The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis.
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ABSTRACT:
SUBMITTER: Ningrum V
PROVIDER: S-EPMC8065439 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:AimPrevious studies have shown that children of caregivers with low oral health literacy (OHL) had more untreated caries than children of caregivers with adequate OHL. However, there is a paucity of information on this relationship among children and youth with special health care needs (CYSHCN). Accordingly, this study aims to assess the association between the caregivers' OHL and the oral health status of CYSHCN.MethodsThis cross-sectional study was conducted in four schools dedicated for CYSHCN. A 48-item questionnaire gathered information about the demographic and socioeconomic factors, the child/adolescent's medical condition, dental characteristics, caregiver self-efficacy and the child's dental attitude. The Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire was used to assess the caregivers' OHL. The Löe & Silness gingival index (GI) and the Silness & Löe plaque index (PI) were used to assess gingival health and plaque levels, respectively. Directed acyclic graphs (DAGs) were utilized for the selection of the appropriate set of confounding variables for regression analysis. The mean score differences and 95% confidence intervals (CI) were estimated to quantify the associations of the various covariates with oral health outcome variables.ResultsThis study included 214 child/caregiver dyads. Most participants were physically disabled (56.1%) followed by children with hearing difficulty (9.8%) and congenital anomalies/syndromes (7.9%). The mean PI and GI of the children was 1.26±0.52 and 1.30±0.47, respectively. The median CMOHK score was 12 and the respondents were dichotomized based on the median value. Low caregiver oral health conceptual knowledge was significantly associated with higher PI scores (β [95% CI] = -0.26 [-0.41, -0.13]; p<0.001. Older participants (12-21-year-olds) had significantly higher plaque scores compared with younger participants (6-12-year-olds) (β [95% CI] = 0.33 [0.18, 0.51]; p<0.001). Participants who brushed their teeth twice or more daily had significantly lower (β [95% CI] = -0.15 [-0.43, -0.01]; p = 0.046). Conceptual knowledge score was not significantly associated with GI.ConclusionThis study found lower caregiver OHL levels to be associated with higher plaque scores for their child.
| S-EPMC8794213 | biostudies-literature
Project description:BackgroundOral health is essential for overall well-being and can significantly improve quality of life. However, people with special health care needs (SHCN) often face challenges in accessing dental services. This study aimed to systematically review all available evidence on the oral and dental service utilization determinants among these individuals. Based on the findings, we also explore strategies to increase their access to dental care.MethodThis study is a systematic review of reviews based on the PRISMA 2020. Six databases were systematically searched including PubMed, Web of Science, Scopus, Embase, ProQuest, and Cochrane Library. Related keywords were applied up to 30 October 2023. This study includes all systematic, scoping, and rapid reviews written in English that examine the factors affecting dental service use among SHCNs. Microsoft Power BI was used for descriptive quantitative analysis, and MAXQDA version 10 was applied for qualitative thematic analysis.ResultsThe number of 2238 articles were retrieved based on the search strategy. After excluding duplications and appraising the eligibility, 7 articles were included. An examination of these 7 articles shows that they were all carried out from 2016 to 2022. Of these, 42% were systematic reviews, 42% used a scoping method, and one study (14%) was a rapid review. According to the thematic analysis, there were five main themes concerning determinants of oral and dental utilization of SHCN: "Financial considerations," "Patient-Provider Relationship," "Accessibility and Availability of Services," "Patient Factors," and "Quality of Care." Additionally, regarding strategies for improving utilization, three main themes emerged: "Education and Training," "Service Improvement," and "Policy Solutions.ConclusionThis study delves into the intricate challenges SHCNs face in accessing dental services, highlighting the imperative for comprehensive interventions addressing supply and demand. Supply-oriented measures encompass dentist education, implementing financial policies for affordable services, and integrating dental care into primary healthcare systems. On the demand side, strategies revolve around empowering patients and caregivers and enhancing cultural inclusivity. Despite sustained efforts, current utilization rates fall short of optimal levels. Thus, effective strategic planning by policymakers and healthcare leaders is paramount to bolster dental service utilization among SHCNs, thereby enhancing their overall well-being.
