Modeling Complex Mechanisms Underlying Oral Health Disparities in Young Children and Their Caregivers

模拟幼儿及其照顾者口腔健康差异背后的复杂机制

• 批准号: 10374518
• 负责人: Brenda Heaton
• 金额: $ 57.62万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-21 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10374518
• 关键词: Address; Affect; Behavior; Behavior Therapy; Behavioral; Biological; Boston; Caregivers; Child; Communities; Complex; Data; Data Collection; Dental Care; Dental caries; Development; Disadvantaged; Disease; Feedback; Foundations; Funding; Goals; Government; Health; Health Status; Health behavior; Healthcare; Housing; Individual; Interdisciplinary Study; Intervention; Methods; Minority Groups; Modeling; Mouth Diseases; Oral health; Outcome; Pathway Analysis; Pathway interactions; Pattern; Perception; Population; Population Distributions; Population Dynamics; Population Group; Positioning Attribute; Poverty; Prevalence; Production; Public Housing; Recording of previous events; Research; Risk; Risk Factors; Role; Sampling; Science; Severities; Shapes; Social Development; Social Environment; Social Network; Structure; System; Testing; Work; authority; base; behavior change; burden of illness; care systems; design; early childhood; experience; family management; health care disparity; health disparity; improved; in silico; insight; interest; member; programs; psychosocial; racial and ethnic; simulation; social; social relationships; social stigma; tool

We propose to use complex systems science methods to understand how social connectedness influences the utilization of dental care by young children and their caregivers. The overall goal of our research program is to address disparities in Early Childhood Caries (ECC) as it remains the most prevalent disease afflicting children, the consequences of which can be serious and long lasting. Social influence is an important moderator of the causes of disease, the population distribution of disease (e.g. disparities), and health-related behavior change via social networks. Understanding the role of social influence provides a potent perspective on why behavioral interventions aimed solely at individuals have often failed to produce meaningful results. For these reasons, interest in the development of social network interventions has grown, but much of the information necessary to develop and adequately tailor interventions to the underlying mechanisms responsible for disease production is severely lacking, especially for populations facing the greatest burdens of disease. Complex systems science approaches, such as agent-based modeling and social network analysis, can provide critical insights into the mechanisms responsible for the production of health disparities. Yet, applications to oral health are minimal. We propose to apply complex systems science methods to understand the mechanisms underlying population distributions of ECC. We propose the following specific aims: (1) Characterize the pathways by which social connectedness of caregivers interacts with individual-level perceptions of oral health status, behaviors and dental care practices to shape population patterns of ECC. (2) Evaluate social network structure and composition of caregivers of young children in relation to individual- level dental care utilization behaviors among a sample of Boston public housing residents. (3) Identify and test hypothetical interventions aimed at modifying the social-behavioral and caries risk mechanisms through the use of in silico experimentation (i.e., simulations). Outcomes of our research will inform the design of targeted interventions that respond to complex system dynamics of populations affected by health disparities. ECC prevalence and severity are disproportionately higher among children from disadvantaged groups, including the poor and certain racial/ethnic minority groups. Importantly, ECC is one of the largest unmet healthcare needs of children in the US, and significant disparities in care utilization exist. Public housing residents are a high impact population for the study of disparities. As a population group, they are characterized by spatial clustering of poverty and poor health and are ideally suited for the proposed work. Our results are expected to yield important insights into the strength of the interactions responsible for producing behavioral patterns and their consequences, and provided the necessary data for using social relationships as potential leverage points for interventions to improve oral health.

我们建议使用复杂系统科学的方法来理解社会联系是如何影响社会发展的