Adherence to Orthodontic Treatment in Youth With Craniofacial Conditions: A Survey of US Orthodontists

Canice E. Crerand, Hillary M. Kapa, Jennifer Litteral, Adriana C. Da Silveira, Mia K. Markey

Research output: Contribution to journalArticle

Abstract

Objective: (1) To explore orthodontists’ perceptions of nonadherence and related factors in their patients with craniofacial conditions; (2) to examine differences in adherence perceptions by provider characteristics; (3) to evaluate current adherence interventions. Design: Cross-sectional. Setting: United States-based orthodontists affiliated with a nonprofit association for providers treating oral cleft and craniofacial conditions received survey invitations via list-serv, e-mail, and social media. Participants: Thirty-eight orthodontists participated (mean age = 50.5 ± 10.7 years; 76% Caucasian; 55% male; 54% private practice). Main Outcome Measure: An 80-item survey assessed demographic characteristics; frequencies of various adherence problems and adherence-related prolonged or terminated treatment; importance of adherence to treatment outcomes; factors that may impact adherence; interest in improving adherence; and use of adherence-enhancing interventions. Results: Adherence problems were common, yet 80.6% of participants rated adherence as “very important” to cleft treatment outcomes. Child behavior and motivation, caregiver reinforcement of behavior, and provider communication with the family were identified as factors that greatly impact adherence. Orthodontists in university-affiliated programs were more likely to rate individual, family, health-care system, and community factors as impacting adherence compared to private practice orthodontists; 80.6% used adherence interventions; these strategies were all rated as “sometimes successful.” Conclusions: Nonadherence to cleft lip/palate-related orthodontic care is common and potentially detrimental to care. Current interventions are not uniformly successful and could be better tailored. Understanding provider, patient, and family factors that affect adherence can inform individualized treatment planning to improve adherence and ultimately, treatment outcomes.

Original languageEnglish (US)
Pages (from-to)1322-1332
Number of pages11
JournalCleft Palate-Craniofacial Journal
Volume56
Issue number10
DOIs
StatePublished - Nov 1 2019

Fingerprint

Orthodontics
Private Practice
Social Media
Therapeutics
Family Health
Cleft Lip
Postal Service
Child Behavior
Cleft Palate
Caregivers
Motivation
Communication
Demography
Outcome Assessment (Health Care)
Surveys and Questionnaires
Orthodontists
Delivery of Health Care

Keywords

  • adherence
  • cleft lip and/or palate
  • orthodontic treatment
  • self-management

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

Cite this

Adherence to Orthodontic Treatment in Youth With Craniofacial Conditions : A Survey of US Orthodontists. / Crerand, Canice E.; Kapa, Hillary M.; Litteral, Jennifer; Da Silveira, Adriana C.; Markey, Mia K.

In: Cleft Palate-Craniofacial Journal, Vol. 56, No. 10, 01.11.2019, p. 1322-1332.

Research output: Contribution to journalArticle

Crerand, Canice E. ; Kapa, Hillary M. ; Litteral, Jennifer ; Da Silveira, Adriana C. ; Markey, Mia K. / Adherence to Orthodontic Treatment in Youth With Craniofacial Conditions : A Survey of US Orthodontists. In: Cleft Palate-Craniofacial Journal. 2019 ; Vol. 56, No. 10. pp. 1322-1332.
@article{498e44cf8d7f4c1299ea7da69ebd5d45,
title = "Adherence to Orthodontic Treatment in Youth With Craniofacial Conditions: A Survey of US Orthodontists",
abstract = "Objective: (1) To explore orthodontists’ perceptions of nonadherence and related factors in their patients with craniofacial conditions; (2) to examine differences in adherence perceptions by provider characteristics; (3) to evaluate current adherence interventions. Design: Cross-sectional. Setting: United States-based orthodontists affiliated with a nonprofit association for providers treating oral cleft and craniofacial conditions received survey invitations via list-serv, e-mail, and social media. Participants: Thirty-eight orthodontists participated (mean age = 50.5 ± 10.7 years; 76{\%} Caucasian; 55{\%} male; 54{\%} private practice). Main Outcome Measure: An 80-item survey assessed demographic characteristics; frequencies of various adherence problems and adherence-related prolonged or terminated treatment; importance of adherence to treatment outcomes; factors that may impact adherence; interest in improving adherence; and use of adherence-enhancing interventions. Results: Adherence problems were common, yet 80.6{\%} of participants rated adherence as “very important” to cleft treatment outcomes. Child behavior and motivation, caregiver reinforcement of behavior, and provider communication with the family were identified as factors that greatly impact adherence. Orthodontists in university-affiliated programs were more likely to rate individual, family, health-care system, and community factors as impacting adherence compared to private practice orthodontists; 80.6{\%} used adherence interventions; these strategies were all rated as “sometimes successful.” Conclusions: Nonadherence to cleft lip/palate-related orthodontic care is common and potentially detrimental to care. Current interventions are not uniformly successful and could be better tailored. Understanding provider, patient, and family factors that affect adherence can inform individualized treatment planning to improve adherence and ultimately, treatment outcomes.",
keywords = "adherence, cleft lip and/or palate, orthodontic treatment, self-management",
author = "Crerand, {Canice E.} and Kapa, {Hillary M.} and Jennifer Litteral and {Da Silveira}, {Adriana C.} and Markey, {Mia K.}",
year = "2019",
month = "11",
day = "1",
doi = "10.1177/1055665619853132",
language = "English (US)",
volume = "56",
pages = "1322--1332",
journal = "Cleft Palate-Craniofacial Journal",
issn = "1055-6656",
publisher = "American Cleft Palate Craniofacial Association",
number = "10",

