Coordinated Oral Health Promotion (CO-OP) Chicago Cohort Study

协调口腔健康促进 (CO-OP) 芝加哥队列研究

• 批准号: 10295258
• 负责人: MOLLY A MARTIN
• 金额: $ 121.55万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-08 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10295258
• 关键词: 3 year old; Absenteeism; Address; Adverse effects; Affect; Affordable Care Act; African American; Age; Behavior; Black race; COVID-19; Caregivers; Chicago; Child; Child Behavior; Child Rearing; Childhood; Clinical; Cohort Studies; Communities; Data; Data Collection; Data Sources; Dental; Dental Care; Dental Hygiene; Dental Plaque; Dental caries; Diet; Direct Costs; Disadvantaged; Disease; Enrollment; Ethnic Origin; Family; Fluorides; Frequencies; Funding; Future; General Anesthesia; Genetic; Grant; Health; Health Food; Health Insurance; Health Promotion; Health Services Accessibility; Health behavior; Healthcare; Hispanics; Home; Individual; Intervention; Longitudinal cohort; Low income; Mediating; Medicaid; Minority Groups; Modeling; Morbidity - disease rate; National Institute of Dental and Craniofacial Research; Nutritional; Oral health; Pain; Participant; Patient Self-Report; Positioning Attribute; Prevalence; Preventive; Provider; Psychosocial Factor; Randomized Controlled Trials; Reporting; Research; Risk; Risk Factors; Schools; Sedation procedure; Subgroup; Surveys; Techniques; Testing; Time; Toothbrushing; Toothpaste; United States; Violence; Water fluoridation; Work; aged; arm; cognitive development; cohort; community intervention; cost; cost effective; demographics; effectiveness testing; experience; food security; health belief; health data; health disparity; health literacy; health related quality of life; healthcare community; high risk; improved; lens; lower income families; primary outcome; recruit; research and development; social; theories; therapy development

SUMMARY Caries prevalence, morbidity, and associated disparities in children have been well documented nationally and locally. Research now is trying to understand why these disparities persist. Caries risk for an individual is considered a combination of genetics and behaviors (diet, oral hygiene, and fluoride exposure). The Coordinated Oral Health Promotion (CO-OP) Chicago Cohort Study will use the social ecological theory lens to examine caries risk factors on multiple levels. CO-OP Chicago was previously funded by NIDCR to reduce oral health disparities in children. The original CO-OP Chicago study [UH2DE02583] established baseline estimates of tooth brushing behaviors and determined the feasibility of objective assessment of tooth brushing behaviors in the homes of high-risk children under the age of three years old. CO-OP Chicago [UH3DE025483] then recruited 420 child/caregiver dyads to participate in a two-arm, cluster-randomized controlled trial testing the effectiveness of a family-focused CHW oral health intervention to improve tooth brushing behaviors for young children. The primary outcome was caregiver-reported brushing frequency and observed plaque score at 12-months. At entry into the study, the mean child age was 21.5 months. Forty-two percent of participants described themselves as Black race, and 54% as Hispanic ethnicity. Most children (89%) had Medicaid health insurance. CO-OP Chicago collected a range of self-reported and observed oral health data as well as family psychosocial factors from these low-income families over one year. However, the study did NOT include a caries assessment. The proposed CO-OP Chicago Cohort Study will transition trial participants into a longitudinal cohort (minimum N=315) to determine multi-level predictors of oral health behaviors and caries risk in low-income, urban young children over time. The CO-OP Chicago Cohort Study uses the social ecologic model to organize oral health risk factors into individual (child), interpersonal (family), organizational (healthcare), and community domains. We will collect four additional years of data with data collection every six months that includes caregiver-reported and observed child oral health behaviors, dental plaque scores, diet, parenting styles, dental provider access, and social risk factors. We will also conduct two caries examinations on children at ages five and seven. Community-level data will be extracted from public data sources. Specific Aim 1 is to examine associations between child, family, healthcare, and community factors on young child home oral health behaviors (child brushing frequency and plaque score) over time. Specific Aim 2 is to examine associations between child, family, healthcare, and community factors on young child caries prevalence over time. Specific Aim 3 is to examine the mediating effects of child brushing frequency and plaque score on the prior identified risk factors associated with caries prevalence. An Exploratory Aim will determine the ability of plaque scores to predict risk of caries. These data will advance our understanding of caries risk factors and inform future research and intervention development.

总结 全国范围内有大量关于儿童龋齿患病率、发病率和相关差异的文献， 在附近现在的研究正在试图理解为什么这些差异持续存在。个人患龋的风险是 被认为是遗传和行为（饮食，口腔卫生和氟化物暴露）的结合。的 协调口腔健康促进（CO-OP）芝加哥队列研究将使用社会生态学理论 透镜，以检查多个层次的龋齿危险因素。CO-OP芝加哥以前由NIDCR资助， 减少儿童口腔健康差距。最初的CO-OP芝加哥研究[UH 2DE 02583]建立了 刷牙行为的基线估计，并确定牙齿客观评估的可行性 在三岁以下高危儿童家中的刷牙行为。合作芝加哥 [UH 3DE 025483]然后招募了420名儿童/护理人员二人组参与一项双臂、随机分组研究。 对照试验测试以家庭为中心的CHW口腔健康干预措施对改善牙齿的有效性 幼儿刷牙行为。主要结果是双方报告的刷牙频率， 观察12个月时的斑块评分。入组研究时，平均儿童年龄为21.5个月。四十二 %的参与者称自己是黑人，54%的人是西班牙裔。大多数孩子 (89%）有医疗保险。CO-OP芝加哥收集了一系列自我报告和观察到的口腔 这些低收入家庭一年多的健康数据以及家庭心理社会因素。但 研究不包括龋齿评估。拟定的CO-OP芝加哥队列研究将过渡到 将试验参与者纳入纵向队列（最少N=315），以确定口服给药的多水平预测因子 健康行为和龋齿风险在低收入，城市幼儿随着时间的推移。芝加哥合作公寓 队列研究使用社会生态模型将口腔健康危险因素组织到个体（儿童）中， 人际（家庭）、组织（医疗保健）和社区领域。我们将收集四个额外的 年的数据，每六个月收集一次数据，包括所有报告和观察到的儿童口腔 健康行为、牙菌斑分数、饮食、父母教养方式、牙科服务提供者的使用和社会风险因素。 我们亦会为五岁及七岁的儿童进行两次龋齿检查。社区一级的数据将 从公共数据源中提取。具体目标1是研究儿童、家庭、 保健和社区因素对幼儿家庭口腔健康行为的影响（儿童刷牙频率和 斑块评分）。具体目标2是检查儿童、家庭、医疗保健和 社区因素对幼儿龋病患病率的影响。具体目标3是检查调解 儿童刷牙频率和牙菌斑评分对先前确定的与龋齿相关的危险因素的影响 普遍性。探索性目标将确定菌斑评分预测龋齿风险的能力。这些数据 将促进我们对龋齿危险因素的理解，并为未来的研究和干预发展提供信息。