Pediatric clinicians can help reduce rates of early childhood caries

Effects of a practice based intervention

Nancy R. Kressin, Martha E. Nunn, Harpreet Singh, Michelle B. Orner, Lori Pbert, Catherine Hayes, Corinna Culler, Stephan R. Glicken, Sean Palfrey, Paul L. Geltman, Cynthia Cadoret, Michelle M. Henshaw

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

OBJECTIVE:: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN:: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION:: We provided communication skills training using the approach of patient centered counseling, edited the electronic medical record to prompt counseling, and provided parents/caregivers with an educational brochure. OUTCOME MEASURES:: We assessed changes in provider knowledge about ECC after the intervention, and examined providers' counseling practices and incidence of ECC over time by site, controlling for baseline ECC, patient sociodemographics and parents'/caregivers' practice of risk factors (diet, oral hygiene, tooth-monitoring), among 1045 children with complete data. RESULTS:: Provider knowledge about ECC increased after the intervention training (percentage correct answers improved from 66% to 79%). Providers at the intervention site used more counseling strategies, which persisted after adjustment for sociodemographic characteristics. Children at the intervention site had a 77% reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; P ≤ 0.004. CONCLUSIONS:: The multifaceted intervention was associated with increased provider knowledge and counseling, and significantly attenuated incidence of ECC. If validated by additional studies, similar interventions could have the potential to make a significant public health impact on reducing ECC among young children.

Original languageEnglish
Pages (from-to)1121-1128
Number of pages8
JournalMedical Care
Volume47
Issue number11
DOIs
StatePublished - Nov 2009
Externally publishedYes

Fingerprint

Counseling
Pediatrics
Caregivers
Parents
Pamphlets
Electronic Health Records
Oral Hygiene
Incidence
Risk Reduction Behavior
Ambulatory Care Facilities
Tooth
Public Health
Communication
Diet

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Pediatric clinicians can help reduce rates of early childhood caries : Effects of a practice based intervention. / Kressin, Nancy R.; Nunn, Martha E.; Singh, Harpreet; Orner, Michelle B.; Pbert, Lori; Hayes, Catherine; Culler, Corinna; Glicken, Stephan R.; Palfrey, Sean; Geltman, Paul L.; Cadoret, Cynthia; Henshaw, Michelle M.

In: Medical Care, Vol. 47, No. 11, 11.2009, p. 1121-1128.

Research output: Contribution to journalArticle

Kressin, NR, Nunn, ME, Singh, H, Orner, MB, Pbert, L, Hayes, C, Culler, C, Glicken, SR, Palfrey, S, Geltman, PL, Cadoret, C & Henshaw, MM 2009, 'Pediatric clinicians can help reduce rates of early childhood caries: Effects of a practice based intervention', Medical Care, vol. 47, no. 11, pp. 1121-1128. https://doi.org/10.1097/MLR.0b013e3181b58867
Kressin, Nancy R. ; Nunn, Martha E. ; Singh, Harpreet ; Orner, Michelle B. ; Pbert, Lori ; Hayes, Catherine ; Culler, Corinna ; Glicken, Stephan R. ; Palfrey, Sean ; Geltman, Paul L. ; Cadoret, Cynthia ; Henshaw, Michelle M. / Pediatric clinicians can help reduce rates of early childhood caries : Effects of a practice based intervention. In: Medical Care. 2009 ; Vol. 47, No. 11. pp. 1121-1128.
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abstract = "OBJECTIVE:: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN:: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION:: We provided communication skills training using the approach of patient centered counseling, edited the electronic medical record to prompt counseling, and provided parents/caregivers with an educational brochure. OUTCOME MEASURES:: We assessed changes in provider knowledge about ECC after the intervention, and examined providers' counseling practices and incidence of ECC over time by site, controlling for baseline ECC, patient sociodemographics and parents'/caregivers' practice of risk factors (diet, oral hygiene, tooth-monitoring), among 1045 children with complete data. RESULTS:: Provider knowledge about ECC increased after the intervention training (percentage correct answers improved from 66{\%} to 79{\%}). Providers at the intervention site used more counseling strategies, which persisted after adjustment for sociodemographic characteristics. Children at the intervention site had a 77{\%} reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; P ≤ 0.004. CONCLUSIONS:: The multifaceted intervention was associated with increased provider knowledge and counseling, and significantly attenuated incidence of ECC. If validated by additional studies, similar interventions could have the potential to make a significant public health impact on reducing ECC among young children.",
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AU - Hayes, Catherine

AU - Culler, Corinna

AU - Glicken, Stephan R.

AU - Palfrey, Sean

AU - Geltman, Paul L.

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N2 - OBJECTIVE:: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN:: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION:: We provided communication skills training using the approach of patient centered counseling, edited the electronic medical record to prompt counseling, and provided parents/caregivers with an educational brochure. OUTCOME MEASURES:: We assessed changes in provider knowledge about ECC after the intervention, and examined providers' counseling practices and incidence of ECC over time by site, controlling for baseline ECC, patient sociodemographics and parents'/caregivers' practice of risk factors (diet, oral hygiene, tooth-monitoring), among 1045 children with complete data. RESULTS:: Provider knowledge about ECC increased after the intervention training (percentage correct answers improved from 66% to 79%). Providers at the intervention site used more counseling strategies, which persisted after adjustment for sociodemographic characteristics. Children at the intervention site had a 77% reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; P ≤ 0.004. CONCLUSIONS:: The multifaceted intervention was associated with increased provider knowledge and counseling, and significantly attenuated incidence of ECC. If validated by additional studies, similar interventions could have the potential to make a significant public health impact on reducing ECC among young children.

AB - OBJECTIVE:: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN:: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION:: We provided communication skills training using the approach of patient centered counseling, edited the electronic medical record to prompt counseling, and provided parents/caregivers with an educational brochure. OUTCOME MEASURES:: We assessed changes in provider knowledge about ECC after the intervention, and examined providers' counseling practices and incidence of ECC over time by site, controlling for baseline ECC, patient sociodemographics and parents'/caregivers' practice of risk factors (diet, oral hygiene, tooth-monitoring), among 1045 children with complete data. RESULTS:: Provider knowledge about ECC increased after the intervention training (percentage correct answers improved from 66% to 79%). Providers at the intervention site used more counseling strategies, which persisted after adjustment for sociodemographic characteristics. Children at the intervention site had a 77% reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; P ≤ 0.004. CONCLUSIONS:: The multifaceted intervention was associated with increased provider knowledge and counseling, and significantly attenuated incidence of ECC. If validated by additional studies, similar interventions could have the potential to make a significant public health impact on reducing ECC among young children.

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