Examining Adolescent Social Networks and Dental Utilization in the National Longitudinal AddHealth Study

摘要

ABSTRACT Adolescence is a developmental period when oral diseases often arise and a time during which dental care is the most common unmet health care need. Approximately one-fifth of U.S. adolescents have untreated dental caries in their permanent teeth, and they use fewer dental services compared with younger children. Adolescence is also a developmental period during which they are strongly influenced by the peers in their social network, which is a person’s network of in-person social interactions and interpersonal relationships. Outside of oral health, research on social networks have been instrumental in advancing our understanding of obesity, smoking, HIV/AIDS and drug addiction. Far less is known about the effects of social networks on oral health; and there is no existing literature on the association between social networks and oral health outcomes in adolescents. This study will examine the extent to which adolescent social networks are predictive of dental utilization. We will use the largest, most comprehensive longitudinal survey of adolescents in the U.S., which is the National Longitudinal Study of Adolescent to Adult Health, 1994-2018 (Add Health). Add Health collected peer network data from 90,118 public school students aged 10 to 19 years from 145 schools in Wave I (1994-1995) and completed 4 additional Waves of data collection through 2018. A whole peer network can be constructed from this dataset, which allows us to study the relationship between social network characteristics and dental utilization cross-sectionally in the same year and longitudinally as the cohort transitioned to adulthood. We will use multiple regression controlling for individual, family, community, and social network characteristics with peer- and school-level random effects to examine the extent to which adolescent social networks are predictive of dental utilization. This proposal addresses the NIDCR’s strategic vision 2030 on Oral Health + Overall Health, which prioritizes longitudinal cohort studies of oral health across the lifespan. The overall impact of this research will increase our understanding of the relationship between social networks and oral health outcomes, apply rigorous social network analytic methods to dental health research, and inform novel approaches to interventions that improve dental utilization in an age range that has persistent untreated dental caries.