{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:24:46Z","timestamp":1777523086342,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T00:00:00Z","timestamp":1559520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>(1) To explore orthodontists\u2019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Thirty-eight orthodontists participated (mean age = 50.5 \u00b1 10.7 years; 76% Caucasian; 55% male; 54% private practice).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Adherence problems were common, yet 80.6% of participants rated adherence as \u201cvery important\u201d 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 \u201csometimes successful.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665619853132","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T01:01:11Z","timestamp":1559610071000},"page":"1322-1332","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Adherence to Orthodontic Treatment in Youth With Craniofacial Conditions: A Survey of US Orthodontists"],"prefix":"10.1177","volume":"56","author":[{"given":"Canice E.","family":"Crerand","sequence":"first","affiliation":[{"name":"Center for Biobehavioral Health, The Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"},{"name":"Departments of Pediatrics and Plastic Surgery, The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6889-9292","authenticated-orcid":false,"given":"Hillary M.","family":"Kapa","sequence":"additional","affiliation":[{"name":"Center for Biobehavioral Health, The Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Litteral","sequence":"additional","affiliation":[{"name":"Center for Biobehavioral Health, The Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana C.","family":"Da Silveira","sequence":"additional","affiliation":[{"name":"Dell Children\u2019s Medical Center of Central Texas, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mia K.","family":"Markey","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA"},{"name":"Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 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