Navigational Assistance for Dental Disease

Overseen By Margaret Samuels-Kalow

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Involuntary holds, Carceral facilities, Acute mental health, IPV, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

2049 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Navigational Assistance for Dental Disease?

Research suggests that patient education, including the use of electronic resources like the Internet, plays a crucial role in dental care. Effective communication and education can improve oral health literacy and outcomes, as seen in studies where tools like Information Prescription enhance patient education and communication. ^{1 2 3 4 5}

How is the Navigational Assistance for Dental Disease treatment different from other treatments?

This treatment is unique because it focuses on providing patients with navigational support to access quality health information and resources, rather than directly treating the dental disease itself. It helps patients find reliable information and resources online, which can empower them to manage their oral health more effectively. ^{6 7 8 9 10}

What is the purpose of this trial?

The goal of this clinical trial is to test the impact of a screening and linkage intervention for adverse social determinants of health (aSDoH) on oral health linkage to care for emergency department patients. Researchers will compare three groups: Patients in Arm A will receive paper handouts with general oral health and aSDoH resources. Patients in Arm B will receive paper handouts with geographically-proximate oral health and aSDoH resources. Patients in Arm C will receive geographically-proximate oral health and aSDoH resources plus active navigational assistance.

Eligibility Criteria

This trial is for emergency department patients with unmet oral health needs who can consent, follow study procedures, and are reachable by phone. It includes adults and children over 1 year old with a guardian present. Participants must speak English or Spanish, have an ESI of 2-5, live in the specified area, and have a working phone number.

Inclusion Criteria

I am willing to follow the study rules and can be reached by phone.

I understand and can agree to the study's procedures verbally.

I can communicate in English or Spanish.

Exclusion Criteria

Presenting for acute mental health care under evaluation for Section 12

Patients on involuntary holds

I am seeking help for issues related to intimate partner violence or after a sexual assault.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive different interventions based on their assigned arm: Arm A receives general oral health and aSDoH resources, Arm B receives geographically-proximate resources, and Arm C receives geographically-proximate resources plus navigational assistance.

12 months

Follow-up

Participants are monitored for completion of dental appointments and return visits to healthcare facilities.

12 months

Treatment Details

Interventions

• General information provision
• Geographic information provision
• Navigational assistance

Trial Overview The MOLAR trial tests how different types of information affect patients' ability to access dental care. Arm A gets general oral health info handouts; Arm B receives geographically tailored info; Arm C gets the same as B plus help navigating services.

Participant Groups

Group I: C--geographic information and navigational assistance Experimental Treatment 2 Interventions

Patients in Arm C will receive geographically-proximate oral health and aSDoH resources plus active navigational assistance.

Group II: B--geographic information Experimental Treatment 1 Intervention

Patients in Arm B will receive paper handouts with geographically-proximate oral health and aSDoH resources.

Group III: A--general information Experimental Treatment 1 Intervention

Patients in Arm A will receive paper handouts with general oral health and aSDoH resources

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

National Institute of Dental and Craniofacial Research (NIDCR)

Collaborator

Trials

312

Recruited

853,000+

Findings from Research

Understanding health care information, such as medication directions and physician guidance, leads to improved health outcomes for consumers.

Lack of comprehension of medical instructions can result in serious health issues, including poor management of chronic conditions like diabetes, increased hospitalizations, and medication errors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Crystal-clear communication. Kantor, A.[2008]

The Information Prescription (Information Rx) Program, implemented by the American College of Physicians Foundation, enhances patient education and communication by directing patients to reliable health information on MedlinePlus, as reported in studies conducted from 2002-2005.

Physicians who use Information Rx feel they are providing a valuable service that improves patient communication and encourages patients to seek quality health information online, ultimately fostering better dialogue and understanding between doctors and patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Information Rx: Evaluation of a new informatics tool for physicians, patients, and libraries. Siegel, ER., Logan, RA., Harnsberger, RL., et al.[2020]

A study involving interviews and observations revealed that while most dental patients felt satisfied with the education they received during visits, 38% still sought additional information online, indicating a gap in their knowledge needs.

