Engagement of dentists and patients in underserved rural and dental health provider shortage areas by the national dental practice-based network

Background: National clinical studies improve generalizability when they enroll participants from geographically underserved areas. We assessed representativeness of dentists and patients in the National Dental Practice-Based Research Network ("Network") by comparing them to national benchmarks for rural/urban and underserved classifications. Methods: Analyses compared rural status using Rural-Urban Continuum Codes and Health Provider Shortage Areas (HPSA), practitioner data from the Network's Enrollment Questionnaire and the American Community Survey (ACS), and patient data from Network clinical studies and the Behavioral Risk Factor Surveillance System (BRFSS). Results: The network has similar proportions of dentists in rural areas compared to national estimates from the ACS (8.5% in Network vs. 8.2% nationally) and comparable proportions in HPSA (76.8% in Network vs. 84.0% nationally). The Network's proportion of patients living in rural areas (33.7%) is much higher than that of Network practitioners (8.5%), and higher than that of the US "dental" population overall from the BRFSS (20.5%). Conclusions: The Network not only is effective at engaging a broad dentist base but also engages a comparably higher proportion of rural patients, a group that is often underrepresented in clinical research. BRFSS respondents are a more-selective subset of the population because they report a recent dental visit, yet the Network exceeded even this benchmark in rural representation.