Addressing Oral Health Disparities in Individuals with Mental Health Problems

解决有心理健康问题的个体的口腔健康差异

• 批准号: 8113890
• 负责人: LISA J. HEATON
• 金额: $ 12.7万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8113890
• 关键词: Address; Adverse effects; Anxiety Disorders; Area; Attitude; Award; Biometry; Caring; Chronic; Clinical Psychology; Complex; Continuing Education; Counseling; Data; Databases; Dental; Dental Care; Dental Hygiene; Dental caries; Development; Disabled Persons; Disadvantaged; Doctor of Philosophy; Epidemiology; Expenditure; Face; Faculty; Florida; Future; Goals; Health; Health Personnel; Health Psychology; Health Resources; Health Sciences; Health Services Research; Health Status; Healthcare; Incentives; Individual; Internships; Intervention; Interview; Investigation; Kentucky; Knowledge; Learning; Link; Medical; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mood Disorders; Motivation; National Health Services; National Research Service Awards; Oral; Oral Surgical Procedures; Oral health; Outcome; Patients; Periodontal Diseases; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Phase; Population; Preventive; Provider; Psychopharmacology; Psychosocial Factor; Public Health; Qualitative Research; Recommendation; Reporting; Research; Research Methodology; Research Personnel; Risk; Risk Factors; Role; Sampling; Self Care; Source; Surveys; Symptoms; Theoretical model; Therapeutic Intervention; Training; Training Programs; Underserved Population; United States; Universities; Washington; Work; Xerostomia; base; health care service utilization; health disparity; innovation; member; multidisciplinary; oral care; oral surgery specialty; post-doctoral training; pre-doctoral; professor; programs; public health relevance; willingness

DESCRIPTION (provided by applicant): This proposal for a K23 Mentored Patient-Oriented Research Career Development Award will provide the candidate with five years of continuous mentored support and additional training in the investigation of risk factors that contribute to the complex relationship between poor oral health outcomes and mental health problems. The long-term goal is for the candidate to become a leading independent investigator in reducing oral health disparities by understanding the ways in which psychosocial factors impact how individuals engage in oral self-care and dental treatment seeking. The candidate received her PhD in Clinical Psychology at the University of Kentucky, completed one year of predoctoral Health Psychology internship training at the University of Florida, and completed three years of NRSA postdoctoral training in the Department of Dental Public Health Sciences at the University of Washington. This award would allow the candidate to evolve into an independent investigator and would prepare the candidate to successfully mentor MS and PhD candidates in oral health disparities research. The training program consists of two phases: a didactic component emphasizing courses in epidemiology; biostatistics; research methods; and health services research, and a research phase involving the investigation of factors contributing to the complex relationship between mental health problems and poor oral health outcomes, such as avoidance of preventive care and delays in necessary dental treatment. Four specific aims are proposed in this training application. Specific Aim 1 will examine the relationship between mental health problems and unmet dental needs in non-institutionalized individuals through a retrospective analysis of a national health services utilization survey. Specific Aim 2 will examine, through individual interviews with non-dental health care providers, what oral health recommendations they currently give to patients with mental health problems and their willingness to intervene in patients' oral health. Specific Aim 3 will determine, through surveys with individuals with mental health problems, the oral health status of and barriers to oral health care faced by individuals in this underserved population. Finally, Specific Aim 4 will determine the feasibility of a pharmacy- based oral health pilot program with individuals taking psychotropic medications. Peter Milgrom, DDS, Professor of Dental Public Health Sciences, will chair a multidisciplinary Mentoring Committee consisting of faculty members from the University of Washington Departments of Pharmacy, Health Services Research, Biostatistics, Dental Public Health Sciences, and Department of Oral and Maxillofacial Surgery. Completion of the proposed Research Plan will provide valuable information regarding the complex, multifactorial relationship between mental health problems and poor oral health. Directly, psychotropic medications can cause dry mouth symptoms harmful to oral health. Indirectly, mood and anxiety disorders can interfere with motivation for adequate oral hygiene and willingness to seek preventive dental treatment. Many individuals with chronic mental health problems come from disadvantaged backgrounds or are disabled and face financial barriers to purchasing dental care. What is not known, however, is what individuals with mental health problems know about their oral health risks and what recommendations, if any, they receive from dental and non-dental health care providers about these risks. This work is expected to show that while people with mental health problems are at an increased risk for poor oral health outcomes, these individuals do not receive consistent recommendations about their oral health, particularly in the absence of a regular source of dental care. Ultimately, this work will result in an R01 application focusing on the role of non- dental health care providers in reducing health disparities in this underserved population. Public Health Relevance: The public health relevance of the proposed Research Plan relates to the use of non-dental health care providers in the delivery of oral health counseling to individuals who lack access to regular dental care. Completion of the studies in this proposal will lay the groundwork for future interventions to increase access to oral health resources for individuals in underserved populations.

