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Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

Award Number: R01DE028530
ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary Low rates of dental visits among populations that experience health disparities contribute to the substantial disparities observed in children’s oral health—with worse oral health observed among children in low-income households and Black and Hispanic children. To increase use of preventive oral health services, the US Preventive Services Task Force recommends that medical providers apply fluoride varnish to the teeth of all children aged 5 years and younger. Private health plans and all state Medicaid programs cover this primary pediatric preventive service without cost-sharing. Existing evidence indicates that delivery of fluoride varnish in medical offices increases utilization and reduces decay. Despite these benefits, few children receive it. Our parent grant (NIDCR R01-HS027994-02), funded from 08/14/20 to 05/31/24, aims to identify child, provider, practice, community-, and policy-level factors affecting delivery of fluoride varnish in medical offices in Massachusetts. In response to Notice of Special Interest: Administrative Supplements to Support Research on Preventive Interventions with Populations that Experience Health Disparities (NOT-OD-22-159), we propose to enhance the existing aims of our parent grant by examining racial and ethnic disparities in receipt of fluoride varnish. We will enhance Aim 1 to describe rates of children receiving fluoride varnish in medical settings by race/ethnicity and to determine whether differences by race/ethnicity result from where a child receives care versus children from different racial/ethnic groups receiving different care from the same provider. We will also enhance Aim 3 to examine the association between measures of structural racism (i.e., racialized economic segregation and residential segregation) and rates of children receiving fluoride varnish in medical settings. Our research team is well-suited to complete this work without 12 months because we have existing programs that can be used for the analysis of the Massachusetts Medicaid data (Aim 1) and because the dataset for Aim 3 has already been obtained and cleaned. This proposal will allow our highly successful interdisciplinary team to expand our work by examining if there is inequitable access to a primary preventive service that reduces dental caries across racial/ethnic groups and across communities impacted by racism. These are issues that we would otherwise not have the resources to address. This innovative and timely supplement has the potential to inform where to prioritize additional resources to increase receipt of preventive oral health services.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	3	4/30/2024	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $353,338 )
2023	2023	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	4	5/9/2023	NON-COMPETING CONTINUATION	$353,338
2023	2022	THE RAND CORPORATION	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	001	3	5/10/2023	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $353,338

Issue Date FY: 2022 ( Subtotal = $843,325 )
2022	2022	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	002	3	9/27/2022	SUPPLEMENT FOR EXPANSION	$0
2022	2022	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	001	3	9/14/2022	SUPPLEMENT FOR EXPANSION	$416,857
2022	2022	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	3	7/19/2022	NON-COMPETING CONTINUATION	$426,468
														Subtotal = $843,325

Issue Date FY: 2021 ( Subtotal = $456,806 )
2021	2021	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	2	5/26/2021	NON-COMPETING CONTINUATION	$456,806
2021	2020	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	001	1	5/28/2021	NEW	$0
														Subtotal = $456,806

Issue Date FY: 2020 ( Subtotal = $430,890 )
2020	2020	RAND CORPORATION, THE	1776 MAIN ST	SANTA MONICA	CA	90401	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	1	8/14/2020	NEW	$430,890
														Subtotal = $430,890

Grand Total All Awards = $2,084,359

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Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

Award Number: R01DE028530

ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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