Coordinated Oral Health Promotion (CO-OP) Chicago

协调口腔健康促进（CO-OP）芝加哥研究[UH 2DE 02583/UH 3DE 025483]是 由国家牙科和颅面研究所（NIDCR）资助，作为开发 和测试干预措施，以减少儿童口腔健康的差距。由此产生的合作芝加哥审判是一个健康的 420名非常年幼的儿童及其家庭的差异队列。在进入试验时，平均儿童年龄 21.5个月大。42%的参与者将自己描述为黑人，54%为西班牙裔 种族大多数儿童（89%）有医疗保险。许多护理人员正在努力刷牙 每天两次为儿童刷牙，提供健康饮食，并带儿童进行预防性口腔保健。多层次 干预措施，如社区卫生工作者（CHW），需要针对这些因素， 个人、家庭、社区和公共卫生水平。 COVID-19给家庭动态带来了新的变化，也给这些家庭带来了不可预见的压力 家庭为这些家庭提供服务的医疗诊所和社会服务机构也得到了 严重影响。当我们开始恢复健康、牙科和社会服务的过程时，我们需要考虑 需要什么样的改变挑战分为几个领域。(1)牙科保健： 在这场危机之前，低收入家庭面临挑战;随着供应商和设施试图恢复，情况将恶化 定期服务，同时也赶上那些已经取消，并保持新的安全协议。 围绕这一过程，存在许多关于COVID-19理解、信任、安全和物流的问题。(2)口服 健康行为：随着学校、儿童保育和就业的中断， 变了吗(3)营养：随着粮食不安全的挑战和更多的在家时间，饮食习惯如何改变？ (4)心理健康：压力、家庭混乱和社会支持系统的交替是如何关联的？ 受影响的家庭我们建议在社区干预中回答这些问题 COVID-19研究后针对低收入城市家庭的修改。结果将为干预措施提供信息 牙科，健康和社会服务机构将需要提供，以支持高风险家庭建立 在COVID-19等重大社会压力因素后，健康的口腔健康行为。 具体目标：确定有关牙科保健获取、口腔健康 行为，营养和心理健康的城市低收入家庭的幼儿， 新冠肺炎。我们将使用从芝加哥合作项目收集的定量和定性数据来实现这一目标 和我们的20个合作伙伴网站。我们的假设是这些家庭的心理健康状况不佳，食物不安全， 家庭口腔健康常规中断，对牙科服务的不信任，以及获得牙科护理的挑战。我们预计 有针对性的社区卫生工作外展和护理协调将是解决这些问题的最佳干预措施。 当谈到从COVID-19的长期复苏时，让我们不要“回到正常状态”。'

The Coordinated Oral Health Promotion (CO-OP) Chicago studies [UH2DE02583/UH3DE025483] were funded by the National Institute of Dental and Craniofacial Research (NIDCR) as part of a consortium to develop and test interventions to reduce oral health disparities in children. The resulting CO-OP Chicago Trial is a health disparities cohort of 420 very young children and their families. At entry into the trial, the mean child age was 21.5 months old. Forty-two percent of participants describe themselves as Black race, and 54% as Hispanic ethnicity. Most children (89%) had Medicaid health insurance. Many caregivers were struggling to brush children's teeth twice a day, provide a healthy diet, and take children for preventive oral healthcare. Multi-level interventions, such as community health workers (CHWs), are needed to target these factors that operate on individual, family, community, and public health levels. COVID-19 has brought new changes to household dynamics and unforeseen stressors to these families. The medical clinics and social service agencies that service these families have also been majorly affected. As we begin the process of resuming health, dental, and social services, we need to consider what changes are needed. Challenges fall into several domains. (1) Dental care: Access to dental services was challenging for low-income families before this crisis; this will worsen as providers and facilities attempt to resume regular services while also catching up on those that had been cancelled and maintaining new safety protocols. Many questions regarding understanding of COVID-19, trust, safety, and logistics surround this process. (2) Oral health behaviors: With the disruption of schools, child care, and employment, how have oral health behaviors changed? (3) Nutrition: How have dietary habits changed with food insecurity challenges and more time at home? (4) Mental health: How has the stress, household chaos, and alternation to social support systems associated with this pandemic affected families? We propose to answer these questions in the Community Intervention Modifications for Low-Income Urban Families after COVID-19 study. The results will inform the interventions dental, health, and social service agencies will need to provide in order to support high-risk families to establish healthy oral health behaviors after a major societal stressor like COVID-19. SPECIFIC AIM: To determine specific intervention needs regarding dental care access, oral health behaviors, nutrition, and mental health for low-income urban families with young children following COVID-19. We will achieve this aim using quantitative and qualitative data collected from the CO-OP Chicago cohort and our 20 partner sites. Our hypothesis is that families will have poor mental health, food insecurity, disrupted home oral health routines, distrust of dental services, and challenges accessing dental care. We expect targeted CHW outreach and care coordination will be the best interventions to address these issues. When it comes to long-term recovery from COVID-19, let us not `go back to normal.'