178173 Improving Use of Oral Health Services Among HIV+ Patients: Project TEETH

Monday, October 27, 2008

Niko Verdecias, MPH , Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY
Paul Meissner, MSPH , Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY
Arthur E. Blank, PhD , Department of Family Medicine and Social Medicine, Center for the Evaluation of Health Programs/Division of Research, Bronx, NY
Joan Grcevic, DDS , Department of Dentistry, Montefiore Medical Center, Bronx, NY
Alison Karasz, PhD , Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
Robert Beil, MD , Montefiore Medical Group, Montefiore Medical Center, Bronx, NY
Background: Project TEETH, a 5-year HRSA-SPNS funded grant, was designed to increase the number of HIV+ patients referred to and utilizing dental services at ten Montefiore Medical Group (MMG2) sites. To accomplish this we delineate three objectives: Design and implement an integrative model of oral health (OH) care; Increase usage rates of OH services in an HIV+ population; and Using a QI orientation and the RE-AIM framework to evaluate our model of dental care with regards to reach, effectiveness, acceptance, implementation and maintenance. Methods: Three of the MMG2 sites have existing dental facilities on/near site, while seven are being serviced by mobile dental unit (MDU). Patient Navigators (PNs) have been integrated at the three sites to act as liaisons between medical care and OH services, assist with the dental appointment process and perform educational and follow-up functions. The MDU has integrated a Dental Hygienist (DH) to act as its liaison/link between medical and dental care. Results: Evaluation includes the bilingual DH and PNs conducting ³300 survey-based patient interviews. We will also conduct frequent QI-based evaluations to monitor the entire program. Currently, we have recorded 30% of patients as routinely receiving OH care off-site; 46.25% of referrals resulted in a dental appointment being made; 18.75% of patients required follow up; and 5% of patients have refused a dental appointment (n=97). Conclusion: We anticipate that the 1000+ HIV+ patients that receive primary care at the MMG2 sites will have been screened, referred, and/or received dental services by the completion of the program.

Learning Objectives:
1. Identify an innovate integrative model of oral health care aimed at increasing oral health care among HIV+ patients in an urban medical setting. 2. Describe effective tools to increase patientsí access and receipt of oral health care.

Keywords: HIV/AIDS, Oral Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Project Director and a member of the team's research evaluation team.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Special Topics in HIV-Related Care
See more of: HIV/AIDS