Family intervention with caregivers of children with urgent dental needs

对有紧急牙科需求的儿童的照顾者进行家庭干预

• 批准号: 8210484
• 负责人: Suchitra S. Nelson
• 金额: $ 29.01万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8210484
• 关键词: 11 year old; Acute; Address; Behavior; Behavior Therapy; Behavioral; Caregivers; Caries prevention; Caring; Child; Chronic Disease; Clinic; Clinical; Clinical Protocols; Communities; Community Dentistry; Data; Data Analyses; Data Collection; Dental; Dental Care; Dental Schools; Dental Staff; Dental caries; Dentists; Development; Disadvantaged; Educational Materials; Effectiveness; Enrollment; Ensure; Evaluation; Faculty; Family; Family Caregiver; Fluoride Varnishes; Focus Groups; Future; Goals; Guidelines; Health; Health Planning; Health Services; Health Services Accessibility; Health education; Healthy People 2010; Individual; Informal Social Control; Institutional Review Boards; International; Intervention; Intervention Studies; Intervention Trial; Interview; Laws; Letters; Low income; Manuals; Mediator of activation protein; Medicaid; Medicine; Methods; Minority; Modeling; Monitor; National Institute of Dental and Craniofacial Research; Neighborhoods; Ohio; Oral health; Parents; Perception; Phase; Phase II Clinical Trials; Pit and Fissure Sealants; Planning Theory; Population; Prevalence; Prevention program; Primary Dentition; Procedures; Process; Protocols documentation; Provider; Public Health; Questionnaires; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Design; Resources; Safety; Sample Size; Sampling; Schedule; Schools; Screening procedure; Secure; Structure; Telephone; Testing; Thinking; Tooth structure; United States Health Resources and Services Administration; Universities; Visit; Washington; Writing; base; care seeking; care systems; community organizations; cost effective; design; elementary school; follow-up; health disparity; high risk; illness perceptions; improved; informant; inner city; innovation; instrument; kindergarten; meetings; operation; permanent tooth; programs; response; second grade; social; soft drink; statistics; success; theories; tool; trend; usability

DESCRIPTION (provided by applicant): Tooth decay in 2 to 11 year olds is increasing nationally especially among poor and minority populations, and it is unlikely that Healthy People 2020 goals will be met. Dental screening of children in public elementary schools has been mandated in 12 states and endorsed by U.S. and international organizations. Nevertheless, in spite of enthusiasm for the concept, screening and referral has been ineffective as a tool to get parents and caregivers to take children to the dentist. This application is to support planning of a Phase II randomized clinical trial to assess the effectiveness of a referral approach to increase dental attendance (for receipt of care) among inner-city urban elementary school children with urgent/restorative needs. The intervention to be tested relies on two theoretical frameworks -Common Sense Model of Self-Regulation (CSM), and the theory of Planned Behavior (TPB) that could be used in conjunction with child-level interventions in a school-based program. The objectives of the R34 study will occur in two phases: (1) pilot phase to validate the modified illness perception questionnaire -Revised (IPQ-RD) for dental caries, acceptability and delivery of the intervention, mediators and moderators for accessing care; focus groups of community organizations and providers to identify enabling resources to be included in the experimental intervention; and testing the experimental intervention regarding appropriateness/accuracy of educational materials; (2) planning phase primarily devoted to the major planning activities required for a U01 submission including development of the study protocol, manual of operations, and Institutional Review Board application and its associated materials. The sample size for the R34 includes 120 caregivers of KG, first, and second grade school children recruited from among 5 elementary schools in an urban inner-city school district in Cleveland, OH, and 10 to 20 key informants from several community agencies or providers. Data collection involves semi-structured one-to-one interviews and questionnaire responses for caregivers and focus groups for community/provider informants. Data analysis will utilize a mixed method design (grounded theory and theory driven) for qualitative data, and descriptive/analytical statistics for quantitative data. This behavioral approach has the potential to change the public health standard of practice for screening programs by utilizing a cost-effective, easily transportable, and sustainable referral approach. The transdiscipilinary research team includes faculty from Department of Community Dentistry at Case Western Reserve and the Northwest Center to Reduce Oral Health Disparities at the University of Washington. PUBLIC HEALTH RELEVANCE: The proposed study addresses an innovative behavioral approach to the referral process never attempted before to address three caregiver issues - (1) importance of caries-free baby teeth for protection of permanent teeth (2) viewing dental caries as a chronic disease rather than acute or episodic; and (3) navigation of resources for dental care access. This behavioral approach also has the potential to change the public health standard of practice for school screening programs required by law in many states.

描述（由申请人提供）：在全国范围内，2至11岁儿童的蛀牙人数正在增加，特别是在贫困和少数民族人群中，2020年健康人目标不太可能实现。12个州已强制要求公立小学对儿童进行牙齿检查，并得到美国和国际组织的认可。然而，尽管人们对这个概念充满热情，筛查和转诊作为一种让父母和照顾者带孩子去看牙医的工具，效果并不好。本申请是为了支持一项二期随机临床试验的规划，以评估转诊方法在有紧急/恢复性需求的市中心城市小学儿童中增加牙科就诊（接受护理）的有效性。要测试的干预依赖于两个理论框架——自我调节的常识模型（CSM）和计划行为理论（TPB），这两个理论框架可以在学校项目中与儿童水平的干预结合使用。R34研究的目标将分两个阶段进行：(1)试点阶段，验证修改后的疾病感知问卷-修订（IPQ-RD），用于龋齿，干预的可接受性和交付，获得护理的中介和调节因素；社区组织和提供者的焦点小组，以确定可纳入实验性干预的有利资源；测试教材的适当性/准确性的实验干预；(2)规划阶段，主要致力于U01提交所需的主要规划活动，包括制定研究方案、操作手册、机构审查委员会申请及其相关材料。R34的样本量包括从俄亥俄州克利夫兰市一个市区内学区的5所小学中招募的120名幼儿园、一年级和二年级儿童的照顾者，以及来自几个社区机构或提供者的10至20名关键线人。数据收集包括半结构化的一对一访谈和针对护理人员的问卷调查，以及针对社区/提供者信息的焦点小组。数据分析将利用混合方法设计（接地理论和理论驱动）定性数据和描述性/分析性统计定量数据。这种行为方法有可能通过利用成本效益高、易于运输和可持续的转诊方法来改变筛查项目的公共卫生实践标准。跨学科研究团队包括来自凯斯西储社区牙科部门和华盛顿大学西北减少口腔健康差距中心的教师。