Implementing a Participatory, Multi-level Intervention to Improve Asian American Health Study
Condition: Oral Disease; Dental Caries
MeSH terms: Dental Caries; Mouth Diseases
Study type: Interventional

Summary: 
      This feasibility and acceptability study will be conducted at 3 community outreach centers
      serving an urban, low-income Chinese population. The study will evaluate the feasibility and
      acceptability of implementing a partnered intervention to improve the oral and general health
      of low-income, urban Chinese American adults and of using remote data entry into an
      electronic health record (EHR). The research staff will survey a sample of Chinese American
      patients screened at each center about their satisfaction with the partnered intervention and
      about their oral health behaviors. An additional sample selected from providers [dentists and
      community health workers (CHW)], research staff, New York University (NYU) administrators,
      site directors, and community advisory board (CAB) members will participate in structured
      interviews about the partnered intervention. The remote EHR evaluation will include group
      adaptation sessions and workflow analyses via multiple recorded sessions with research staff,
      NYU administrators, outreach site directors, and providers (dentists and CHWs). The study
      will also model knowledge held by these non-patient participants (including CAB members) to
      evaluate and enhance the partnered intervention during and/or after the feasibility and
      acceptability study for use in future implementations.
    

Detailed description: 
      Introduction: While the US health care system has the capability to provide amazing treatment
      of a wide array of conditions, this care is not uniformly available to all population groups.
      Oral health care is one of the dimensions of the US health care delivery system in which
      striking disparities exist. More than half of the population does not visit a dentist each
      year. Improving access to oral health care is a critical and necessary first step to
      improving oral health outcomes and reducing disparities. Fluoride has contributed profoundly
      to the improved dental health of populations worldwide and is needed regularly throughout the
      life course to protect teeth against dental caries. To ensure additional gains in oral
      health, fluoride toothpaste should be used routinely at all ages. Evidence-based guidelines
      for annual dental visits and brushing teeth with fluoride toothpaste form the basis of this
      implementation science project that is intended to bridge the care gap for underserved Asian
      American populations by improving access to quality oral health care and enhancing effective
      oral health promotion strategies. The ultimate goal of this study is to provide information
      for the design and implementation of a randomized controlled trial of a participatory,
      multi-level, partnered (i.e., with community stakeholders) intervention to improve the oral
      and general health of low-income Chinese American adults.

      Methods: This study will evaluate the feasibility and acceptability of implementing a
      partnered intervention using remote data entry into an electronic health record (EHR) to
      improve access to oral health care and promote oral health. The research staff will survey a
      sample of Chinese American patients (planned n = 90) screened at 3 outreach centers about
      their satisfaction with the partnered intervention. Providers (dentists and community health
      workers), research staff, administrators, site directors, and community advisory board
      members will participate in structured interviews about the partnered intervention. The
      remote EHR evaluation will include group adaptation sessions and workflow analyses via
      multiple recorded sessions with research staff, administrators, outreach site directors, and
      providers. The study will also model knowledge held by non-patient participants to evaluate
      and enhance the partnered intervention for use in future implementations.
    

Intervention name(s): Partnered intervention
Intervention type(s): Behavioral
Intervention description(s): CHWs will provide dental education and counseling, lead interactive demonstrations of brushing with fluoride toothpaste and flossing, and improve access to dental care through dental coverage enrollment and linkage to local dentists.
Intervention model: Single Group Assignment
Intervention model description: Feasibility and acceptability study.
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Chinese American; implementation science; feasibility; acceptability; oral health; dental care; health equity; urban health