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Prevention of Dental Caries in Early Head Start Children

早期启蒙儿童的龋齿预防

基本信息

批准号：
8288662
负责人：
RICHARD GARY ROZIER
金额：
$ 87.85万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8288662
关键词：
1 year old 2 year old 3 year old Affect Affective Age Age-Months Behavior Caregivers Caries prevention Caring Centers for Disease Control and Prevention (U.S.)Characteristics Child Childhood Chronic Disease Clinical Cognitive Communities Control Groups Counseling County Dental Dental Care Dental Health Education Dental caries Disadvantaged Disease Economics Educational Intervention Educational workshop Effectiveness Effectiveness of Interventions Enrollment Ensure Epidemic Evaluation Face Family Feedback Funding Grant Head Start Program Health Health Personnel Health Resources Health Services Administration Home environment Improve Access Interview Knowledge Lesion Link Low income Manuscripts Measures Medicaid Medical Methods Modeling Mouth Diseases National Institute of Dental and Craniofacial Research North Carolina Nurses ORALIT Oral cavity Oral health Outcome Parenting Education Parents Phase Physicians Population Pregnant Women Preventive Primary Health Care Program Evaluation Provider Public Health Public Health Practice Quality of life Race Randomized Readiness Reporting Research Resources Risk Risk Assessment Screening procedure Self Efficacy Services Site Source Staging System Testing Tooth Diseases Tooth structure Topical Fluorides Training United States Dept. of Health and Human Services United States Health Resources and Services Administration Work base burden of illness cohort community based practice design disorder risk early childhood expectation falls follow-up health literacy health related quality of life improved instrument intervention effect motivational enhancement therapy prevent programs secondary outcome social social cognitive theory therapy design

项目摘要

Early childhood caries (ECC) is the most common chronic disease of childhood, affecting more than 4 million children nationwide. The burden of disease falls mostly on disadvantage children. The purpose of this research is to evaluate an already funded and ongoing intervention designed to prevent ECC in children 0-2 years of age through a combination of preventive dental activities in medical offices and Early Head Start (EHS) centers. EHS staff in North Carolina are being trained to provide dental health education and promotion activities for children and their families, and to link children enrolled in EHS with medical providers in their communities who provide preventive dental services. As part of a statewide Medicaid program, about 500 medical offices are providing preventive dental services for children, including screening, risk assessment and referral, parent counseling and topical fluoride applications. Children and their parents in 18 EHS programs in 28 counties in the state have close geographic proximity to 75 sites where medical providers are offering preventive dental services. The dental educational intervention with EHS staff is based mainly on Social Learning Theory and consists of statewide forums, workshops with audit and feedback of practices, and educational workshops and resource materials. The educational intervention for parents is based in part on the Transtheoretical Model, which uses Stages of Change as its key concept, and motivational interviewing. Staff provide classroom preventive dental activities for children and education for parents, with support provided from local dental public health providers. A non- randomized, pretest-posttest nested cohort control group cluster trial will determine the effects of the combined dental exposures provided in EHS programs and medical offices on preventing noncavitated and cavitated carious lesions in EHS children. About 800 0- and 1-year old children will be enrolled in each of the study groups and examined for ECC at 3 years of age. Age- and race-matched children enrolled in Medicaid but not EHS will serve as community-specific controls. Parents will be interviewed at baseline, and follow-up interviews will take place when their study-enrolled children are 18 and 36 months of age. The clinical examination of the child at 3 years of age will occur at the final follow-up parent interview. Secondary outcomes include cognitive (dental knowledge) and affective (value placed on dental health, self-efficacy, outcome expectations, readiness to change) characteristics, establishment of a dental home for the child and family, and improvements in parent reported oral health-related quality of life (OHRQoL) for the child and themselves. A final aim of the study will determine the extent to which dental health literacy modifies the effectiveness of the intervention in improving outcomes. OHRQoL, dental health literacy and dental "homeness" will be measured with instrument developed by the research team in previous research. Intent-to-treat analyses will determine effects of the intervention on dental outcomes. Dental disease in young children is at epidemic levels among low-income children and they face a number of barriers that prevent them from getting needed dental care. This study will test several ways in which access to preventive dental services can be increased among children 0-2 years of age enrolled in Early Head Start programs across North Carolina. The result of successful implementation of preventive dental programs should be less disease and improved quality of life among children and their families.

儿童早期龋病(ECC)是儿童最常见的慢性疾病，影响超过4 全国有一百万儿童。疾病的负担主要落在弱势儿童身上。目的这项研究旨在评估一项旨在预防ECC的已资助和正在进行的干预措施 0-2岁儿童，通过在医务室和早期开展预防性牙科活动相结合头部启动(EHS)中心。北卡罗来纳州的EHS工作人员正在接受培训，以提供牙齿健康教育和促进儿童及其家庭的活动，并将参加EHS的儿童与医疗联系起来社区中提供预防性牙科服务的提供者。作为全州医疗补助计划的一部分在该方案中，约有500个医疗机构正在为儿童提供预防性牙科服务，包括筛查、风险评估和转介、家长咨询和局部氟化物应用。儿童和他们的父母在该州28个县的18个EHS项目中，地理位置接近75个地点那里的医疗提供者提供预防性牙科服务。开展牙科教育干预的研究 EHS工作人员主要基于社会学习理论，由全州范围的论坛、研讨会和审核和反馈实践、教育研讨会和资源材料。教育性的对父母的干预在一定程度上是基于跨理论模型，该模型将变化的阶段作为其关键概念和激励性访谈。工作人员为儿童提供课堂预防牙科活动以及对父母的教育，并得到当地牙科公共卫生提供者的支持。一个非- 随机、前测-后测嵌套队列对照组群试验将确定在EHS计划和医疗办公室提供的联合牙科暴露，以防止非空洞和 EHS儿童的空洞性龋损。大约800名0岁和1岁的儿童将在每个研究人员在3岁时分组并检查ECC。年龄和种族匹配的儿童参加医疗补助而不是EHS将作为社区特定的控制措施。家长将在基线时接受采访，后续采访将在他们参加研究的孩子分别为18个月和36个月时进行。 3岁儿童的临床检查将在最后的后续家长访谈中进行。次要结果包括认知(牙科知识)和情感(重视牙齿健康，自我效能感、结果预期、准备改变)特征，建立牙科之家对于儿童和家庭，以及父母报告的口腔健康相关生活质量(OHRQOL)的改善为了孩子和他们自己。这项研究的最终目标将确定牙齿健康的程度识字改变了干预措施在改善结果方面的有效性。OHRQOL，牙齿健康识字和牙齿的“本色”将用研究小组在#年开发的仪器进行测量。之前的研究。意向治疗分析将确定干预对牙科结果的影响。幼儿的牙病在低收入儿童中处于流行水平，他们面临着许多阻碍他们获得所需牙科护理的障碍。这这项研究将测试获得预防性牙科服务的几种方式在参加早期Head Start计划的0-2岁儿童中有所增加北卡罗来纳州。成功实施预防牙科项目的结果应该减少疾病，提高儿童及其家庭的生活质量。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Development and testing of a patient-centered dental home assessment for low-income families.

为低收入家庭开发和测试以患者为中心的牙科家庭评估。

DOI：
10.1111/jphd.12323
发表时间：
2019
期刊：
Journal of public health dentistry
影响因子：
2.3
作者：
Rozier,RichardGary;White,BenjaminAlexander;Wang,Mian;Meyer,BeauD;Lee,JessicaY
通讯作者：
Lee,JessicaY

Propensity score weighting: an application to an Early Head Start dental study.