Understanding Barriers to Oral Health Care In Pregnancy: The First Step to Improv

描述（由申请人提供）：口腔健康疾病，如儿童龋齿和牙周病是不成比例地影响种族/少数民族和弱势群体的流行病。龋齿是最常见的慢性儿童疾病，影响儿童的人数是哮喘的5倍。龋齿导致牙齿脱落，随之而来的是营养和社会后果。成人牙周病影响高达40%的育龄妇女，并与不良妊娠结局相关，如早产，胎儿生长受限和先兆子痫。有效的预防和治疗措施，以减少龋齿和牙周病的发病率存在，数据表明，母亲的口腔疾病的治疗可能会改善口腔健康的后代和降低风险的不良妊娠结局。然而，尽管存在这些以证据为基础的干预措施来预防或减轻儿童和妇女的口腔疾病负担，但龋齿和牙周病仍然普遍存在，特别是在低收入家庭和少数种族和少数民族成员中。我们的长期目标是降低孕妇及其子女的口腔疾病发病率，消除口腔健康方面的差距。我们假设，母亲对口腔健康的知识和态度，以及缺乏获得口腔健康服务，极大地影响了母亲的行为，促进母亲和她的后代的口腔健康。本研究的主要目的是确定孕妇，特别是少数民族和社会经济地位较低的孕妇口腔保健的障碍，然后制定干预策略，以消除或降低障碍，使现有的循证干预措施可以更有效地应用。我们将通过实现以下具体目标来实现这一目标：1.收集和分析数据，了解孕妇目前的做法，态度和感知的系统障碍，关于最佳的牙齿健康。2.测试四到八种潜在干预措施的可行性，可接受性和可能使用性，以消除和/或减少障碍，并鼓励改善口腔健康实践。3.对目标2中的一项或多项干预措施进行试点研究。该提案汇集了一个多学科团队，在怀孕期间的口腔健康，公共卫生规划，行为研究，定性分析和公共政策方面具有优势。这项研究的结果将为制定创新的、对文化敏感的战略和方法提供框架，通过减少口腔保健的障碍来改善母亲及其子女的健康和福祉。口腔健康疾病是不成比例地影响种族/族裔少数群体和弱势个人的普遍状况。尽管存在循证干预措施和有效的预防和治疗措施，但口腔疾病仍然普遍存在。我们的长期目标是降低孕妇及其子女的口腔疾病发病率，并确定口腔保健的障碍，这将为制定具有文化敏感性的创新战略和方法提供框架，通过减少口腔保健的障碍来改善母亲及其子女的健康和福祉。

DESCRIPTION (provided by applicant): Oral health diseases such as childhood caries and periodontal diseases are prevalent conditions that disproportionately affect racial/ethnic minorities and disadvantaged individuals. Dental caries is the most common chronic childhood disease, affecting 5 times more children than asthma. Caries leads to tooth loss, with subsequent nutritional and social consequences. Adult periodontal disease affects up to 40% of reproductive age women, and is associated with adverse pregnancy outcomes such as preterm birth, fetal growth restriction and preeclampsia. Effective preventive and treatment measures to reduce the morbidity of caries and periodontal disease exist, and data suggest that treatment of maternal oral disease may improve the oral health of the offspring and reduce risk for adverse pregnancy outcome. However, despite the presence of these evidence-based interventions to prevent or reduce the burden of oral diseases among children and women, both caries and periodontal disease remain prevalent, particularly among low-income families and members of racial and ethnic minorities. Our long-term goal is to reduce morbidity of oral diseases among pregnant women and their children, and to eliminate disparities in oral health. We hypothesize that maternal knowledge about and attitudes toward oral health, as well as lack of access to oral health services, greatly affect maternal behaviors that promote the oral health of both the mother and her offspring. The primary objective of this study is to identify barriers to oral health care among pregnant women, particularly racial and ethic minorities and those of lower socio-economic status, and then develop intervention strategies for removing or lowering the barriers so that existing evidence-based interventions can be more effectively applied. We will pursue this objective by achieving the following specific aims: 1. Collect and analyze data to understand pregnant women's current practices, attitudes, and perceived system barriers regarding optimal dental health. 2. Test the feasibility, acceptability, and likely use of four to eight potential interventions to remove and/or reduce barriers and encourage improved oral health practices. 3. Conduct pilot study of one or more interventions developed in aim 2. This proposal brings together a multidisciplinary team with strength in oral health in pregnancy, public health programming, behavioral research, qualitative analysis and public policy. Findings from this research will provide the framework for development of innovative, culturally sensitive strategies and approaches to improve the health and well-being of mothers and their children by reducing barriers to oral health care. Oral health diseases are prevalent conditions that disproportionately affect racial/ethnic minorities and disadvantaged individuals. Despite the presence of evidence-based interventions and effective preventive and treatment measures, oral diseases remain prevalent. Our long-term goal is to reduce morbidity of oral diseases among pregnant women and their children and identify barriers to oral health care which will provide the framework for development of innovative, culturally sensitive strategies and approaches to improve the health and well-being of mothers and their children by reducing barriers to oral health care.