Patient education accounted for a significant portion of dental visit time (29% during initial exams and 7% during routine visits), suggesting that integrating effective educational strategies into dental workflows could enhance patient understanding and care outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An initial, qualitative investigation of patient-centered education in dentistry. Clayton, M., Borromeo, C., Hess, S., et al.[2013]

Educating patients and families about oral care is crucial for improving adherence to treatment regimens and enhancing overall patient outcomes during cancer therapy.

A significant barrier to effective oral care is the lack of knowledge among health care professionals, highlighting the need for improved training in oral assessment and hygiene for oncology nurses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Educational issues in oral care. Daniel, BT., Damato, KL., Johnson, J.[2019]

A study involving 50 participants, including 44 dental providers and 6 oral health literacy experts, revealed that while dental providers value effective communication, they rarely use recommended techniques, relying mostly on simple language and visual aids.

Key barriers to effective communication identified include time constraints, financial incentives favoring treatment over prevention, and a lack of training and resources in oral health literacy, suggesting a need for improved support and education for dental providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California. Tseng, W., Pleasants, E., Ivey, SL., et al.[2021]

A new method for organizing consumer health information was developed, which combines semantic annotation and Formal Concept Analysis, resulting in improved navigation for users seeking health information online.

This method achieved a recall increase of 36.5% in multi-topic assignment of health questions, while maintaining high precision, indicating it can effectively enhance access to quality health information without compromising accuracy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multi-topic assignment for exploratory navigation of consumer health information in NetWellness using formal concept analysis. Cui, L., Xu, R., Luo, Z., et al.[2021]

About 51.3% of consumers with chronic health conditions reported having navigational needs when seeking health information online, indicating a significant portion would benefit from assistance in finding reliable resources.

Participants with navigational needs tended to have lower eHealth literacy and sought a wider variety of health information, suggesting that targeted support could enhance their ability to manage their health effectively online.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Consumer Use of "Dr Google": A Survey on Health Information-Seeking Behaviors and Navigational Needs. Lee, K., Hoti, K., Hughes, JD., et al.[2022]

A survey of 400 Australian adults revealed that over half of the participants preferred navigational support from health professionals when searching for online health information, regardless of their self-identified need for support.

The main barriers to finding reliable online health information were the overwhelming volume of available data and inconsistencies between different sources, affecting both those who needed support and those who did not.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dr Google Is Here to Stay but Health Care Professionals Are Still Valued: An Analysis of Health Care Consumers' Internet Navigation Support Preferences. Lee, K., Hoti, K., Hughes, JD., et al.[2018]

A network map was created to visualize the complex web of health information available online, highlighting the varying quality of sources accessed by patients and medical professionals.

This prototype map serves as a tool to help users navigate and evaluate the reliability of different consumer e-health information websites, potentially improving decision-making in healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A trend map for e-health information. Plasek, JM., Pieczkiewicz, DS.[2016]

A computer-assisted learning package on the oral manifestations of HIV was developed and assessed by 75 general dental practitioners (GDPs) in the UK, with 72% providing feedback on its effectiveness.

The majority of GDPs found the package to be user-friendly and more effective than traditional educational methods like videos and journals, leading to its modification and distribution for broader use in England and Wales.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computer assisted learning (CAL) of oral manifestations of HIV disease. Porter, SR., Telford, A., Chandler, K., et al.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Crystal-clear communication. [2008]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Information Rx: Evaluation of a new informatics tool for physicians, patients, and libraries. [2020]

3. Netherlands pubmed.ncbi.nlm.nih.gov

An initial, qualitative investigation of patient-centered education in dentistry. [2013]

4. United States pubmed.ncbi.nlm.nih.gov

Educational issues in oral care. [2019]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Multi-topic assignment for exploratory navigation of consumer health information in NetWellness using formal concept analysis. [2021]

7. Canada pubmed.ncbi.nlm.nih.gov

Consumer Use of "Dr Google": A Survey on Health Information-Seeking Behaviors and Navigational Needs. [2022]

8. Canada pubmed.ncbi.nlm.nih.gov

Dr Google Is Here to Stay but Health Care Professionals Are Still Valued: An Analysis of Health Care Consumers' Internet Navigation Support Preferences. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

A trend map for e-health information. [2016]

10. England pubmed.ncbi.nlm.nih.gov

Computer assisted learning (CAL) of oral manifestations of HIV disease. [2019]