Implementing a Participatory, Multi-level Intervention to Improve Asian American Health

New York University, New York NY

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Abstract

ABSTRACT Lack of access to oral health care contributes to profound and enduring oral health disparities in the United States and worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include but are not limited to racial and ethnic minorities, including immigrants and non-English speakers. The Commission on Dental Accreditation (CODA) pre-doctoral standard 2-25 states: Dental education programs must make available opportunities and encourage students to engage in service learning experiences and/or community-based learning experiences. The New York University College of Dentistry (NYU Dentistry) aims to transcend this notable advance in dental education and build equitable partnerships with local community- based agencies, organizations, and institutions dedicated to improving the health and well-being of their constituents. Beyond the rewards of immersive learning experiences and the opportunity to improve the health of neighboring communities, our students and faculty will learn innovative local solutions from our partners. The 2011 report by the National Academies titled, Improving Access to Oral Health Care for Vulnerable and Underserved Populations is based on the following 2 well-established and evidence-based principles: (1) Oral health is an integral part of overall health and, therefore, oral health care is an essential component of comprehensive health care. (2) Oral health promotion and disease prevention are essential to any strategies aimed at improving access to care. Our long-term goal is to improve Asian American health. The current project will make a vital contribution by using well-established public health (CBPR, ecological models) and implementation science [Consolidated Framework for Implementation Research (CFIR), Implementation Outcomes Framework (IOF)] approaches in Chinese American partnering sites to achieve 3 specific aims: Aim 1: To use the remote capability of the axiUm Dental Software at NYU Dentistry to enter patient information at community sites into its electronic health record (EHR) system, thus enabling: tracking at the community, site, provider, and patient levels of receipt of oral health care visits, services, and health outcomes; evaluation of implementation effectiveness; and integration with the Epic EHR system at NYU Langone Medical Center. Aim 2: To compare the effectiveness of 2 multi-level interventions to improve oral health for Chinese adults: (A) EHR enhanced community outreach providing dental screening, health promotion, and incentives; (B) Partnered EHR enhanced community outreach providing written agreements of collaboration for dental screening, health promotion, and incentives; culturally-tailored and language-specific adaptation of materials; demonstrations with role-playing of proper brushing with fluoride toothpaste and flossing techniques; and CHW follow-up with patients of oral health care receipt and dental hygiene behaviors. Aim 3: To model the knowledge gained about factors at the community, site, provider, family, and patient levels to enhance community- and clinic-based oral health service delivery and improve health outcomes.