Oral Health Disparities: Actions Taken About Pain

口腔健康差异：针对疼痛采取的行动

• 批准号: 6895622
• 负责人: JOSEPH L RILEY
• 金额: $ 31.76万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6895622
• 关键词: African American; Hispanic Americans; analgesia; behavioral /social science research tag; caucasian American; clinical research; dental disorder; dental health services; health behavior; health care policy; health care service utilization; health disparity; health services research tag; interview; longitudinal human study; pain; racial /ethnic difference; self medication

DESCRIPTION (provided by applicant): One of the primary goals of Healthy People 2010 is to eliminate health disparities among different segments of the population, with substantial emphasis given to disparities associated with race and ethnicity. The recent, first-ever Surgeon General's Report on Oral Health addresses the inequities and disparities among those least able to achieve optimal oral health, and relates the consequences as leading to needless pain and suffering. Studies show that pain is the most commonly reported impact of oral disease and is more strongly associated with perceived need for care, actual dental care, and diminished quality of life than other subjective signs or symptoms. We have conducted community-based studies that provide evidence that US minority adults are at increased risk for orofacial pain and are less likely to use oral health services in response to pain. However, there is little known about the interplay between race and ethnicity with individual, social, and economic characteristics as determinants of taking therapeutic action for orofacial pain. This project proposes to examine common and unique mechanisms underlying decisions to seek care or self-manage orofacial pain with a sampling strategy that will allow for comparisons among race and ethnic subgroups. Along with African- Americans, we have targeted Hispanic adults, a group that is particularly understudied regarding painful oral symptoms, given that they represent the fastest growing ethnic group in America. The aims of this study are to test hypothesis regarding: 1) Differences in the action taken to manage orofacial pain between minority Americans and non-Hispanic Whites; 2) That race and ethnicity interact with the sensory, emotional, and temporal characteristics of pain, behavioral and emotional impacts, and attitudes and beliefs about care as predictors of visiting a health care professional, engaging in pain self-management, or talking to others about pain. The study design will be a cross-sectional baseline study with a prospective longitudinal panel. We will conduct telephone interviews with a representative probability sample of community-dwelling adults, which will include oversampling of Hispanics and African-Americans within Miami-Dade, Broward, and Palm Beach counties in the state of Florida. Florida's population is rapidly increasing in both size and ethnic diversity and offers a unique opportunity to examine the interethnic differences in the actions taken to manage oral pain. This study proposes to use the Andersen Behavioral Model of Health to account for predisposing, enabling, and need characteristics as predictors of the targeted health enhancing behaviors. Unique contributions of this project will be the use of a validated model of health care use, the inclusion of a broad range of health behaviors (health care visits across multiple disciplines, self-care behaviors, and communicating with others), and the inclusion of Hispanic Americans. As culture can have a significant impact on the subjective experience of illness, differences in response to painful symptoms may help explain differences in behavioral options considered (or not considered) in response to oral disease. This information has important health policy implications for reducing the race and ethnic disparities in oral health through interventions that facilitate access to care and utilization of appropriate services.

描述（由申请人提供）：2010年健康人的主要目标之一是消除不同人群之间的健康差距，重点是与种族和民族有关的差距。最近，有史以来第一次外科医生关于口腔健康的报告解决了那些最不能实现最佳口腔健康的人之间的不平等和差异，并将其后果与导致不必要的疼痛和痛苦联系起来。研究表明，疼痛是口腔疾病最常见的影响，与其他主观体征或症状相比，疼痛与感知的护理需求、实际牙科护理和生活质量下降的相关性更强。我们已经进行了基于社区的研究，提供证据表明，美国少数民族成年人的口面疼痛风险增加，并且不太可能使用口腔健康服务来应对疼痛。然而，很少有人知道种族和民族之间的相互作用与个人，社会和经济特征的决定因素，采取治疗行动的orofacial疼痛。该项目提出了一种抽样策略，将允许种族和民族亚组之间的比较，以检查共同和独特的机制，决定寻求护理或自我管理orofacial疼痛。沿着非裔美国人，我们的目标是西班牙裔成年人，这是一个群体，特别是研究不足的痛苦口腔症状，鉴于他们代表了增长最快的种族群体在美国。本研究的目的是检验以下假设：1）美国少数民族和非西班牙裔白人在口面疼痛治疗上的差异; 2）种族和民族与疼痛的感觉，情绪和时间特征，行为和情绪影响以及对护理的态度和信念相互作用，作为访问医疗保健专业人员的预测因素，参与疼痛自我管理，或者和别人谈论痛苦研究设计将是一项具有前瞻性纵向面板的横断面基线研究。我们将对社区居住成年人的代表性概率样本进行电话访谈，其中包括对佛罗里达州迈阿密-戴德县、布劳沃德县和棕榈海滩县的西班牙裔和非洲裔美国人进行过抽样。佛罗里达的人口规模和种族多样性都在迅速增加，并提供了一个独特的机会，以检查采取的行动，以管理口腔疼痛的种族间的差异。本研究建议使用安德森健康行为模型来解释作为预测目标的健康促进行为的易感性，使能性和需求特征。该项目的独特贡献将是使用经过验证的医疗保健使用模型，包括广泛的健康行为（跨多个学科的医疗保健访问，自我保健行为和与他人沟通），以及西班牙裔美国人的参与。由于文化可以对疾病的主观体验产生重大影响，因此对疼痛症状的反应差异可能有助于解释在应对口腔疾病时考虑（或不考虑）的行为选择差异。这一信息具有重要的卫生政策的影响，减少种族和民族的差距，通过干预措施，促进获得护理和利用适当的服务，在口腔健康。