Testing a Multi-behavioral Intervention to Improve Oral Health Behaviors in the Pediatric Dental Surgery Population

测试多种行为干预措施以改善儿童牙科手术人群的口腔健康行为

基本信息

批准号：
10504758
负责人：
JOANNA BUSCEMI
金额：
$ 33.19万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-20 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10504758
关键词：
Address Adherence Adult Affect Anesthesiology Bacteria Behavior Behavior Therapy Behavioral Calories Caregivers Child Child Behavior Child Health Child Psychology Child Rearing Childhood Chronic Disease Clinical Community Health Aides Conflict (Psychology)Consumption Data Dental Dental caries Dentistry Development Diet Dietary Intervention Disease Dissemination and Implementation Dose Effectiveness of Interventions Enrollment Etiology Event Family Frequencies Future General Anesthesia Goals Health Status Health behavior Health behavior change Household Iatrogenesis Intake Intervention Knowledge Life Link Low income Measurement Measures Mediation Mediator of activation protein Medicaid Mental Health Modeling Monitor Motivation Nursery Schools Nutritional Science Operative Surgical Procedures Oral health Outcome Parents Participant Pathway interactions Pediatric Surgical Procedures Perioperative Persons Phase Pilot Projects Population Population Intervention Preschool Child Prevalence Preventive dental care Protocols documentation Provider Qualitative Research Quality of life Randomized Randomized Clinical Trials Randomized Controlled Trials Recurrence Recurrent disease Reporting Research Research Personnel Ribosomal RNA Risk Role Safety Schedule Self Efficacy Target Populations Telephone Testing Text Messaging Time Toothbrushing Training Work acceptability and feasibility aged behavior change behavior influence burden of illness catalyst clinical development dental surgery disorder risk early childhood efficacy testing evidence base experience feasibility testing follow-up health knowledge high risk improved intervention delivery longitudinal analysis lower income families nutrition obesity in children operation oral microbiome prevent primary outcome psychosocial psychosocial wellbeing racial and ethnic racial minority population recruit remote assessment rural area rural dwellers saliva sample secondary outcome social social cognitive theory stressor sugar treatment as usual treatment comparison treatment group

项目摘要

Project Summary. Vulnerable (Medicaid enrolled, low-income, minoritized, urban/rural resident) children are at high risk for severe early childhood caries (S-ECC). Treating young children for S-ECC often requires dental surgery under general anesthesia (DGA). Unfortunately, surgery is not an effective cure. A DGA event does not address underlying oral health behaviors such as tooth brushing and diet, so caries commonly recurs. Changing oral health behaviors is challenging, as parents struggle with concurrent life stressors. However, parents want to change their child’s oral health behaviors and identify that they need help to enact change at the time of a DGA event. We propose a behavioral parenting intervention to support oral health behavior change within families whose children experience the most severe disease burden at a critical point in their child’s oral health. We will develop and test the efficacy of PROTECT (Preventing Recurrent Operations Targeting Early Childhood Caries Treatment), a community health worker (CHW)-delivered, behavioral parenting intervention for preschool-aged children scheduled for DGA. The primary outcomes are frequency of tooth brushing and percent of total calorie intake from added sugar. The first session will occur in person at the time of surgery (60 minutes) and the remaining 10 sessions (30 minutes) will be delivered by phone to address barriers to engagement. The intervention will take place over a 6-month period, starting with the surgical event, with assessments measuring primary and secondary outcomes at baseline, 2 weeks, 6 months and 12-month follow up. Our investigators are experts in clinical (anesthesiology, dentistry, pediatrics, psychology, nutrition) and scientific realms (randomized controlled trials, management and analysis of longitudinal behavioral, psychosocial, and clinical outcomes, nutrition science, development of clinical interventions, dissemination and implementation). During the UG3 phase, we aim to develop PROTECT and test for feasibility and acceptability. The development of PROTECT will be informed by behavior change mechanisms of Social Cognitive Theory (SCT; e.g., positive parenting, self-efficacy, knowledge) and evidence-based behavioral parenting and dietary interventions, along with stakeholder (caregivers, providers, CHWs) input. We will identify barriers to recruitment, retention, intervention delivery, and outcome measurements. During the UH3 phase, we will test the efficacy of PROTECT compared to Usual Care (UC) to improve oral health behaviors. Participants will be randomized to receive PROTECT (n = 210) or UC (n = 210). We hypothesize that participants in the PROTECT group will increase tooth brushing and decrease added sugar intake to a greater degree than those in the UC group. Secondary outcomes and hypothesized SCT mechanisms of intervention effectiveness will also be tested. As an exploratory aim, saliva samples will be collected to assess changes to the oral microbiome from baseline to 6 months. This work fits within our broad research goal to improve children’s oral health, starting with the surgical population and potentially extending to children and adults within households.

项目摘要。脆弱的（医疗补助招募，低收入，少数，城市/农村居民）儿童在严重的幼儿汽车（S-ECC）的高风险。治疗S-ECC的幼儿通常需要牙齿全身麻醉（DGA）的手术。不幸的是，手术不是有效的治愈方法。 DGA活动没有解决基本的口腔健康行为，例如刷牙和饮食，因此通常会出现。更改随着父母在同时发生的生活压力方面挣扎，口腔健康行为具有挑战性。但是，父母想要改变孩子的口腔健康行为，并确定他们需要帮助，以进行更改 DGA事件。我们提出了一种行为育儿干预措施，以支持口腔健康行为的变化孩子经历最严重疾病的家庭在孩子的口腔健康中的关键点燃烧。我们将开发和测试保护的效率（防止针对性的反复操作儿童龋齿治疗），一名社区卫生工作者（CHW），交付，行为育儿干预适用于计划为DGA的学龄前儿童。主要结果是刷牙的频率和添加糖的总卡路里摄入量的百分比。第一次会议将在手术时亲自举行（60个分钟），其余10次会议（30分钟）将通过电话交付，以解决障碍订婚。干预措施将在一个6个月的时间内，从外科活动开始，在基线，2周，6个月零12个月后，评估主要和次要结果的评估向上。我们的研究人员是临床专家（麻醉，牙科，儿科，心理学，营养）和科学领域（纵向行为的随机对照试验，管理和分析，社会心理和临床结果，营养科学，临床干预的发展，传播和执行）。在UG3阶段，我们旨在开发和测试可行性和可接受性。保护的发展将通过社会认知理论的行为变化机制来告知（sct;例如，积极的育儿，自我有效，知识）以及基于证据的行为育儿和饮食干预措施以及利益相关者（护理人员，提供者，CHW）的意见。我们将确定招聘的障碍，保留，干预交付和结果测量。在UH3阶段，我们将测试与通常的护理（UC）相比，保护口腔健康行为。参与者将被随机接收保护（n = 210）或UC（n = 210）。我们假设保护小组的参与者将与UC组中的刷子相比，增加刷牙并减少添加的糖摄入程度。还将测试次要结果和假设的SCT机制。作为探索性目的将收集唾液样本，以评估从基线到口服微生物组的变化 6个月。这项工作符合我们的广泛研究目标，以改善儿童的口腔健康，从外科手术开始人口，有可能延伸到家庭中的儿童和成人。