| S-EPMC11334590 | biostudies-literature
Project description:Robust evidence-based guidelines are important in everyday clinical practice, especially when delivering and managing oral care needs to a vulnerable group such as children with special healthcare needs (SHCNs). Methods: To assess the quality of guidelines on the management of oral care for children with special healthcare needs (SHCNs) and to find appropriate guidelines, an electronic search of MEDLINE Ovid was carried out alongside an additional search of common guideline websites. The AGREE II tool was used to assess the quality of the guidelines. Assessment was undertaken independently by three assessors. Furthermore, the underlying evidence used to formulate recommendations in the identified guidelines was qualitatively assessed. Results: There were nine guidelines, with 41 recommendations, that met the eligibility criteria. The quality of the guidelines was generally found to be poor. Only one guideline was assessed as “recommended” by the assessors, based on the quality of the methods, the reporting, or both. Only 2 of the 41 sets of recommendations, made across the nine guidelines, were judged to be valid and based on a rigorous systematic review of the evidence. Conclusions: The current state of guidelines on oral care management for children with special healthcare needs (SHCNs) is, on the whole, of very low quality. The scientific community should work together to enhance the quality and strength of the current clinical guidelines and to ensure that they are trustworthy prior to implementation.
| S-EPMC9914149 | biostudies-literature
Project description:ObjectiveTo examine the effectiveness of hospital-based comprehensive care programs in improving the quality of care for children with special health care needs.Data sourcesA systematic review was conducted using Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Sociological Abstracts SocioFile, and Web of Science.Study selectionEvaluations of comprehensive care programs for categorical (those with single disease) and noncategorical groups of children with special health care needs were included. Selected articles were reviewed independently by 2 raters.Data extractionModels of care focused on comprehensive care based at least partially in a hospital setting. The main outcome measures were the proportions of studies demonstrating improvement in the Institute of Medicine's quality-of-care domains (effectiveness of care, efficiency of care, patient or family centeredness, patient safety, timeliness of care, and equity of care).Data synthesisThirty-three unique programs were included, 13 (39%) of which were randomized controlled trials. Improved outcomes most commonly reported were efficiency of care (64% [49 of 76 outcomes]), effectiveness of care (60% [57 of 95 outcomes]), and patient or family centeredness (53% [10 of 19 outcomes). Outcomes less commonly evaluated were patient safety (9% [3 of 33 programs]), timeliness of care (6% [2 of 33 programs]), and equity of care (0%). Randomized controlled trials occurred more frequently in studies evaluating categorical vs noncategorical disease populations (11 of 17 [65%] vs 2 of 16 [17%], P = .008).ConclusionsAlthough positive, the evidence supporting comprehensive hospital-based programs for children with special health care needs is restricted primarily to nonexperimental studies of children with categorical diseases and is limited by inadequate outcome measures. Additional high-quality evidence with appropriate comparative groups and broad outcomes is necessary to justify continued development and growth of programs for broad groups of children with special health care needs.
| S-EPMC3932746 | biostudies-literature
Project description:IntroductionAlthough play has been used as a means to meet therapeutic goals by health care practitioners for a long time, there is a need to continuously review its conceptualisation and use in everyday practice to promote evidence-based practice. This systematic review aimed to evaluate the evidence on how the play of children with Special Health Care Needs (SHCN) is similar or different to that of typically developing children.MethodsGuided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, we conducted a comprehensive review across five electronic databases for all studies that compared how the play of children with SHCN was similar or different to that of typically developing children. Data were extracted from the included studies, and methodological quality was assessed.ResultsEighteen studies met eligibility criteria. All the studies in this review were at risk of bias due to the study design. There was great variation in sample sizes, ranging between five and 112 participants in the diagnostic groups and five and 546 participants in control groups (typically developing children). The included studies investigated different aspects of play, which made it difficult to synthesise. However, of the 18 studies reviewed, thirteen reported that children with SHCN engage in less play, compared with typically developing children.ConclusionsEvidence supports the assumption that children with SHCN are less playful and spend less time engaging in play compared with typically developing children. This systematic review reveals paucity of research on play for children with several common chronic conditions such as HIV/AIDS, cancer, and cardiovascular diseases. Future studies need to reduce risks of bias, including the use of appropriate sample sizes, and must provide detailed results after investigating play in children with SHCN.
