Banigan Megan, Smolen Darlene, Sutherland Marilynn

机构信息

Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.

University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.

出版信息

Soc Sci Med. 2015 Nov;144:9-18. doi: 10.1016/j.socscimed.2015.09.005. Epub 2015 Sep 8.

DOI:10.1016/j.socscimed.2015.09.005

PMID:26372934

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4610142/

Abstract

UNLABELLED

This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of four conditions to receive prenatal or postpartum motivational interviewing/counseling (MI) or prenatal or postpartum health education (HE). Counselors also functioned as patient navigators. Primary outcomes were dental attendance during pregnancy for the mother and for the child by age 18 months. Attendance was obtained from the Oregon Division of Medical Assistance Programs and participant self-report. Statewide self-reported utilization data were obtained from the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Maternal attendance was 92% in the prenatal MI group and 94% in the prenatal HE group (RR = 0.98; 95% CI = 0.93-1.04). Children's attendance was 54% in postpartum MI group and 52% in the postpartum HE group (RR = 1.03; 95% CI = 0.82-1.28). Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40-50%) and for their children by 24 months (36% statewide; 95% CI = 27-44%). MI did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT01120041.

摘要

未标注

本研究测试了一种行为干预措施，以提高俄勒冈州农村低收入妇女及其子女的牙科就诊率。该研究采用了多地点、单盲、随机试验设计。400名妇女被随机分为四个组之一，分别接受产前或产后动机性访谈/咨询（MI）或产前或产后健康教育（HE）。咨询师还兼任患者导航员。主要结局指标是母亲孕期的牙科就诊率以及孩子18个月大时的牙科就诊率。就诊率数据来自俄勒冈医疗救助项目部门以及参与者的自我报告。全州范围的自我报告使用数据来自俄勒冈妊娠风险评估监测系统（PRAMS）。产前MI组的母亲就诊率为92%，产前HE组为94%（相对危险度=0.98；95%可信区间=0.93 - 1.04）。产后MI组儿童的就诊率为54%，产后HE组为52%（相对危险度=1.03；95%可信区间=0.82 - 1.28）。与全州范围的PRAMS数据相比，研究中的母亲在孕期的就诊率更高（全州范围为45%；95%可信区间=40 - 50%），她们孩子在24个月时的就诊率也更高（全州范围为36%；95%可信区间=27 - 44%）。与单独的HE相比，MI并没有带来更高的就诊率，而且实施成本更高。高就诊率可能归因于咨询师的患者导航员功能。