# Removing Barriers to Fluoride Varnish Application in Primary Care Settings

> **NIH NIH R15** · KENNESAW STATE UNIVERSITY · 2022 · $423,574

## Abstract

Removing Barriers to Fluoride Varnish Application in Primary Care Settings
Project Summary/Abstract:
 Dental decay is an important, ongoing public health concern that impacts children from
low-income households and from racial and ethnic minorities at higher rates than the general
population. Because young children are much more likely to visit a primary care provider than a
dentist, including appropriate and effective preventive oral health services (POHS) at pediatric
well-child visits has the potential to dramatically improve children’s oral health. Fluoride varnish
(FV) application is one such POHS that is reimbursed by insurance programs in the primary
care setting for younger children, yet only a small proportion of physicians apply FV. The
objective of this project is to assess and reduce barriers currently dissuading PCPs from
providing FV during well-child visits.
 The first aim is to collect and analyze detailed data on time, costs and workflow
associated with FV delivery in primary care settings. Key components to achieve this aim will
include time study and bottleneck analysis of data from partner clinics with a variety of practice
characteristics. The second aim is to assess barriers and facilitators to POHS delivery in
primary care settings. Applying the Consolidated Framework for Implementation Research
(CFIR) to the collection and analysis of data from key informant interviews, stakeholders’
perspectives on intervention climates will be analyzed to better understand the rationale
underlying apparent barriers to POHS delivery, with a focus on process flow barrier elimination.
The final aim is to optimize FV application in the well-child visit workflow. Statistical analysis,
simulation, and mathematical modeling will be utilized to establish how to minimize time and
costs under the influence of variability for different combinations of environmental factors. Best
practices for implementation will be collated and disseminated. While FV application does not
operate in isolation of other activities, these models can also help determine whether
reimbursements would fund additional resources to add FV application without sacrificing other
preventive care.
 The research contribution will be specific workflow suggestions and resulting resource
and cost data, as well as a better understanding of barriers and facilitators to implementation,
that will allow physicians’ offices to make decisions on how to integrate FV in their pediatric well-
child visits based on their own unique practice characteristics. These improved frameworks,
widely disseminated, will faciliate more widespread delivery of POHS during well-child visits.

## Key facts

- **NIH application ID:** 10359596
- **Project number:** 1R15DE031428-01
- **Recipient organization:** KENNESAW STATE UNIVERSITY
- **Principal Investigator:** Christina Scherrer
- **Activity code:** R15 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $423,574
- **Award type:** 1
- **Project period:** 2022-02-15 → 2025-02-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10359596

## Citation

> US National Institutes of Health, RePORTER application 10359596, Removing Barriers to Fluoride Varnish Application in Primary Care Settings (1R15DE031428-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10359596. Licensed CC0.

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