ETE Interventions in the Dental Setting

Purpose

The purpose of this study is to use information technology (IT) to support the delivery of HIV prevention and care best practices in the dental care setting to meet the Department of Health and Human Services (DHHS) Ending the HIV Epidemic (ETE) goals.

Condition

  • HIV Infections

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

Dental Team/Patient Navigator: To be eligible, members of the Dental Team or Patient Navigator need to have direct contact with patients at a participating dental clinic site during the months of the pilot study. Patient: To be eligible, patients must: - Be 18 years or older - Have at least one visit during the months of the pilot study at a participating dental clinic

Exclusion Criteria

  • Not meeting inclusion criteria

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Crossover Assignment
Intervention Model Description
Each site will experience a care delivery model for 3 months, followed by a 1 month washout period, and then 3 months with the alternative care delivery model.
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Placebo Comparator
Dental Team
ETE activity implementation with existing Dental Team only (i.e. practitioners, dental assistants, hygienists)
  • Other: Health Information Supported Ending the HIV Epidemic (ETE) Activities in Dental Setting
    Dental Teams will receive a Best Practice Alert (BPA) when they have a patient who should be offered HIV testing. Dental Teams will also be notified when they have a patient known to be HIV positive but out of HIV care.
Active Comparator
Care Navigator
ETE activity implementation with additional Care Navigator resource
  • Other: Care Navigator
    The Dental Team will have a Care Navigator as an added resource to assist with offering, implementing, and counseling for HIV testing; providing PrEP education and linkage; and providing linkage and re-linkage to HIV care.
  • Other: Health Information Supported Ending the HIV Epidemic (ETE) Activities in Dental Setting
    Dental Teams will receive a Best Practice Alert (BPA) when they have a patient who should be offered HIV testing. Dental Teams will also be notified when they have a patient known to be HIV positive but out of HIV care.

Recruiting Locations

Columbia University Irving Medical Center / NewYork-Presbyterian Hospital
New York, New York 10032
Contact:
Michael Yin, MD, MS
212-305-7185
mty4@cumc.columbia.edu

Weill Cornell Medical Center / NewYork-Presbyterian Hospital
New York, New York 10065
Contact:
Ariel Blanchard, DMD
212-746-5175
aab9028@med.cornell.edu

More Details

NCT ID
NCT05584501
Status
Recruiting
Sponsor
Columbia University

Study Contact

Michael Yin, MD, MS
212-305-7185
mty4@cumc.columbia.edu

Detailed Description

Routine HIV screening in all health care settings is considered a best practice by the Centers for Disease Control and Prevention (CDC), DHHS Ending the Epidemic Initiative, the New York State Blueprint to End the AIDS Epidemic, and is mandated by law in New York for all individuals over the age of 13 who receive hospital or primary care. Despite this, many patients are not screened for HIV during routine care, including in dental care settings, resulting in missed opportunities for identifying undiagnosed HIV infections, providing education for and linkage to PrEP, and linking and re-engaging HIV-positive patients into HIV care. The investigators will use information technology in the following two ways to support the delivery of HIV prevention and care best practices in the dental care setting to meet the DHHS Ending the HIV Epidemic (ETE) goals. First, Dental Teams will receive a Best Practice (BPA) alert whenever they have a patient who should be offered HIV testing. This BPA is linked to an order set to simplify ordering HIV tests and reporting results. Second, Dental teams will be contacted whenever they have a patient who is known to have HIV and is out of HIV care. A critical knowledge gap for implementing these ETE activities in the dental setting is whether comprehensive ETE efforts could be integrated into existing dental teams consisting of practitioners, dental assistants and hygienists or require augmentation by a dedicated care navigator. Therefore the investigators will pilot the Dental Team and Care Navigator models at two different dental sites (NYP-Columbia and NYP-Weill Cornell) using a cross-over design to evaluate acceptability and feasibility of providing HIV prevention and treatment services supported by these health IT strategies in the dental setting under these two care delivery models. If the strategies are found to be acceptable and feasible for both dental care patients and providers, then the study will expand to 4 sites and examine the effectiveness of these strategies for delivering HIV prevention and care best practices in the dental setting.