Linking Mother and Child Access to Dental Care

描述（由研究者提供）：背景。2010年健康人和美国外科医生的报告，美国口腔健康，表明龋齿是一个严重的口腔健康问题，低收入，少数学龄前儿童，这是复杂的低获得牙科保健。 这一问题的潜在解决办法可能存在于母亲和儿童获得牙科保健之间的联系。 如果低收入的母亲有一个定期的牙科保健（RSDC），口腔健康的好处可能会通过生物和牙科保健机制，但鲜为人知的是，这些协会。 目的。 在华盛顿州参加医疗补助牙科保险的3至6岁儿童中，（N= 115，853），研究目的是：1）测量患有RSDC的母亲的百分比，并确定母亲患有RSDC的决定因素; 2）在母亲中，确定是否有RSDC与更多的牙科知识，口腔健康行为，牙科满意度，更好的自我报告的口腔健康，较少的修复治疗和工作损失，由于牙齿护理; 3）在儿童中，以确定是否有一个母亲与RSDC与更多的利用牙齿护理和更好的口腔健康;以及4）在儿童中，确定母亲失去牙科保险的儿童是否比其他儿童使用更少的牙科。 方法. 目标将通过一个前瞻性队列研究设计来实现，该设计包括对母亲的基线调查和对医疗补助牙科索赔中儿童牙科使用情况的一年随访。 不成比例的分层随机抽样将在四个种族/民族分层（非西班牙裔白色人（n= 3，050）、西班牙裔（n= 4，511）、非洲裔美国人（n= 6，100）和其他种族/民族（n= 4，518））中选择有3至6岁儿童的医疗补助家庭。 至少有780名抽样母亲将完成基线电话或邮件调查。 一年后，将为抽样儿童提取调查前/后一年的医疗补助牙科索赔。 将对每个人种/种族分层进行单独的回归分析。 目标1分析将确定与母亲有RSDC相关的因素。 目的2分析母亲将确定有一个RSDC和知识和态度的牙齿护理，口腔健康行为和牙科利用之间的关联。 目的3分析儿童将确定是否有一个母亲与RSDC与更大的牙科利用在未来的一年。 目标4：对儿童的分析将确定母亲失去牙科保险是否会导致儿童牙科使用减少。

DESCRIPTION (provided by investigator): Background. Healthy People 2010 and the U.S. Surgeon General's report, Oral Health in America, indicate that caries is a severe oral health problem among low-income, minority preschool children that is compounded by low access to dental care. Potential solutions to this problem may exist in the linkage between mother and child access to dental care. If low-income mothers have a regular source of dental care (RSDC), oral health benefits may accrue to both mother and child through biological and dental care mechanisms, but little is known about these associations. Aims. Among children aged three-to-six years old and enrolled in Medicaid dental insurance in Washington state (N=115,853), study aims are: 1) to measure the percentage of mothers with a RSDC and identify the determinants of mothers having a RSDC; 2) among mothers, to determine whether having a RSDC is associated with greater dental knowledge, oral health behaviors, dental satisfaction, better self-reported oral health, and less reparative treatment and work loss due to dental care; 3) among children, to determine whether having a mother with a RSDC is associated with greater utilization of dental care and better oral health; and 4) among children, to determine whether children with mothers losing dental coverage have less dental utilization than other children. Methods. Aims will be achieved through a prospective cohort study design composed of a baseline survey of mothers and one-year follow-up of children's dental utilization from Medicaid dental claims. Disproportionate stratified random sampling will select Medicaid households with children aged three-to-six years in four racial/ethnic strata (White non-Hispanic (n=3,050), Hispanic (n=4,511), African-American (n=6,100), and other race/ethnic groups (n=4,518). At least 780 sampled mothers will complete a baseline telephone or mail survey. One year later, Medicaid dental claims for one-year pre/post-survey will be extracted for sampled children. Separate regression analyses will be conducted for each racial/ethnic stratum. Aim 1 analyses will identify factors associated with mothers having a RSDC. Aim 2 analyses of mothers will determine the association between having a RSDC and knowledge and attitudes about dental care, oral health behaviors, and dental utilization. Aim 3 analyses of children will determine whether having a mother with a RSDC is associated with greater dental utilization in the prospective year. Aim 4 analyses of children will determine whether mothers' loss of dental insurance results in fewer children dental utilization.