Capacity Building for PCOR/CER in Veteran, LGBTQIA+ and Rural Oral Health

Background: Almost half of the world’s population has untreated oral disease, affecting more people than mental disorders, cardiovascular disease, diabetes, chronic respiratory disease and cancers combined. Veterans have double the prevalence of heart disease compared to nonveterans and 25% higher prevalence of diabetes—with rates increasing exponentially for veterans living in rural areas and LGBTQIA+ veterans. These alarming statistics combined with the chronic lack of access to care and inability to afford dental treatment indicate veterans are among the highest risk populations suffering from dental disease.

Motivation: Existing data clearly highlight disparities caused by chronic lack of access to dental care within these communities and among their intersecting identities (e.g., rural veterans), with many relationships still left unexplored. Through the proposed project, The American Institute of Dental Public Health (AIDPH) will expand their existing model to address disparate oral health outcomes and poor dental care access among rural, LGBTQIA+ and veteran communities.

Goal: The goal of this project is to build the capacity of AIDPH and patient partners to engage in patient-centered outcomes research/comparative clinical effectiveness research (PCOR/CER) with diverse stakeholders.

Objectives: To achieve this goal, AIDPH will pursue the following five objectives:

1. Build internal/external capacity for AIDPH to implement PCOR/CER in oral health within core communities of focus. 
2. Improve, expand and replicate a preliminary community-engaged framework for PCOR/CER.
3. Identify, engage and convene a network of diverse stakeholders for rural and LGBTQIA+ oral health to inform a PCOR/CER strategy. 
4. Build sustainable stakeholder partnerships for PCOR/CER and create activation for a collaborative research agenda.
5. Amplify oral health as a critical component of whole-person health.

Activities: AIDPH will engage stakeholders in co-creating a research agenda and roadmap. Project leadership will build authentic investment and connection within core communities of focus to deepen and strengthen connection for PCOR/CER. AIDPH will center the voices of LGBTQIA+, veteran and rural communities in the development of a collaborative research agenda, community advisory board, and a network of stakeholders who are equipped to implement oral health PCOR/CER.

Deliverables:

1. A road map for engaging in PCOR/CER.
2. Two convenings for PCOR/CER stakeholders. 
3. A community advisory board comprising core communities of focus.
4. A diverse PCOR/CER network.
5. A targeted scientific communications plan.
6. An expansion of a community-engaged research model for engaging in PCOR/CER within core communities of focus.

Projected Outcomes and Outputs: By the end of the project period, AIDPH will have the knowledge and capacity to lead PCOR/CER using established relationships and support within the PCORI network of organizations as they launch their research initiatives.

Within two years, AIDPH will implement the roadmap with a network of sustainable, diverse stakeholders who are prepared and trained for effective PCOR/CER in LGBTQIA+, rural and veteran oral health.

Patient and Stakeholder Engagement Plan: AIDPH will grow its existing community-engaged research framework for veteran oral health and extend engagement into LGBTQIA+ and rural communities. AIDPH will form a community advisory board and engage other small organizations as project leadership.

Project Collaborators: Minority Veterans of America is consulting with AIDPH as a patient stakeholder/collaborator.