Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources
Introduction There are substantial inequities in oral health access and outcomes in the USA, including by income and racial and ethnic identity. People with adverse social determinants of health (aSDoH), such as housing or food insecurity, are also more likely to have unmet dental needs. Many patien...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e078157.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850205243367751680 |
|---|---|
| author | Margaret E Samuels-Kalow Leon D Sanchez William Manning Carlos Camargo Rebecca E Cash Lisa Simon Regan Marsh Bruce Donoff Vanessa Cardenas Stephanie Loo |
| author_facet | Margaret E Samuels-Kalow Leon D Sanchez William Manning Carlos Camargo Rebecca E Cash Lisa Simon Regan Marsh Bruce Donoff Vanessa Cardenas Stephanie Loo |
| author_sort | Margaret E Samuels-Kalow |
| collection | DOAJ |
| description | Introduction There are substantial inequities in oral health access and outcomes in the USA, including by income and racial and ethnic identity. People with adverse social determinants of health (aSDoH), such as housing or food insecurity, are also more likely to have unmet dental needs. Many patients with dental problems present to the emergency department (ED), where minimal dental care or referral is usually available. Nonetheless, the ED represents an important point of contact to facilitate screening and referral for unmet oral health needs and aSDoH, particularly for patients who may not otherwise have access to care.Methods and analysis Mapping Oral health and Local Area Resources is a randomised controlled trial enrolling 2049 adult and paediatric ED patients with unmet oral health needs into one of three trial arms: (a) a standard handout of nearby dental and aSDoH resources; (b) a geographically matched listing of aSDoH resources and a search link for identification of geographically matched dental resources; or (c) geographically matched resources along with personalised care navigation. Follow-up at 3, 6, 9 and 12 months will evaluate oral health-related quality of life, linkage to resources and dental treatment, ED visits for dental problems and the association between linkage and neighbourhood resource density.Ethics and dissemination All sites share a single human subjects review board protocol which has been fully approved by the Mass General Brigham Human Subjects Review Board. Informed consent will be obtained from all adults and adult caregivers, and assent will be obtained from age-appropriate child participants. Results will demonstrate the impact of addressing aSDoH on oral health access and the efficacy of various forms of resource navigation compared with enhanced standard care. Our findings will facilitate sustainable, scalable interventions to identify and address aSDoH in the ED to improve oral health and reduce oral health inequities.Trial registration number NCT05688982. |
| format | Article |
| id | doaj-art-cfabb4faa9fd4247bbec4eca1f0e51db |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-cfabb4faa9fd4247bbec4eca1f0e51db2025-08-20T02:11:08ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-078157Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resourcesMargaret E Samuels-Kalow0Leon D Sanchez1William Manning2Carlos Camargo3Rebecca E Cash4Lisa Simon5Regan Marsh6Bruce Donoff7Vanessa Cardenas8Stephanie Loo9Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USAHarvard Medical School, Boston, Massachusetts, USADepartment of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA1Brigham and Women’s Hospital, Boston, United States of AmericaDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USADepartment of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USAHarvard Medical School, Boston, Massachusetts, USADepartment of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts, USARutgers, The State University of New Jersey, New Brunswick, New Jersey, USADepartment of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USAIntroduction There are substantial inequities in oral health access and outcomes in the USA, including by income and racial and ethnic identity. People with adverse social determinants of health (aSDoH), such as housing or food insecurity, are also more likely to have unmet dental needs. Many patients with dental problems present to the emergency department (ED), where minimal dental care or referral is usually available. Nonetheless, the ED represents an important point of contact to facilitate screening and referral for unmet oral health needs and aSDoH, particularly for patients who may not otherwise have access to care.Methods and analysis Mapping Oral health and Local Area Resources is a randomised controlled trial enrolling 2049 adult and paediatric ED patients with unmet oral health needs into one of three trial arms: (a) a standard handout of nearby dental and aSDoH resources; (b) a geographically matched listing of aSDoH resources and a search link for identification of geographically matched dental resources; or (c) geographically matched resources along with personalised care navigation. Follow-up at 3, 6, 9 and 12 months will evaluate oral health-related quality of life, linkage to resources and dental treatment, ED visits for dental problems and the association between linkage and neighbourhood resource density.Ethics and dissemination All sites share a single human subjects review board protocol which has been fully approved by the Mass General Brigham Human Subjects Review Board. Informed consent will be obtained from all adults and adult caregivers, and assent will be obtained from age-appropriate child participants. Results will demonstrate the impact of addressing aSDoH on oral health access and the efficacy of various forms of resource navigation compared with enhanced standard care. Our findings will facilitate sustainable, scalable interventions to identify and address aSDoH in the ED to improve oral health and reduce oral health inequities.Trial registration number NCT05688982.https://bmjopen.bmj.com/content/13/12/e078157.full |
| spellingShingle | Margaret E Samuels-Kalow Leon D Sanchez William Manning Carlos Camargo Rebecca E Cash Lisa Simon Regan Marsh Bruce Donoff Vanessa Cardenas Stephanie Loo Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources BMJ Open |
| title | Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources |
| title_full | Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources |
| title_fullStr | Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources |
| title_full_unstemmed | Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources |
| title_short | Mapping Oral health and Local Area Resources (MOLAR): protocol for a randomised controlled trial connecting emergency department patients with social and dental resources |
| title_sort | mapping oral health and local area resources molar protocol for a randomised controlled trial connecting emergency department patients with social and dental resources |
| url | https://bmjopen.bmj.com/content/13/12/e078157.full |
| work_keys_str_mv | AT margaretesamuelskalow mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT leondsanchez mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT williammanning mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT carloscamargo mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT rebeccaecash mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT lisasimon mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT reganmarsh mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT brucedonoff mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT vanessacardenas mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources AT stephanieloo mappingoralhealthandlocalarearesourcesmolarprotocolforarandomisedcontrolledtrialconnectingemergencydepartmentpatientswithsocialanddentalresources |