Trial Outcomes & Findings for Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in American Indian Head Start Programs (NCT NCT01116739)

NCT ID: NCT01116739

Last Updated: 2021-06-10

Results Overview

The number of decayed, missing, and filled tooth surfaces (dmfs) for each child. The dental examiners will be trained and calibrated, and standardized criteria and instruments will be used for the detection of the dental caries.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

2060 participants

Primary outcome timeframe

Baseline

Results posted on

2021-06-10

Participant Flow

Participant milestones

Participant milestones
Measure
COHS Administered Fluoride Varnish and Oral Health Education
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Overall Study
STARTED
1056
1004
Overall Study
COMPLETED
926
868
Overall Study
NOT COMPLETED
130
136

Reasons for withdrawal

Reasons for withdrawal
Measure
COHS Administered Fluoride Varnish and Oral Health Education
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Overall Study
Child had 2 years of HS
110
128
Overall Study
Withdrawal by Subject
6
0
Overall Study
child too young
2
6
Overall Study
child not enrolled in head start
10
2
Overall Study
enrolled caregiver not legal guardian
2
0

Baseline Characteristics

Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in American Indian Head Start Programs

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=926 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=868 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Total
n=1794 Participants
Total of all reporting groups
Age, Categorical
<=18 years
463 Participants
n=99 Participants
434 Participants
n=107 Participants
897 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
463 Participants
n=99 Participants
434 Participants
n=107 Participants
897 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Sex: Female, Male
Female
621 Participants
n=99 Participants
582 Participants
n=107 Participants
1203 Participants
n=206 Participants
Sex: Female, Male
Male
305 Participants
n=99 Participants
286 Participants
n=107 Participants
591 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
926 Participants
n=99 Participants
868 Participants
n=107 Participants
1794 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
White
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
United States
926 participants
n=99 Participants
868 participants
n=107 Participants
1794 participants
n=206 Participants
Child Enrolled in a Head Start program in one of 53 centers on the Navajo Nation
926 Participants
n=99 Participants
868 Participants
n=107 Participants
1794 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Baseline

Population: Only children, not parents, were analyzed for this outcome measure.

The number of decayed, missing, and filled tooth surfaces (dmfs) for each child. The dental examiners will be trained and calibrated, and standardized criteria and instruments will be used for the detection of the dental caries.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=443 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=424 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Evaluation of Decayed, Missing, and Filled Tooth Surfaces (Dmfs) at Baseline
19.9 dmfs
Standard Deviation 20.1
22.8 dmfs
Standard Deviation 20.1

PRIMARY outcome

Timeframe: 1 Year

Population: Only children, not parents, were analyzed for this outcome measure. Some participants were unavailable for analysis at this timepoint.

The number of decayed, missing, and filled tooth surfaces (dmfs) for each child. The dental examiners will be trained and calibrated, and standardized criteria and instruments will be used for the detection of the dental caries.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=217 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=231 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Evaluation of Decayed, Missing, and Filled Tooth Surfaces (Dmfs) at Year 1
23.3 dmfs
Standard Deviation 20.4
27.1 dmfs
Standard Deviation 21.5

PRIMARY outcome

Timeframe: 2 Years

Population: Only children, not parents, were analyzed for this outcome measure. Some participants were unavailable for analysis at this timepoint.

The number of decayed, missing, and filled tooth surfaces (dmfs) for each child. The dental examiners will be trained and calibrated, and standardized criteria and instruments will be used for the detection of the dental caries.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=238 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=229 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Evaluation of Decayed, Missing, and Filled Tooth Surfaces (Dmfs) at Year 2
28.5 dmfs
Standard Deviation 21.1
31.2 dmfs
Standard Deviation 21.3

PRIMARY outcome

Timeframe: 3 Years

Population: Only children, not parents, were analyzed for this outcome measure. Some participants were unavailable for analysis at this timepoint.

The number of decayed, missing, and filled tooth surfaces (dmfs) for each child. The dental examiners will be trained and calibrated, and standardized criteria and instruments will be used for the detection of the dental caries.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=118 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=111 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Evaluation of Decayed, Missing, and Filled Tooth Surfaces (Dmfs) at Year 3
32.8 dmfs
Standard Deviation 22.3
33.6 dmfs
Standard Deviation 18.6

SECONDARY outcome

Timeframe: Over 3 years

Population: Only the caregivers, not the children, were analyzed for this outcome measure. Not all participants were available for analysis at every time point.

