Parental Help Seeking for Dental Care

描述(申请人提供)：这项发展/探索性研究将使用医学中用于促进机会和改善结果的理论模型，作为研究为什么低收入和社会弱势西班牙裔、非裔美国人和高加索父母没有为他们的孩子获得牙科护理的出发点。这项建议的短期目标是确定影响父母寻求帮助的心理社会、结构和文化因素，并改进和评估提高父母牙科护理寻求行为的干预措施。这项先导性研究的长期目标是在R01多点疗效试验中测试社区、家庭和实践方法，以改善获得护理的机会。试点研究将分两个阶段完成。在第一阶段，我们将利用焦点小组制定基于家庭和社区的干预措施，并将在第二阶段使用。在第二阶段，将使用随机对照重复措施设计对干预措施进行试点测试，其中家庭将被分配到干预组和对照组。数据将在家庭干预实施之前和之后的三个评估期通过电话访问向所有参与的家长收集。数据将从干预组中去牙科诊所就诊的父母中的一个子样本和控制组中的所有父母中第三次收集。将使用协变量分析和逻辑回归程序来分析干预的直接影响。还将对干预进程进行评估。这一试点项目的结果需要直接支持R01多点干预效果试验的实施，该试验将(1)对试点研究中使用的措施进行实证交叉验证，并改进干预模式，以及(2)测试干预的直接和间接影响。这项拟议的研究涉及NIDCR的健康差异计划，该计划认识到需要以患者为导向的研究，以了解健康差异的基础：具体地说，是寻求医疗行为的社会学、人类学和政治学基础。

DESCRIPTION (provided by applicant): This Developmental/Exploratory study will use theoretical models that have been used in medicine to promote access and improve outcomes as the point of departure for examining why low-income and socially disadvantaged Hispanic, African American, and Caucasian parents do not obtain dental care for their children. The short goal of this proposal is to determine the psychosocial, structural and cultural factors that impact parental help seeking and to refine and evaluate an intervention to enhance parental dental care seeking behavior. The long-term goal of this pilot research is to test a community, family, and practice approach to improve access to care in an R01 multi-site efficacy trial. The pilot research will be accomplished in two phases. In Phase I we will use focus groups to develop a family and community based intervention and measures that will be used in Phase II. In Phase II the intervention will be pilot tested using a randomized controlled repeated measures design in which families will be assigned to an intervention group and a control group. Data will be collected from all participating parents by telephone interview at three assessment periods prior to and immediately after the family intervention implementation. Data will be collected for a third time from a subsample of parents in the intervention group who visit the dental office and all parents in the control group. Analysis of Covariates and logic regression procedures will be used to analyze the direct effects of the intervention. Evaluation of the intervention processes will also be conducted. The results of this pilot project are needed to directly support implementation of an R01 multi-site intervention efficacy trial that will (1) empirically cross validate the measures used in the pilot study and refine the intervention model, and (2) test the direct and indirect effects of the interventions. The proposed research addresses the NIDCR's Health Disparities Plan that recognizes the need for patient-oriented research to understand the bases of health disparities: specifically, the sociological, anthropological and political underpinnings of health-care seeking behavior.