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NCT Number: NCT06581250

Improving Show Rates in Dental Care Settings Serving Underserved Populations

The goal of this study is to compare different no-show interventions in dental clinics serving underserved populations. The main question it seeks to answer is

* How do different no-show intervention methods compare in reducing no-shows?

Participants will be asked to

* Implement different interventions * Report a limited set of data to researchers

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Conditions

Dental Care

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Wisconsin - Madison

Madison, Wisconsin, 53705, United States

About this study

Persistent no-show rates contribute to the oral health disparities and inadequate access to dental care that disproportionately affect underserved populations. The proposed research will test the impact of three different strategies on improving show rates using a full factorial design. Specifically, the study is designed as a 2×2×2 factorial cluster-randomized trial of reminder messaging, motivation-enhanced communication, and walk-in visit. The unit of intervention and randomization will be dental clinic sites (clusters). Forty clinics will be randomized between eight possible combinations of receiving or not receiving the three study interventions, with five clinics receiving each intervention. Findings from this study seek to provide an evidence-based approach to reducing no-shows and increasing access to dental care for underserved populations.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Sites must be:

  • Serve at least a 51 percent self-pay and Medicaid patients
  • Be willing to provide limited data sets of clinic data to the research team
  • Be willing to undertake and support and organizational improvement project to improve show rates

Staff must be:

  • A paid staff member at a participating clinic
  • Be able and willing to provide written or verbal consent

Exclusion criteria

  • No exclusion criteria for clinics or staff

Treatment and study plan

Reminder messages

Behavioral

Dental clinic staff will use scripts to contact patients 24 and 48 hours before appointments. These scripts will guide staff in confirming the patient will appear for their appointment.

Walk-in Visits

Behavioral

When contacting patients to schedule an appointment (by phone, email, text, or other methods), dental clinic staff will notify patients of times during which patients can walk-in for a dental visit, if convenient for them; otherwise, a regular appointment will be arranged. Scheduled appointments will continue to be available in addition to the walk-in hours.

Motivation-enhanced Communication

Behavioral

Participating clinic site staff will be trained in motivation-enhanced communication techniques using the guide for dental clinic sites and coaching. Topics to be included in the motivation-enhanced communication training are a) to determine what patients hope to gain from their dental care, steps needed to succeed, how the agency and client will work together to attain the goals, and b) to identify patient barriers to attending their visit (e.g., transportation, payment, do not understand need for visit, etc.), and what the agency and patient will do to overcome those barriers. Staff will be instructed to use these techniques with patients at every contact about an upcoming appointment.

Primary outcomes

  1. Change in proportion of scheduled appointments for which the patient attends, pre-to-post intervention

    Time frame: 6 months pre-intervention to 12 months post-intervention

    To test the efficacy of motivation-enhanced communication, reminder messaging, and walk-in visits as compared to treatment as usual For each of the three interventions, the pre-to-post intervention change in show rates.

    Show rate is defined as the proportion of scheduled appointments for which the patient attends their scheduled clinic appointment. Appointments cancelled or rescheduled more than 24 hours in advance are not included in the calculation.

    Outcome will be measured by data exported from the clinical electronic health records monthly.

Secondary outcomes

  1. Organizational Change Manager (OCM) Score

    Time frame: Survey will be administered at 3 months

    To examine whether Organizational Readiness for Change moderates the efficacy of the targeted evidence-based practices.

    Organizational readiness for change will be assessed by a validated 16-item index called the Organizational Change Manager (OCM) For each clinic site, a group of 5 people that includes clinicians, dental hygienists, manager, and scheduler each team member will provide their own OCM responses.

    Outcome will be measured by combined responses to Organizational Change Manager survey tool. Total possible ranges of scores will be 0-104, with a higher score indicating increased readiness. The responses to the Organizational Change Manager survey from each clinic staff respondent will be added and an average of those scores will be calculated.

  2. Statistical Comparison of Interventions for Effectiveness Analysis

    Time frame: 6 months pre-intervention to 12 months post-intervention

    Evaluate the efficacy of motivation-enhanced communication, reminder messaging, and walk-in visits compared to each other.

    Comparative effectiveness analyses: Evaluate the efficacy of motivation-enhanced communication, reminder messaging, and walk-in visits compared to each other For each of the interventions, the difference in the pre-to-post intervention change in show rates in clinics receiving the different interventions Outcomes will be measured by data exported from the clinical electronic health records monthly.

  3. Statistical Comparison of Combining Multiple Interventions for Interaction Analysis

    Time frame: 6 months pre-intervention to 12 months post-intervention

    Evaluate the synergy of combining multiple interventions. For each pair of interventions, the difference in the pre-to-post intervention change in show rates in clinics receiving both interventions compared to clinics receiving only one of them.

    Outcomes will be measured by data exported from the clinical electronic health records monthly.

Sponsors and collaborators

Lead sponsor

University of Wisconsin, Madison

Other

Collaborators

  • National Institute of Dental and Craniofacial Research (NIDCR)

Registry information

Official study title

No-Show Prevention Practices in Dental Care Settings Serving Underserved Populations

Important dates

Study start
2025
Primary completion
2029
Study completion
2029
First posted
Sep 3, 2024
Registry last updated
Apr 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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