Braun Patricia A, Wiggins Kimberly T, Flowerday Cherith, Bienstock Andrew, Dickinson L Miriam
Denver Health and Hospital, Denver, CO, USA.
Department of Family Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251360952. doi: 10.1177/21501319251360952. Epub 2025 Jul 31.
Evaluate healthcare providers' and staffs' knowledge, self-reported abilities, activities, and barriers to providing preventive oral health services (POHS) at primary care medical visits before and after participation in the Rocky Mountain Network of Oral Health (RoMoNOH) project.
The RoMoNOH project integrated POHS into primary care medical visits of young children at 22 community health centers (CHCs) in Arizona, Colorado, Montana, and Wyoming by medical team members and/or by embedded dental hygienists (DHs). Twelve CHCs embedded DHs onto their teams. In an observational pre/post evaluation, a convenience sample of healthcare providers' characteristics were surveyed at baseline and 3 years across 4 oral health domains: knowledge, self-reported abilities, behaviors, and barriers. Each domain was scored from 0% to 100%, with 100% being optimal. Differences between pre- and post-project domain scores were assessed using chi-square, t-tests, and linear and logistic regression adjusting for providers' age.
Embedding DHs into CHCs and staff turnover impacted pre/post survey participants. The final analytic cohort included 213 (pre-survey response rate: 71%) and 165 (post-survey response rate: 52%) healthcare providers who worked with children < age 3. Participants were female (pre: 81%, post: 81%) and aged >35 years (pre: 39%, post: 41%). Unadjusted mean differences across surveys improved across all oral health domains (pre/post): knowledge: 65%/81%, < .001; self-reported ability: 52%/71%, < .001; activities: 32%/57%, < .001; barriers: 27%/21%, = .011. After adjustment for age, these improvements remained significant (all ≤ .011).
Healthcare providers' oral health practices improved over a multi-year oral health integration project aimed at increasing delivery of POHS at medical visits.
评估医疗服务提供者和工作人员在参与落基山口腔健康网络（RoMoNOH）项目前后，在初级保健就诊时提供预防性口腔健康服务（POHS）的知识、自我报告的能力、活动及障碍。
RoMoNOH项目通过医疗团队成员和/或嵌入式牙科保健员（DH），将POHS整合到亚利桑那州、科罗拉多州、蒙大拿州和怀俄明州22个社区卫生中心（CHC）的幼儿初级保健就诊中。12个CHC在其团队中配备了DH。在一项观察性前后评估中，在基线和3年时，针对医疗服务提供者的特征，在4个口腔健康领域进行便利抽样调查：知识、自我报告的能力、行为和障碍。每个领域的评分从0%到100%，100%为最佳。使用卡方检验、t检验以及针对提供者年龄进行调整的线性和逻辑回归，评估项目前后领域评分的差异。
在CHC中配备DH以及人员流动对前后调查参与者产生了影响。最终的分析队列包括213名（调查前回复率：71%）和165名（调查后回复率：52%）为3岁以下儿童提供服务的医疗服务提供者。参与者以女性为主（调查前：81%，调查后：81%），年龄大于35岁（调查前：39%，调查后：41%）。所有口腔健康领域在调查前后未经调整的平均差异均有所改善（调查前/后）：知识：65%/81%，P＜0.001；自我报告的能力：52%/71%，P＜0.001；活动：32%/57%，P＜0.001；障碍：27%/21%，P = 0.011。在对年龄进行调整后，这些改善仍然显著（均P≤0.011）。
在一个旨在增加初级保健就诊时POHS提供量的多年口腔健康整合项目中，医疗服务提供者的口腔健康实践得到了改善。