An automated computer assisted survey interview (ACASI)will be done of the caregivers of the children. The questions have been standardized across 6 studies from the Collaborating Research Centers to Reduce Oral Health Disparities. The survey assessing attitudes and behaviors is comprised of 12 items. Scores are calculated as a percentage of appropriate responses. Therefore, possible scores range from 0-100.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=463 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=434 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Acquisition of Dental Attitudes and Behaviors of the Caregivers of the Children
Year 1
62.7 score on a scale
Standard Deviation 18.8
58.2 score on a scale
Standard Deviation 19.6
Acquisition of Dental Attitudes and Behaviors of the Caregivers of the Children
Baseline
54.4 score on a scale
Standard Deviation 19.3
56.1 score on a scale
Standard Deviation 18.3
Acquisition of Dental Attitudes and Behaviors of the Caregivers of the Children
Year 2
63.4 score on a scale
Standard Deviation 18.7
61.1 score on a scale
Standard Deviation 18.3
Acquisition of Dental Attitudes and Behaviors of the Caregivers of the Children
Year 3
65.6 score on a scale
Standard Deviation 18.9
66.4 score on a scale
Standard Deviation 17.6

SECONDARY outcome

Timeframe: Over 3 years

Population: Only children, not parents, were analyzed for this outcome measure. Some participants were unavailable for analysis at each timepoint.

Caries patterns will be studied in terms of the specific teeth and tooth surfaces that are affected. Caries prevalence is defined as the presence of more than 0 dmfs (decayed, missing, or filled surfaces) in the child participant. The percentage of child participants with caries prevalence is reported.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=443 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=424 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Evaluation of Caries Patterns
Year 1
89.9 percentage of participants
90.9 percentage of participants
Evaluation of Caries Patterns
Baseline
86.5 percentage of participants
90.1 percentage of participants
Evaluation of Caries Patterns
Year 2
95.4 percentage of participants
96.1 percentage of participants
Evaluation of Caries Patterns
Year 3
96.6 percentage of participants
98.2 percentage of participants

SECONDARY outcome

Timeframe: Up to 3 years after randomization

Population: Cost and utilization outcome measure data was not collected.

Utilization and costs of dental care received by the children in the study will be compared, as well as the costs of the intervention program.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Over 3 years

Population: Only the caregivers, not the children, were analyzed for this outcome measure. Not all participants were available for analysis at every time point.

An automated computer assisted survey interview (ACASI)will be done of the caregivers of the children. The questions have been standardized across 6 studies from the Collaborating Research Centers to Reduce Oral Health Disparities. The survey assessing knowledge is comprised of 14 items. Scores are calculated as a percentage of correct answers. Therefore, possible scores range from 0-100.

Outcome measures

Outcome measures
Measure
COHS Administered Fluoride Varnish and Oral Health Education
n=463 Participants
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years. Fluoride varnish: Fluoride varnish will be administered by the COHS quarterly for 2 years. Oral health education: Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
Usual Care
n=434 Participants
Usual care will include regular dental services provided by the Indian Health Service. Dental services delivered by the Indian Health Service.
Acquisition of Dental Knowledge of the Caregivers of the Children
Year 2
81.4 score on a scale
Standard Deviation 14.8
78.0 score on a scale
Standard Deviation 13.2
Acquisition of Dental Knowledge of the Caregivers of the Children
Year 3
81.2 score on a scale
Standard Deviation 13.4
79.5 score on a scale
Standard Deviation 12.8
Acquisition of Dental Knowledge of the Caregivers of the Children
Baseline
75.1 score on a scale
Standard Deviation 30.7
73.6 score on a scale
Standard Deviation 13.1
Acquisition of Dental Knowledge of the Caregivers of the Children
Year 1
80.4 score on a scale
Standard Deviation 13.1
76.8 score on a scale
Standard Deviation 13.5

Adverse Events

COHS Administered Fluoride Varnish and Oral Health Education

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Usual Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Patricia A. Braun

University of Colorado Denver

Phone: 3037241111

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place