描述（由申请人提供）：K23指导的以患者为导向的研究职业发展奖的提案将为候选人提供五年的持续指导支持和额外的培训，以调查导致口腔健康不良结果和心理健康问题之间复杂关系的风险因素。长期目标是通过了解心理社会因素影响个人如何参与口腔自我护理和牙科治疗寻求的方式，使候选人成为减少口腔健康差异的领先独立调查员。候选人在肯塔基州大学获得临床心理学博士学位，在佛罗里达大学完成了一年的博士前健康心理学实习培训，并在华盛顿大学牙科公共卫生科学系完成了三年的NRSA博士后培训。该奖项将允许候选人发展成为一名独立的调查员，并准备候选人成功地指导MS和博士候选人在口腔健康差异研究。该培训计划包括两个阶段：一个教学组成部分，强调流行病学课程;生物统计学;研究方法;和卫生服务研究，以及一个研究阶段，涉及调查导致心理健康问题和口腔健康不良结果之间复杂关系的因素，如避免预防性护理和必要的牙科治疗的延误。本培训申请提出了四个具体目标。具体目标1将通过对国家卫生服务利用调查的回顾性分析，研究非制度化个体的心理健康问题和未满足的牙科需求之间的关系。具体目标2将通过与非牙科保健提供者的个别访谈，研究他们目前向有精神健康问题的患者提供哪些口腔健康建议，以及他们是否愿意干预患者的口腔健康。具体目标3将通过对有精神健康问题的个人进行调查，确定这一服务不足人群中个人的口腔健康状况和口腔保健面临的障碍。最后，具体目标4将确定一个以药房为基础的口腔健康试点计划与个人服用精神药物的可行性。牙科公共卫生科学教授Peter Milgrom将主持一个多学科指导委员会，该委员会由来自华盛顿大学药学部、卫生服务研究部、生物统计学部、牙科公共卫生科学部和口腔颌面外科部的教员组成。完成拟议的研究计划将提供有关心理健康问题和口腔健康不良之间复杂的多因素关系的有价值的信息。精神药物会直接导致口腔干燥症状，对口腔健康有害。间接地，情绪和焦虑症会干扰充分口腔卫生的动机和寻求预防性牙科治疗的意愿。许多患有慢性心理健康问题的人来自弱势背景或残疾人，在购买牙科护理方面面临经济障碍。然而，目前尚不清楚的是，有心理健康问题的人对他们的口腔健康风险了解多少，以及他们从牙科和非牙科医疗保健提供者那里得到了哪些关于这些风险的建议。这项工作预计将表明，虽然有心理健康问题的人口腔健康状况不佳的风险增加，但这些人没有得到关于其口腔健康的一致建议，特别是在缺乏定期牙科护理的情况下。最终，这项工作将产生一个R 01应用程序，重点是非牙科医疗保健提供者在减少这一服务不足人群的健康差距方面的作用。 公共卫生相关性：拟议研究计划的公共卫生相关性涉及使用非牙科医疗保健提供者向缺乏定期牙科护理的个人提供口腔健康咨询。完成本提案中的研究将为未来的干预措施奠定基础，以增加服务不足人群的个人获得口腔卫生资源的机会。