Effects of a Brief Case Management Intervention Linking People With HIV to Oral Health Care: Project SMILE.
Objectives. Although people with HIV experience significant oral health problems, many consistently identify oral health as an unmet health care need. We conducted a randomized controlled trial to evaluate the impact of a dental case management intervention on dental care use. Methods. We evaluated the intervention according to self-reported dental care use at 6-, 12-, and 18-month follow-ups. Multivariable logistic models with generalized estimating equations were used to assess the effects of the intervention over time. Results. The odds of having a dental care visit were about twice as high in the intervention group as in the standard care group at 6 months (adjusted odds ratio [OR] = 2.52; 95% confidence interval [CI] = 1.58, 4.08) and 12 months (adjusted OR = 1.98; 95% CI = 1.17, 3.35), but the odds were comparable in the 2 groups by 18 months (adjusted OR = 1.07; 95% CI = 0.62, 1.86). Factors significantly associated with having a dental care visit included frequent physician visits and dental care referrals. Conclusions. We demonstrated that a dental case management intervention targeting people with HIV was efficacious but not sustainable over time. Barriers not addressed in the intervention must be considered to sustain its use over time.
At the time of the study, Lisa R. Metsch, Margaret Pereyra, Yves Jeanty, and Eduardo Valverde were with the Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL. Shari Messinger, Gabriel Cardenas, and Henry Boza are with the Department of Public Health Sciences, Miller School of Medicine, University of Miami. Carrigan Parish is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Scott Tomar is with the Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville.
Lisa R
LR
Metsch
Margaret
M
Pereyra
Shari
S
Messinger
Yves
Y
Jeanty
Carrigan
C
Parish
Eduardo
E
Valverde
Gabriel
G
Cardenas
Henry
H
Boza
Scott
S
Tomar