Information and Communication Technologies (ICTS) in Dentistry for SUS
2021年3月12日 更新者：Mariana Minatel Braga、University of Sao Paulo
Using Information and Communication Technologies (ICTs) to Solve the Repressed Demand for Primary Dental Care in the SUS Due to the COVID-19 Pandemic
At the time of the COVID-19 pandemic, thousands of children had their dental care interrupted or postponed, generating a pent-up demand for primary care.
In order to minimize the impact of this outage of face-to-face care, information and communication technologies could be an alternative and even likely to be envisioned within the Brazilian Unified Health System (SUS).
In this sense, this study sought to show the impact of the use of information and communication technologies (ICT) in the resolution of the pent-up demand for primary dental care to children in the SUS, due to the COVID-19 pandemic, proposing the use of telemonitoring, teleorientation and telescreening to resolve and address demands arising from this outage in primary elective care.
The impact of the use of these strategies will be measured in terms of problem-solving, reduction of waiting time to resolve complaints and caregivers' perception about received care.
For this, two clinical studies were designed and a primarily trial-based economic evaluation was planned.
Mathematical models will be used to transpose these results into the reality of the SUS, in view of the State Health Secretariat of São Paulo and different Brazilian scenarios.
Finally, the investigators also aim to study the possibility of implementing these technologies mentioned in the daily life of the SUS, even after a pandemic, and to check the possibility of incorporating and costing them, as well as exploring possible social impact and relationship with possible inequities in health.
調査の概要
詳細な説明
Project Objectives:
This proposal has as a general objective to show the impact of the use of information and communication technologies (ICT) on the resolution of the pent-up demand for primary dental care to children in the SUS, due to the COVID-19 pandemic.
To this do so, the following specific objectives are defined:
- To identify the pent-up demand for the outage of dental care and the benefits and difficulties, as well as the perception of users, in the implementation of new strategies of non-face-to-face care based on technology (teleservice), using a primary care cell unit for children and prospecting, through models, this situation for the scenario of the Unified Health System (SUS).
- Perform different forms of economic evaluation to measure whether the gains achieved with the implementation of teleservice (telescreening, teleorientation and telemonitoring) compensate for the additional costs possibly associated with it, or whether teleservice modalities are associated with long-term resource savings, taking into account the implementation sized for the Brazilian public health system.
- Explore how the introduction of these technologies could benefit the SUS in the trans and post-pandemic period, contribute to the correction of possible inequities in health care and other social aspects, as well as result in possible differences when different Brazilian scenarios are explored.
研究の種類
介入
入学 (予想される)
368
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究連絡先
- 名前：Mariana M Braga, PhD
- 電話番号：55 11 30917835
- メール：mmbraga@usp.br
研究連絡先のバックアップ
- 名前：Karina Haibara
- 電話番号：55 11 30917835
- メール：karina.natal@usp.br
研究場所
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São Paulo、ブラジル、05508000
- 募集
- University of Sao Paulo
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コンタクト：
- Mariana Minatel Braga, Phd
- 電話番号：992014818
- メール：mmbraga@usp.br
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コンタクト：
- Maria Eduarda Franco Viganó, Graduation
- 電話番号：(11)99518-1964
- メール：maria.vigano@usp.br
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
3年～13年 (子)
健康ボランティアの受け入れ
はい
受講資格のある性別
全て
説明
Inclusion Criteria:
- Children from 3 to 13 years old who are involved in clinical studies and who already undergo follow-up from 6 to 60 months in the mobile dental unit.
Exclusion Criteria:
- Guardian´s participants) who do not accept to participate in the research and if participants accept.
- Children who do not assent with participation in the research (when already literate). - For children aged 3 to 6 years, included in the research, the waiver of the need to fill out the term of free and informed assent was requested, considering that these children are not literate and would not be able to write, to assent with the participation. t
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：支持療法
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Intervention
In the intervention group there will be the application of the intervention - use of telemonitoring and teleorientation applied to children in primary care in Dentistry.