| S-EPMC7695500 | biostudies-literature
Project description:BackgroundFamily income is known to affect child health, but this relationship can be bidirectional. We sought to characterize this relationship by quantifying forgone family employment (FFE) due to a child's health condition in families of children with special health care needs (CSHCN) with updated figures.MethodsWe conducted a secondary data analysis from the 2016-2017 National Survey of Children's Health. CSHCN with previously employed caregivers were included (N = 14 050). FFE was defined as any family member having stopped work and/or reduced hours because of their child's health or health condition. Child, caregiver, and household characteristics were compared by FFE status. Logistic regression analysis was conducted to evaluate the association between hours of medical care provide by a family member and FFE. US Bureau of Labor Statistics reports were used to estimate lost earnings from FFE.ResultsFFE occurred in 14.5% (95% confidence interval [CI] 12.9%-16.1%) of previously employed families with CSHCN and was 40.9% (95% CI 27.1%-54.7%) for children with an intellectual disability. We observed disproportionately high FFE among CSHCN who were 0 to 5 years old and of Hispanic ethnicity. We found a strong association between FFE and increasing hours of family-provided medical care, with an adjusted odds ratio (aOR) of 1.72 (95% CI 1.25-2.36) for <1 hour per week (compared with 0 hours), an aOR of 5.96 (95% CI 4.30-8.27) for 1 to 4 hours per week, an aOR of 11.89 (95% CI 6.19-22.81) for 5 to 10 hours per week, and an aOR of 8.89 (95% CI 5.26-15.01) for >10 hours per week. Lost earnings for each household with FFE were estimated at ∼$18 000 per year.ConclusionsWith our findings, we highlight the need to implement programs and policies that address forgone income experienced by families of CSHCN.
| S-EPMC9219960 | biostudies-literature
Project description:BackgroundChildren with Special Health Care Needs (CSHCN) require greater attention from family caregivers as they present temporary or permanent physical, developmental, behavioral, or emotional issues. This demand for care generates overload and stress among family caregivers. So far, there is no study that gathers the available literature regarding the use of biomarkers to assess stress among caregivers of CSHCN. Hence, we aimed to synthetize and to assess the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.MethodsThis systematic review and meta-analysis protocol was elaborated following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The search strategy will be undertaken through 7 electronic bibliographic databases: Embase, MEDLINE/PubMed, Cochrane Library, Web of Science, CINAHL, Scopus, and PsycINFO. In addition, secondary searches in other sources, such as Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Google Scholar, and medRXiv will be also carried out. The reference section of the included studies will be hand searched for additional relevant studies. There will be no restriction regarding the publication dates or languages for this systematic review. Moreover, in an independently manner, 2 investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected studies, based on their designs. The heterogeneity among the studies will be assessed using the I2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the SPSS version 23.0.ResultsThis systematic review and meta-analysis will provide better insights regarding the biomarkers associated with stress in caregivers of CSHCN. Hence, consistent data and robust evidence will be provided to help practitioners and decision-makers in this area.ConclusionsTo the best of our knowledge this study, will be the first to synthetize and critically evaluate the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.
