Pathways to Oral Health Among Low-income Pregnant Urban Women

项目总结/摘要 少数种族/族裔和低收入妇女在怀孕期间最容易受到口腔健康不良的影响。 这些脆弱的妇女不太可能比白色和高收入妇女利用牙科保健期间， 怀孕然而，怀孕往往是这些妇女唯一可以通过牙科保健的时间。 医疗补助计划。国家循证指南倡导怀孕期间的牙齿护理，以改善 口腔健康.然而，产前口腔健康计划，旨在增加牙科利用率之间的脆弱 孕妇的结果令人失望。查明上游障碍的主要障碍是 下游牙科保健利用在怀孕期间是缺乏纵向数据的因素，预测 弱势妇女的牙科保健利用和口腔健康。这项研究是由理论的通知， 约束的选择（Bird & Rieker，1999），它假定女性创造健康生活方式的机会 由于与生物过程相互作用的社会和性别相关过程而受到限制（例如， 怀孕）。这项研究将利用纽约 牙科大学和贝尔维尤医院妇产科服务。我们将收集 关于第一次调查期间这些弱势妇女的社会行为和心理社会因素的调查数据， 怀孕三个月我们将进行临床口腔检查，以评估牙齿脱落，龋齿， 并将介绍所有妇女接受牙齿护理。我们将重新调查和审查这些 妇女在怀孕的第三个三个月，并将使用医疗补助索赔，以评估牙科保健利用。 我们将使用横截面和纵向结构方程模型，以确定社会行为和 孕期牙科保健利用和口腔健康的社会心理预测因素。该项目明确 响应RFA-OD-19-029的呼吁，检查性和性别对口腔健康和口腔疾病的影响， 扩大对女性特有的状况和疾病的研究，包括生殖阶段和孕产妇及 妇科健康这项研究将阐明在设计干预措施时必须解决哪些因素 改善口腔健康风险升高的孕妇的牙科保健利用率和口腔健康结果 疾病这项研究是实现我们改善弱势群体口腔健康长期目标的第一步。 妇女在怀孕期间进行干预。

Project Summary/Abstract Racial/ethnic minority and low-income women are most vulnerable to poor oral health during pregnancy. These vulnerable women are less likely than White and higher-income women to utilize dental care during pregnancy. However, pregnancy is often the only time when these women can access dental care through the Medicaid program. National evidence-based guidelines advocate for dental care during pregnancy to improve oral health. However, prenatal oral health programs designed to increase dental utilization among vulnerable pregnant women have had disappointing results. The major obstacle to identifying upstream barriers to downstream dental care utilization during pregnancy is the lack of longitudinal data on factors that predict dental care utilization and oral health in vulnerable women. This study is informed by the Theory of Constrained Choice (Bird & Rieker, 1999), which posits that women’s opportunities to create a healthy lifestyle are constrained due to social and gender-related processes that interact with biological processes (e.g., pregnancy). This study will leverage an ongoing interprofessional collaboration between the New York University College of Dentistry and the Bellevue Hospital Obstetrics and Gynecology Service. We will collect survey data on socio-behavioral and psychosocial factors common in these vulnerable women during the first trimester of pregnancy. We will conduct clinical oral examinations to evaluate tooth loss, dental caries, gingivitis and periodontitis and will refer all women for dental care. We will re-survey and re-examine these women during the third trimester of pregnancy and will use Medicaid claims to evaluate dental care utilization. We will use cross-sectional and longitudinal structural equation modeling to identify socio-behavioral and psychosocial predictors of dental care utilization and oral health during pregnancy. This project explicitly addresses RFA-OD-19-029’s call to examine sex and gender influences on oral health and oral disease and expand research on female-specific conditions and diseases, including reproductive stages and maternal and gynecologic health. This research will elucidate which factors must be addressed when designing interventions to improve dental care utilization and oral health outcomes among pregnant women at elevated risk for oral disease. This study is the first step in addressing our long-term goal to improve the oral health of vulnerable women by intervening during pregnancy.