Objectives To study the determinants of emergency department (ED) utilization for non‐traumatic dental conditions (NTDCs) by adults in Massachusetts. Methods We analyzed patient‐level factors associated with ED utilization for NTDCs in Massachusetts during 2013, using the Massachusetts All Payer Claims Dataset. The primary independent variables of interest were use of preventive dental service in the year preceding the ED visit and dental insurance coverage. Key covariates included age, gender, income, day of the ED visit, payer type, and residing in a geographically designated dental health professional shortage area (DHPSA). A multilevel logistic regression model was used to estimate the odds of NTDC ED visits as compared to two other categories of ED visits. Results 1.1 percent of all ED visits in Massachusetts were for NTDCs in 2013. Preventive dental service use in the preceding year decreased the odds (OR = 0.72) of a NTDC ED visit, whereas having dental insurance coverage increased the odds (OR = 1.1) of a NTDC ED visit. Other patient‐level characteristics that significantly increased odds of a NTDC ED visit included being between 26 and 35 years of age (OR = 1.2), male (OR = 1.3), uninsured (OR = 1.7) or enrolled in Medicaid (OR = 1.2), and visiting on a weekend (OR = 1.3). Conclusions Increased access to preventive dental services may lower likelihood of ED use for NTDCs. Interventions that target younger adults, Medicaid enrollees, and the uninsured, may be the most efficient way to lower NTDC ED use.

Parents play a critical role in facilitating children's physical activity, as they are an important source of modeling and support. While Human-Computer Interaction (HCI) researchers have explored exergame design for children or adults separately, an important open area of work is identifying design guidelines for family exergames. One question that researchers have increasingly posed is, how can exergames be designed to avoid potential negative consequences of competition? To address these questions we designed Spaceship Launch, an exergame for parents and kids in lower income neighborhoods, where obesity is most prevalent. We describe our iterative design process: the formative study to identify design opportunities, our resulting system, and our field evaluation of the tool. Our findings highlight the impact of SL on physical activity intentions, and how parental preferences for in-game competition were aligned with the psychological needs of relatedness and competence. We conclude with design recommendations for future family-focused exergames.

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Objectives Research examining the effect of changes in Medicaid dental benefits on emergency department (ED) use for dental conditions has had mixed results. We examined the effect of changes in Medicaid dental benefits on ED use for nontraumatic dental conditions (NTDCs) among adults in Massachusetts before and after Medicaid dental benefits for adults were eliminated (July 2010) and partially restored (January 2013). Methods We used 2009-2013 data from the Massachusetts All-Payer Claims Database. The study population included Medicaid enrollees aged ≥21 who made a visit to the ED for an NTDC that was paid for by Medicaid during the study period. We used an interrupted time-series study design and segmented regression model to assess the effect of the policy changes on ED use for NTDCs. We also conducted a subanalysis by patient age, sex, and geographic location. Results During the study period, 21 731 Medicaid enrollees aged ≥21 made 35 660 NTDC ED visits. Eliminating comprehensive dental benefits led to a significant increase in the use of EDs for NTDCs. This increase occurred over time (11% increase at 15 months after elimination of comprehensive dental benefits; estimate, 0.64 [95% CI, 0.07-1.21]; P = .03) rather than immediately after the policy change took effect. The partial restoration of certain dental benefits led to a significant decrease in the rate of ED visits for NTDCs over time (15.7% decrease at 5 months after partial restoration of certain dental benefits; estimate, –0.97 [95% CI, –1.83 to –0.11]; P = .03). Conclusion Strengthening dental coverage policies for adult Medicaid enrollees could decrease their reliance on EDs for NTDCs.