Dental Diseases
Conditions
Brief summary
The goal of this clinical trial is to test the impact of a screening and linkage intervention for adverse social determinants of health (aSDoH) on oral health linkage to care for emergency department patients. Researchers will compare three groups: Patients in Arm A will receive paper handouts with general oral health and aSDoH resources. Patients in Arm B will receive paper handouts with geographically-proximate oral health and aSDoH resources. Patients in Arm C will receive geographically-proximate oral health and aSDoH resources plus active navigational assistance.
Interventions
BEHAVIORALGeneral information provision
Patients will receive information with general oral health and aSDoH resources.
BEHAVIORALGeographic information provision
Patients will receive information with geographically-proximate oral health and aSDoH resources based on a directory created by the study team.
BEHAVIORALNavigational assistance
Patients will receive phone-based navigational assistance from the study navigator.
Sponsors
Massachusetts General Hospital
National Institute of Dental and Craniofacial Research (NIDCR)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* To be eligible to participate in this study, an individual must meet all of the following criteria: * No evidence of lack of capacity to provide verbal informed consent (as documented in the chart). * Willing to comply with all study procedures and be available by phone for the duration of the study (as reported by the patient) * Unmet oral health needs as ascertained by the Hope Home (adult) or Gazzaz (pediatric) questions * Adult (age ≥18 years old) ED patient or pediatric ED patient (\>1 year of age) presenting with parent or legal guardian. Parent will be the primary study participant but if age \> 7 years, the child will provide assent for medical record review. * Ability to communicate in English or Spanish (as reported by the patient) * Emergency severity index (ESI) 2-5 (as documented in the electronic medical record) * Residence within catchment area of 3-hospital region (defined by MGB home hospital catchment area) at initial enrollment (as reported by the patient) * Working phone number
Exclusion criteria
* Patients on involuntary holds (per electronic medical record review) * Presenting from carceral facilities (per electronic medical record review) * Presenting for acute mental health care under evaluation for Section 12 (per electronic medical record review) * Patients presenting for assistance with intimate partner violence (IPV) or care following sexual assault
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Linkage to oral health care | Within 12 months of randomization | binary, completion of a dental appointment or not |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to completion of dental appointment at the individual level | Within 12 months of randomization | continuous, days from randomization to completion of dental appointment |
| Repeat visits for oral health problems | Within 12 months of randomization | binary, any return visit or not |
| Rate of linkage to oral health care at the neighborhood level | Within 12 months of randomization | continuous rate, ranges from 0-100 |
| Oral health quality of life | Within 12 months of randomization | Total score on OHIP-14 (continuous, ranges from 0-56) or OHIP-5 (0-20) |
| Return visits | Within 12 months of initial visit | Number of return visits to the ED, outpatient visits, inpatient admissions, and ICU admissions (each continuous). |
Countries
United States
Contacts
CONTACTMargaret Samuels-Kalow
Outcome results
None listed