权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Developing Topical Fluoride Hesitancy Measures for Causal Modeling and Intervention Research

为因果建模和干预研究制定局部氟化物犹豫措施

基本信息

批准号：
10470032
负责人：
Donald Leslie Chi
金额：
$ 10.33万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10470032
关键词：
Address Adolescent Advisory Committees Awareness Behavior Behavior Therapy Behavioral Belief Benefits and Risks Child Child Health Clinical Clinical Trials Communication Complex Conflict (Psychology)Data Decision Making Dental Dental Care Dental caries Dentistry Dentists Development Diagnostic Education Effectiveness English Language Ensure Evidence based treatment Exhibits Feedback Fluoride Varnishes Fluorides Foundations Future Goals Grant Health Health Insurance Health Personnel Healthcare Healthy People 2020 Home Income Intervention Intervention Studies Interview Laboratories Length Liquid substance Low income Measures Medicaid Medical Medicare/Medicaid Methods Modeling National Institute of Dental and Craniofacial Research Oral health Outcome Parents Patients Perception Physicians Prevention Preventive Preventive care Preventive dental care Preventive service Primary Prevention Process Public Health Reporting Research Resistance Risk Safety Screening procedure Subgroup Testing Theoretical model Time Toothpaste Topical Fluorides Vaccines Validity and Reliability Visit Water fluoridation Work base behavioral clinical trial causal model checkup examination clinical practice cognitive interview design effectiveness measure field study health belief health communication health equity health inequalities high risk improved instrument prevent programs systematic review theories therapy design vaccine hesitancy

项目摘要

Topical fluorides help prevent tooth decay and are a routine part of dental visits for children and adolescents. However, concerns about the safety, necessity, and effectiveness of fluorides have resulted in fluoride hesitancy, leading some parents to refuse fluoride treatment for their children. Our data indicate that 13% of parents refuse topical fluoride during dental or medical visits, which is similar to vaccine refusal rates. Many more parents may accept fluoride but are hesitant. According to dentists, fluoride hesitancy and refusal are growing problems, but many dentists do not realize how universal approaches of providing fluoride to all children regardless of caries risk may have contributed to the problem. To convince hesitant and refusing parents to accept fluoride, dentists rely on paternalistic educational approaches that are largely ineffective at changing parents’ beliefs or behaviors. This is because education alone ignores the specific reason(s) why a parent is hesitant about fluoride. When efforts to change parent behaviors fail, some dentists dismiss these patients from their practices and most dentists avoid talking about fluoride to hesitant parents at subsequent visits to avoid conflict. Behavioral risk-based approaches could help dentists to address fluoride hesitancy and refusal in clinical practice. Validated measures will be needed to assess such approaches, but such measures currently do not exist. In this measure development study, we will address this critical gap. We will use the Health Belief Model and the Extended Parallel Process Model to understand fluoride hesitancy and refusal behaviors and to develop 2 measures for use in research and clinical settings. The Aims are to: (1) Construct a theoretical model of topical fluoride hesitancy/refusal; (2) Develop and validate 2 measures – a screening tool to identify fluoride hesitant/refusing parents and a diagnostic instrument to identify the reason(s) for topical fluoride hesitancy/refusal; and (3) Determine the stability of fluoride hesitancy/refusal behaviors. After the study is completed, the next step will be to design a behavioral clinical trial that incorporates a multi-pronged approach that addresses the specific reason(s) a parent is fluoride- hesitant/refusing and appropriate communication strategies used by health providers that incorporate a child’s caries risk. Our long-term goal is to improve oral health outcomes in high-risk children and adolescents who may otherwise not have an opportunity to benefit from fluorides, thereby addressing a growing threat to reducing dental caries rates and achieving health equity. The proposed study addresses Healthy People 2020’s Oral Health Objectives 1 and 8, and the Centers for Medicare and Medicaid Oral Health Initiative on Access to Quality Dental Care. By using dentistry as a laboratory, the proposed work is broadly applicable in understanding and addressing similar issues in public health like vaccine refusal and other phenomena involving communication of complex health information, interpretation of this information by parents, perceptions of health risks and benefits, and health care-related decision making.

局部氟化物有助于预防蛀牙，是儿童和青少年牙科就诊的常规部分。