Oral Health Education and Navigation Program for Older Immigrants with Limited English Proficiency

针对英语水平有限的老年移民的口腔健康教育和导航计划

• 批准号: 10463858
• 负责人: YURI JANG
• 金额: $ 25.65万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-06 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10463858
• 关键词: Address; Behavioral; Behavioral Model; California; Characteristics; Clinical Trials; Communities; Community Health Aides; County; Data; Dental; Dental Care; Dental Insurance; Development; Diabetes Mellitus; Distal; Education; Eligibility Determination; Environment; Ethnic group; Exploratory/Developmental Grant; Feedback; Focus Groups; Foundations; Geographic Locations; Goals; Health education; Healthcare; Human; Immigrant; Individual; Insurance Coverage; Intervention; Korean American; Koreans; Language; Libraries; Limited English Proficiency; Location; Los Angeles; Methodology; Methods; Modeling; Monitor; National Institute of Dental and Craniofacial Research; Nature; Oral health; Outcome; Participant; Patient Self-Report; Population; Preventive; Preventive dental care; Procedures; Process; Program Evaluation; Protocols documentation; Readiness; Research; Research Design; Research Project Grants; Resources; Risk; Self Efficacy; Smoking; Solid; System; Target Populations; Technology; Testing; Touch sensation; Training; Underserved Population; Visit; Work; acceptability and feasibility; base; behavioral health; bilingualism; community based participatory research; community partnership; computerized; design; digital; health disparity; health inequalities; health knowledge; individual variation; interest; personalized intervention; pilot test; programs; protocol development; satisfaction; skills; translational model

PROJECT SUMMARY Building upon the evidence that limited English proficiency (LEP) poses a critical risk to older immigrants' oral health and dental care, the proposed study focuses on older Korean Americans as an initial target group for evaluating an oral health education and navigation program designed to promote older LEP immigrants' use of preventive dental services. The study is based on four premises: (1) oral health knowledge and healthcare navigation skills are critical imperatives in reducing oral health disparities in LEP populations and, thus, are important intervention targets, (2) bilingual and bicultural community health worker (CHW) participation is critical in reaching out to older LEP immigrants, (3) language diversities in LEP populations, as well as differences in personal needs, necessitate a sustainable method to personalize the intervention (i.e., computerized tailoring), and (4) the combination of “human touch” (CHWs) and “digital touch” (technology) requires a pilot test to evaluate feasibility and acceptability. The program we envision is an oral health education and navigation assistance program that is personalized by a computerized tailoring system and delivered by CHWs. The long-term goal of the program, inspired by the Transtheoretical Model (TTM) and the Fogg Behavioral Model (FBM), is to promote both proximal (oral health knowledge and self-efficacy) and distal (use of preventive dental services) outcomes. As a first step toward the goal, this R21 study pursues the following activities: (1) focus group with a Community Advisory Board, (2) assessment of the local dental service environment, (3) content development for education and navigation materials, (4) development of a computerized tailoring system, (5) development of protocols for CHW training and monitoring, and (6) pilot testing and evaluation of the program. Each step will be guided by the principles of Community-Based Participatory Research (CBPR). The products from these initial activities will include a content library of oral health education materials and local resources for dental care, a computerized tailoring system, and a protocol for CHW training and monitoring. Pilot testing will be conducted with 40 older Korean Americans who meet the eligibility criteria (having LEP and no use of preventive dental services in the past 12 months). Each participant will be assigned to one of four trained CHWs and will receive a personalized one-on-one education session (30 minutes, using an iPad). The research team will contact participants three months later to determine whether they had used any preventive dental services since the education session. Using an adaptive design, a CHW-led personalized navigation assistance program will be provided to non-users. The research team will collect and analyze data from both the participants and the CHWs, including quantitative data on participation rate and satisfaction with the program and qualitative feedback. The findings will form a solid foundation for a larger, definitive study with a clinical trial (e.g., R01) to identify behavioral health outcomes and provide a translational model for reducing barriers to preventive dental services for diverse LEP groups.

项目摘要 有证据表明，有限的英语水平（LEP）对老年人构成严重风险， 移民的口腔健康和牙齿护理，拟议的研究重点是老年韩裔美国人 作为评估口腔健康教育和导航计划的初始目标群体 旨在促进老年LEP移民使用预防性牙科服务。这项研究是 基于四个前提：（1）口腔健康知识和医疗导航技能至关重要 减少LEP人群口腔健康差异的必要性，因此， 干预目标，（2）双语和双文化社区卫生工作者（CHW）的参与， 在接触老年LEP移民的关键，（3）LEP人群的语言障碍， 以及个人需求的差异，需要一种可持续的方法来个性化 干预（即，计算机化剪裁），以及（4）“人情味”（CHW）和 “数字触摸”（技术）需要进行试点测试，以评估可行性和可接受性。的 我们设想的计划是一个口腔健康教育和导航援助计划， 通过计算机化定制系统进行个性化定制，并由CHW提供。的长期目标 该计划受到跨理论模型（TTM）和Fogg行为模型的启发 (FBM)，是促进近端（口腔健康知识和自我效能）和远端（使用 预防性牙科服务）的结果。作为实现目标的第一步，这项R21研究追求 （1）与社区咨询委员会的焦点小组，（2）评估 本地牙科服务环境，（3）教育和导航内容开发 材料，（4）开发计算机化剪裁系统，（5）开发 CHW培训和监测，以及（6）试点测试和评估该计划。每一步都将 以社区为基础的前瞻性研究（CBPR）的原则为指导。产品 从这些初步活动将包括一个内容图书馆的口腔健康教育材料， 牙科护理的本地资源，计算机化定制系统和CHW协议 培训和监测。试点测试将在40名年长的韩裔美国人中进行， 符合资格准则（患有低年龄段牙周炎，及在过去12年内没有使用预防性牙科服务 月）。每名参加者将被分配到四个受过培训的CHW中的一个，并将获得一个 个性化的一对一教育课程（30分钟，使用iPad）。研究团队将 三个月后联系参与者，以确定他们是否使用了任何预防措施， 自教育部成立以来，使用自适应设计，CHW领导的个性化 导航辅助程序将提供给非用户。研究小组将收集和 分析来自参与者和CHW的数据，包括以下方面的定量数据： 参与率和对方案的满意度以及定性反馈。其成果将 为更大规模的、确定性的临床试验研究奠定坚实的基础（例如，R01）识别 行为健康结果，并提供一个转化模型，以减少预防性 为不同的LEP群体提供牙科服务。

项目成果

Intervention to promote preventive dental care for older Korean-American Medi-Cal enrollees in Los Angeles.

旨在促进洛杉矶老年韩裔美国 Medi-Cal 参保者预防性牙科护理的干预措施。

• DOI: 10.1186/s12903-024-04113-z
• 发表时间: 2024
• 期刊: BMC oral health
• 影响因子: 2.9
• 作者: Jang,Yuri;Park,Juyoung;Park,Chaeyoon;Wu,Shinyi;Suarez-Durall,Piedad;Chung,Soondool;Kim,MiyongT
• 通讯作者: Kim,MiyongT