}

TY - JOUR

T1 - Adherence to Orthodontic Treatment in Youth With Craniofacial Conditions

T2 - A Survey of US Orthodontists

AU - Crerand, Canice E.

AU - Kapa, Hillary M.

AU - Litteral, Jennifer

AU - Da Silveira, Adriana C.

AU - Markey, Mia K.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Objective: (1) To explore orthodontists’ perceptions of nonadherence and related factors in their patients with craniofacial conditions; (2) to examine differences in adherence perceptions by provider characteristics; (3) to evaluate current adherence interventions. Design: Cross-sectional. Setting: United States-based orthodontists affiliated with a nonprofit association for providers treating oral cleft and craniofacial conditions received survey invitations via list-serv, e-mail, and social media. Participants: Thirty-eight orthodontists participated (mean age = 50.5 ± 10.7 years; 76% Caucasian; 55% male; 54% private practice). Main Outcome Measure: An 80-item survey assessed demographic characteristics; frequencies of various adherence problems and adherence-related prolonged or terminated treatment; importance of adherence to treatment outcomes; factors that may impact adherence; interest in improving adherence; and use of adherence-enhancing interventions. Results: Adherence problems were common, yet 80.6% of participants rated adherence as “very important” to cleft treatment outcomes. Child behavior and motivation, caregiver reinforcement of behavior, and provider communication with the family were identified as factors that greatly impact adherence. Orthodontists in university-affiliated programs were more likely to rate individual, family, health-care system, and community factors as impacting adherence compared to private practice orthodontists; 80.6% used adherence interventions; these strategies were all rated as “sometimes successful.” Conclusions: Nonadherence to cleft lip/palate-related orthodontic care is common and potentially detrimental to care. Current interventions are not uniformly successful and could be better tailored. Understanding provider, patient, and family factors that affect adherence can inform individualized treatment planning to improve adherence and ultimately, treatment outcomes.

AB - Objective: (1) To explore orthodontists’ perceptions of nonadherence and related factors in their patients with craniofacial conditions; (2) to examine differences in adherence perceptions by provider characteristics; (3) to evaluate current adherence interventions. Design: Cross-sectional. Setting: United States-based orthodontists affiliated with a nonprofit association for providers treating oral cleft and craniofacial conditions received survey invitations via list-serv, e-mail, and social media. Participants: Thirty-eight orthodontists participated (mean age = 50.5 ± 10.7 years; 76% Caucasian; 55% male; 54% private practice). Main Outcome Measure: An 80-item survey assessed demographic characteristics; frequencies of various adherence problems and adherence-related prolonged or terminated treatment; importance of adherence to treatment outcomes; factors that may impact adherence; interest in improving adherence; and use of adherence-enhancing interventions. Results: Adherence problems were common, yet 80.6% of participants rated adherence as “very important” to cleft treatment outcomes. Child behavior and motivation, caregiver reinforcement of behavior, and provider communication with the family were identified as factors that greatly impact adherence. Orthodontists in university-affiliated programs were more likely to rate individual, family, health-care system, and community factors as impacting adherence compared to private practice orthodontists; 80.6% used adherence interventions; these strategies were all rated as “sometimes successful.” Conclusions: Nonadherence to cleft lip/palate-related orthodontic care is common and potentially detrimental to care. Current interventions are not uniformly successful and could be better tailored. Understanding provider, patient, and family factors that affect adherence can inform individualized treatment planning to improve adherence and ultimately, treatment outcomes.

KW - adherence

KW - cleft lip and/or palate

KW - orthodontic treatment

KW - self-management

UR - http://www.scopus.com/inward/record.url?scp=85071120918&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071120918&partnerID=8YFLogxK

U2 - 10.1177/1055665619853132

DO - 10.1177/1055665619853132

M3 - Article

C2 - 31159560

AN - SCOPUS:85071120918

VL - 56

SP - 1322

EP - 1332

JO - Cleft Palate-Craniofacial Journal

JF - Cleft Palate-Craniofacial Journal

SN - 1055-6656

IS - 10

ER -