Oral community health worker-led interventions in households with average levels of psychosocial factors.
Oral community health worker-led interventions in households with average levels of psychosocial factors.
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DOI：
10.3389/froh.2022.962849
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发表时间：
2022
影响因子：
--
通讯作者：
Martin, Molly A.
中科院分区：
文献类型：
--
作者：
Lee, Helen H. H.;Avenetti, David;Edomwande, Yuwa;Sundararajan, Vyshiali;Cui, Liyong;Berbaum, Michael;Nordgren, Rachel;Sandoval, Anna;Martin, Molly A.
关键词：
家庭层面的心理社会压力水平与儿童刷牙行为有关。社区卫生工作者（CHW）针对高危社区的心理社会因素的干预措施与健康行为的变化有关。观察社会心理因素随时间的变化以及社会心理因素与芝加哥城市家庭CHW干预剂量之间的关联。参与者（N = 420个家庭）从伊利诺伊州库克县的10个社区诊所和10个妇女，婴儿或儿童（WIC）中心招募参加临床试验。研究人员收集了参与者报告的心理社会因素（家庭功能和照顾者报告的抑郁，焦虑，支持和社会功能）和CHW领导的口腔健康干预访问的特征（数量，内容，儿童参与）在0，6和12个月。社区卫生工作者在家访后记录了对家庭环境、社会环境、压力源和支持的实地观察。整个队列的参与者报告的心理社会因素水平几乎与一般人群的平均水平一致。社会心理因素并没有随着时间的推移而变化。在0、6和12个月时，社会功能是报告的唯一低水平指标[32.0（6.9）; 32.1（6.7）; 32.7（6.9）;平均值= 50（标准差）]。我们没有观察到暴露于CHW领导的干预访视（对照组，0，1，2，3和4次访视）的社会功能评分随时间推移的有意义的差异。社区卫生工作者进行的实地观察描述了一系列与贫困、语言障碍和移民身份有关的心理压力。在与贫困，缺乏支持，移民身份和语言障碍有关的压力的实地观察的背景下，随着时间的推移，出乎意料的平均和不变的心理社会因素表明，我们的研究没有充分捕捉到与口腔健康行为相关的健康的社会决定因素，或者测量偏差排除了准确的评估。未来的研究将使用各种工具评估心理社会因素，试图更好地衡量心理社会因素，包括我们城市人口中的社会支持，抑郁，焦虑，功能，创伤和复原力。我们还将研究社区压力和恢复力的邻里水平因素，以更好地将社会生态模型应用于儿童口腔健康行为。
Household-level psychosocial stress levels have been linked to child tooth brushing behaviors. Community health worker (CHW) interventions that target psychosocial factors in high-risk communities have been associated with changes in health behaviors. Observe changes in psychosocial factors over time and an association between psychosocial factors and CHW intervention dose amongst urban Chicago families. Participants (N = 420 families) were recruited from 10 community clinics and 10 Women, Infants, or Children (WIC) centers in Cook County, Illinois to participate in a clinical trial. Research staff collected participant-reported psychosocial factors (family functioning and caregiver reports of depression, anxiety, support, and social functioning) and characteristics of CHW-led oral health intervention visits (number, content, child engagement) at 0, 6, and 12 months. CHWs recorded field observations after home visits on household environment, social circumstances, stressors, and supports. Participants across the cohort reported levels of psychosocial factors consistent with average levels for the general population for nearly all measures. Psychosocial factors did not vary over time. Social functioning was the only measure reported at low levels [32.0 (6.9); 32.1 (6.7); 32.7 (6.9); mean = 50 (standard deviation)] at 0, 6, and 12 months. We did not observe a meaningful difference in social functioning scores over time by exposure to CHW-led intervention visits (control arm, 0, 1, 2, 3, and 4 visits). Field observations made by CHWs described a range of psychosocial stress related to poverty, language barriers, and immigration status. The unexpectedly average and unchanging psychosocial factors over time, in the context of field observations of stress related to poverty, lack of support, immigration status, and language barriers, suggests that our study did not adequately capture the social determinants of health related to oral health behaviors or that measurement biases precluded accurate assessment. Future studies will assess psychosocial factors using a variety of instruments in an attempt to better measure psychosocial factors including social support, depression, anxiety, functioning, trauma and resilience within our urban population. We will also look at neighborhood-level factors of community distress and resilience to better apply the social ecologic model to child oral health behaviors.
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