| S-EPMC9646662 | biostudies-literature
Project description:The association between physical activity (PA) and mental health in typically developing children has been amply documented, but little is known about the corresponding association in children with special educational needs (SEN). This systematic review aimed to synthesize the evidence for the association between PA and mental health in children with SEN. A systematic literature search of five databases (PsycINFO, SPORTDiscus, PubMed, Web of Science, and CINAHL) was conducted, and the publication year was between October 2010 and February 2021. Two researchers performed abstract and full text screening and extracted the data independently. Inclusion and exclusion criteria followed the PICOS framework, and the quality of eligible studies was assessed using the McMaster critical review form. Eighteen studies that met the inclusion criteria and had quality ratings ≥ 60% were included in this review. PA was positively associated with overall psychological well-being and its subtypes (including enjoyment, self-worth, self-competence, mental wellness, and quality of life), and negatively associated with anxiety and fatigue. Body composition, age, and sex were moderators of the association. The findings of this review indicated that PA was consistently associated with mental health in children with SEN. These associations were the most powerful when PA was conducted in unstructured types such as free play and recess activities. Structured types including physical education classes were more strongly related to mental health than overall PA (combined structured and unstructured types). Future PA interventions are needed to promote mental health in children with SEN.
| S-EPMC8193140 | biostudies-literature
Project description:The purpose of this pilot study was to assess the knowledge and awareness of dental students with respect to oral health care of the person with special health care needs (SHCN) and evaluate effectiveness of an education program on improving their knowledge.An evaluation consisting of a questionnaire was answered before and immediately after a 30-minute educational presentation in the form of a DVD that includes a PowerPoint and a video of oral health care for individuals with SHCN. The questionnaire was based on the materials and information presented in the DVD and included 26 questions (true/false/I do not know).The mean (± SD) score on the pretest was 10.85 (± 5.20), which increased to 16.85 (± 5.47) on the posttest. This difference was statistically significant (P < 0.001). Forty percent of the students surveyed reported that they were very satisfied with the educational part of the presentation, while 50% were somewhat satisfied. Thirty percent of students expressed that the educational intervention used is very effective.Viewing the educational intervention was effective in informing the sophomore students and providing them with instructive basic information on person with SHCN. Dental colleges should increase students' knowledge, training, and exposure to individuals with SHCN.
| S-EPMC4407527 | biostudies-other
Project description:To describe the parent-reported prevalence of treatments for attention deficit/hyperactivity disorder (ADHD) among a national sample of children with special health care needs (CSHCN), and assess the alignment of ADHD treatment with current American Academy of Pediatrics guidelines.Parent-reported data from the 2009-2010 National Survey of Children with Special Health Care Needs allowed for weighted national and state-based prevalence estimates of medication, behavioral therapy, and dietary supplement use for ADHD treatment among CSHCN aged 4-17 years with current ADHD. National estimates were compared across demographic groups, ADHD severity, and comorbidities. Medication treatment by drug class was described.Of CSHCN with current ADHD, 74.0% had received medication treatment in the past week, 44.0% had received behavioral therapy in the past year, and 10.2% used dietary supplements for ADHD in the past year. Overall, 87.3% had received past week medication treatment or past year behavioral therapy (both, 30.7%; neither, 12.7%). Among preschool-aged CSHCN with ADHD, 25.4% received medication treatment alone, 31.9% received behavioral therapy alone, 21.2% received both treatments, and 21.4% received neither treatment. Central nervous system stimulants were the most common medication class (84.8%) among CSHCN with ADHD, followed by the selective norepinephrine reuptake inhibitor atomoxetine (8.4%).These estimates provide a benchmark of clinical practice for the period directly preceding issuance of the American Academy of Pediatrics' 2011 ADHD guidelines. Most children with ADHD received medication treatment or behavioral therapy; just under one-third received both. Multimodal treatment was most common for CSHCN with severe ADHD and those with comorbidities. Approximately one-half of preschoolers received behavioral therapy, the recommended first-line treatment for this age group.
| S-EPMC4469986 | biostudies-literature