Formative and Pilot Study for an Effectiveness-Implementation Hybrid Cluster Randomized Trial to Incorporate Oral...

Area of Science:

• Public Health
• Implementation Science
• Pediatric Medicine

Background:

• Dental caries significantly impacts children's systemic health.
• Early dental care utilization is crucial for preventing caries in young children.
• The Pediatric Providers Against Cavities in Children's Teeth (PACT) trial aims to improve oral health for Medicaid-enrolled children aged 3-6.

Purpose of the Study:

• To present formative and pilot work for the PACT trial.
• To refine multi-level interventions for increasing dental utilization.
• To test the feasibility of integrating oral health into well-child visits.

Main Methods:

• Formative work included focus groups and interviews to gather insights on oral health communication and study logistics.
• A pilot study at two pediatric practices tested provider training, electronic medical record (EMR) integration, and recruitment strategies.
• The RE-AIM framework will be used in the main trial for effectiveness and implementation measures.

Main Results:

• Formative work identified needs for caries knowledge and dentist lists, informing protocol revisions.
• The pilot study successfully trained providers, integrated EMR questions, and recruited participants.
• Providers delivered oral health interventions in under 2 minutes with high EMR documentation rates.

Conclusions:

• Formative and pilot findings were crucial for refining the oral health intervention and protocol.
• The refined approach facilitated the successful implementation of the main PACT trial.
• This research provides a foundation for effective pediatric oral health integration into primary care.