Telephone-Based Motivational Interviewing to Promote Dental Visits Among Low-Income Rural Pregnant Women

Project Number: R40 MC 08725-02
Project Date: 9/1/2007
Grantee: University of Washington
Department/Center: Office of Sponsored Programs

Final Report

Pending

Principal Investigator

Christine Ann Riedy PhD,
, University of Washington Office of Sponsored Programs,
1100 NE 45th St., Suite 300
Seattle, WA 98105-4696
cariedy@u.washington.edu

Abstract

This R40 application "Extramural MCH Research Program" corresponds to the Maternal Child Health Bureau Strategic Research Issues #’s II (MCH services and systems of care efforts to eliminate health disparities and barriers to health care access for MCH populations) and IV (Promoting the healthy development of MCH populations). Pregnancy is increasingly recognized as a critical period in which to intervene to improve oral health in both mother and child. The rationale for public health research to find efficacious and effective ways to increase dental care use by pregnant women and new mothers stems from some key facts: (1) dental caries is an infectious, transmissible disease from mother to baby; (2) oral health of mother and mother’s prior experiences with the dental care system are linked and have an impact on her children’s oral health; and (3) links between mother’s oral health and pregnancy outcomes. Information obtained in this study can be used to improve the oral health system to take advantage of this critical period. Primary Objective: To examine the application of the basic principles of Motivational Interviewing (MI), a client-centered counseling approach, within a dental managed care organization (DCO) for providing care to low income, mostly rural women served by Medicaid in the State of Oregon. Specific Aims: To evaluate a telephone-based MI intervention to increase dental utilization among pregnant women served by Medicaid in rural Oregon. a. To use focus groups to validate previously identified motivational "triggers" ("pros") and "barriers" ("cons") to dental care utilization during pregnancy and to refine menu items to overcome barriers, and to refine telephone scripts and mail prompts to be used in MI. b. To implement and examine whether an innovative enhanced telephone/mail MI intervention, increases the proportion of women receiving dental care during pregnancy in comparison to women receiving either the brief MI intervention or a control group receiving only a pamphlet. This study will use a three-group design with stratified random assignment of women to one of three groups (brief MI, enhanced MI, and a control). The two strata will be English and Spanish language. The current study will examine both a control and experimental groups with regards to the implementation of a program to promote dental visits during pregnancy. Comparing dental attendance in the three randomly assigned groups will provide valuable information regarding the impact of the program on dental treatment-seeking. Tying the intervention to the delivery and insurance system, including the participation of a major vendor of print materials for dentists, is an efficient and sustainable approach. Additional measures of readiness to seek dental care, depression and difficult life circumstances will be collected to individualize the MI intervention as well as to help explain the outcome of the interventional study. The first phase of the study uses qualitative methods and focus groups to tailor the telephone scripts and menu items for the MI intervention within this population.

Publications

Pending

Keywords

Access to Health Care, Counseling, Health care Utilization, MCH Research, Oral Health, Pregnant Women