Multi-Level Interventions to Reduce Oral Health Disparities Among Adults in Primary Care Settings

What this Trial Is About

Researchers are evaluating multi-level interventions designed to increase dental visits among Medicaid-enrolled older adults aged 55 years or older who attend non-urgent primary care visits in MetroHealth practice settings. This study uses a cluster randomized clinical trial design to compare an intervention that combines practice-level electronic health record (EHR) changes and provider education with a control group receiving standard oral health care education. The goal is to improve dental attendance and oral health outcomes in this population. The study involves 12 primary care practices randomized into two groups. The intervention group receives EHR modifications to support ask, advise, assess, and connect (AAAC) strategies delivered by medical staff, along with theory-based training for clinicians to communicate oral health facts. The control group receives standard American Dental Association-based oral health education for clinicians only, without EHR changes or medical staff involvement. Older adults are recruited during their first primary care visit and followed for approximately 24 months, with provider training and booster sessions scheduled during the study period. Participants undergo multiple assessments including questionnaires on oral health behaviors and quality of life, biometric data abstraction from EHR, and dental claims data review to measure dental attendance. Data collection occurs at baseline and follow-up visits at 12 and 24 months. Additional evaluations include provider training assessments, documentation of oral health messaging, and monitoring of implementation factors such as adoption and fidelity. The study aims to understand how these interventions affect dental care utilization and oral health among older adults over time.

Oral Health Intervention in Adult Primary Care