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Teleservice will be performed through a digital platform (Video for Health" - V4H).
The service will consist of: a) recognition of the condition identified in the pandemic period, including updates on medical history, current oral health condition, search for dental care in other units, need for referral, change of hygiene habits, b) realization of diet guidance, hygiene and other necessary habits, made from a situational recognition of such habits, c) targeting the needs presented, in which individualized counselling will be given seeking to meet the demand presented by that family nucleus.
A dental form developed on the digital platform Google Forms will serve as a guide for the performance of the service and where the collected data will be formally recorded.
The guidelines, although individualized for the needs of each child, will follow a pre-defined and standardized structure and based on the best evidence available in the subject.
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アクティブコンパレータ：Waiting list
In the control group, children waiting to be booked to the intervention (in implementation in the unit because of the pandemic) will be evaluated for the outcomes.
Only after the evaluation, the control group's children will be invited to perform the teleconsultation (proposed intervention).
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No intervention (at least, until the time frame for outcome assessment)
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Family/patient´s perception about the dental care
時間枠：2 weeks after intervention (or one week of waiting - in the case of the control group)
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Evaluation of the quality of dental care to be measured by the SERVQUAL questionnaire (a multi-dimensional research instrument) - total of 22 items and 5 dimensions, comprising 4 items to capture tangibles, 5 items to capture reliability, 4 items for responsiveness, 4 items for assurance and 5 items to capture empathy. A total of 100 points is allocated among the five dimensions. The participants evaluate the degree to which they perceived the proposed service. To identify participants' perceptions, one item asked, "How do you feel about these service attributes that are already provided?", which was scored on a 5-point Likert-type scale of "very bad (1)" to "very good (5)." |
2 weeks after intervention (or one week of waiting - in the case of the control group)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Increment in caries experience since the interruption of dental care
時間枠：1 year after intervention
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Clinical examination focused using dmft and DMFT indices and comparison to those.
An previously recorded in participant´s records, resulting in the difference between the indices between these moments (DMFT+dmft final - DMFT+dmft when treatment was interrupted).
An examiner unaware of baseline conditions will assess these indices.
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1 year after intervention
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Increment or changes in the needs for dental treatment
時間枠：1 year after intervention
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Clinical examination focused in detecting if there is need for dental treatment or not (including untreated caries, need for restoration repair, need of gingival or periodontal treatment, need for extractions for any reason).
An examiner unware of baseline conditions will assess such needs.
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1 year after intervention
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Demand resolution after intervention
時間枠：2 weeks after intervention
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Interview for checking about the resolution of demands pointed out during the baseline consultation.
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2 weeks after intervention
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Need for reorientation about oral hygiene
時間枠：2 weeks, 3 months, 6 months, 1 year after intervention
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Interview for checking doubts about oral hygiene and checklist of items to be accomplished during oral hygiene demonstrated by child.
An external examiner will evaluate all listed items.
In case of any one is not checked, the need of reorientation is considered.
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2 weeks, 3 months, 6 months, 1 year after intervention
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Perception of caregivers regarding primary care and dental care.
時間枠：2 weeks after intervention
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Semi-structured interviews, applied with guided questions to try to assess participants' and parents' perception, as well as potential barriers and facilitators associated with dental care during the pandemic period with the caregivers of the children who followed the teleservice.
For this, individual interviews will be recorded and transcribed.
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2 weeks after intervention
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
捜査官
- 主任研究者：Mariana M Braga, PhD、USP
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2020年12月1日
一次修了 (予想される)
2021年6月30日
研究の完了 (予想される)
2022年6月30日
試験登録日
最初に提出
2021年3月8日
QC基準を満たした最初の提出物
2021年3月12日
最初の投稿 (実際)
2021年3月15日
学習記録の更新
投稿された最後の更新 (実際)
2021年3月15日
QC基準を満たした最後の更新が送信されました
2021年3月12日
最終確認日
2021年3月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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