Integrating Social and Systems Science Approaches to Promote Oral Health Equity

整合社会科学和系统科学方法促进口腔健康公平

• 批准号: 8420978
• 负责人: CAROL KUNZEL
• 金额: $ 80.48万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8420978
• 关键词: Adopted; Adult; Age; Aging; Behavior; Biological Models; Buffers; Caring; Chronic Disease; Clinic; Communities; Comprehensive Health Care; Computer software; Coupled; Dental; Dental Care; Dentistry; Development; Diabetes Mellitus; Dimensions; Elderly; Environment; Exercise; Funding Opportunities; Geographic Information Systems; Health; Health Policy; Health Promotion and Care; Health Services Accessibility; Health behavior; Health behavior outcomes; Healthcare; Human; Hypertension; Improve Access; Individual; Investigation; Knowledge; Learning; Medical; Methodology; Methods; Minority; Minority Groups; Modeling; Monitor; Neighborhoods; Oral health; Outcome; Pathway interactions; Patients; Periodontal Diseases; Policies; Population; Population Group; Population Heterogeneity; Research; Sampling; Science; Screening procedure; Services; Shapes; Social Environment; Social Sciences; System; Thinking; Tooth Loss; Tooth structure; Underserved Population; United States National Institutes of Health; Work; base; care seeking; community setting; expectation; health care delivery; health equity; healthy aging; improved; oral care; oral condition; peer; programs; social; social model; stressor

DESCRIPTION (provided by applicant): Demographic shifts that include an aging and more racially and ethnically diverse population coupled with ongoing changes in the healthcare policy environment are demanding that the dental profession both redirect and expand its focus. Challenges include providing more comprehensive care for patients with complicated medical and social needs, while improving access to care for underserved population groups. In the coming years, the practice of dentistry is expected to include screening for, and monitoring of, chronic diseases such as hypertension and diabetes related to cumulative oral conditions such as tooth loss and periodontal disease. Meanwhile, expectations for dentistry by the public will require the field to develop strategies to manage the oral health of groups not now receiving adequate care, including older adults. Recent methodological developments enabled by computational advances, such as agent-based modeling, system dynamics, and geographic information systems, have spurred a body of research on the effects of multiple scales (e.g., community, interpersonal, and individual) and dimensions (e.g., built environment and social context at the community scale) on health behaviors and outcomes. Yet, because software platforms capable of combining these approaches have only recently become available, the methods have generally been applied only in isolation. In particular, little empirical work has examined how factors at multiple scales contribute to oral health and care-seeking behaviors for racial and ethnic minority older adults. Previous research conducted with racial and ethnic minority older adults who attend senior centers in underserved urban neighborhoods (hereafter referred to as urban minority senior center attendees) found lower levels of tooth loss than in US national samples. In order to learn from what is working well in this older adult population, the specific aims and hypotheses are to: (1) understand how urban minority senior center attendees utilize services such as health and dental care at the community scale to enhance their oral health; (2) identify how factors at the interpersonal scale enhance care-seeking behaviors and improve the oral health outcomes of urban minority senior center attendees; (3) examine the cultural acceptability of screening for hypertension and diabetes in the dental setting at the individual scale for urban minority senior center attendees; and (4) model the knowledge gained about factors at the community, interpersonal, and individual scales for urban minority senior center attendees in Aims 1, 2, and 3 to enhance community- and clinic-based oral health service delivery and improve oral health outcomes. These aims are consistent with the research objectives of the National Institutes of Health through Funding Opportunity Announcement PAR-11-314 to develop applied projects utilizing systems science methodologies relevant to human behaviors, social sciences, and health. Successful completion of these aims will aid in understanding how community assets shape familial and peer interactions and contribute to oral health promotion and care seeking behaviors as adult's age. ! PUBLIC HEALTH RELEVANCE: Demographic shifts that include an aging and more racially and ethnically diverse population coupled with ongoing changes in the healthcare policy environment are demanding that the dental profession both redirect and expand its focus. This study is original in utilizing social and systems science to explore integrated models of primary and oral health screening for older adults in community settings.

描述(由申请人提供)：人口结构的变化，包括老龄化和更多的种族和民族多样性的人口，加上医疗保健政策环境的持续变化，要求牙科专业改变方向并扩大其重点。挑战包括为有复杂医疗和社会需求的患者提供更全面的护理，同时改善服务不足人群获得护理的机会。在未来几年，牙科实践预计将包括筛查和监测与累积口腔疾病(如牙齿脱落和牙周病)有关的慢性疾病，如高血压和糖尿病。与此同时，公众对牙科的期望将要求该领域制定战略，管理目前没有得到足够护理的群体的口腔健康，包括老年人。最近的方法论发展，如基于主体的建模、系统动力学和地理信息系统，促进了对多个尺度(例如，社区、人际和个人)和维度(例如，社区尺度上的建筑环境和社会背景)对健康行为和结果的影响的研究。然而，由于能够结合这些方法的软件平台直到最近才出现，这些方法通常只在孤立的情况下应用。特别是，很少有实证工作研究多个尺度上的因素如何影响种族和少数民族老年人的口腔健康和寻求护理行为。之前对在服务不足的城市社区的老年中心就诊的种族和少数民族老年人(以下称为城市少数族裔老年中心参与者)进行的研究发现，牙齿脱落的水平低于美国全国样本。研究的具体目的和假设是：(1)了解城市少数民族老年中心的参与者如何利用社区规模的健康和牙科保健等服务来提高他们的口腔健康；(2)确定人际尺度上的因素如何促进城市少数民族老年中心参与者的就医行为和改善其口腔健康结果；(3)考察城市少数民族老年中心参与者个体尺度上的牙科筛查高血压和糖尿病的文化可接受性；以及(4)在目标1、2和3中为城市少数民族老年中心参与者在社区、人际和个人量表上获得的关于因素的知识建模，以加强基于社区和诊所的口腔健康服务的提供，并改善口腔健康结果。这些目标与国家卫生研究院通过资助机会公告PAR-11-314来开发应用项目的研究目标是一致的，这些项目利用与人类行为、社会科学和健康相关的系统科学方法。成功完成这些目标将有助于理解社区资产如何塑造家庭和同伴互动，并有助于成人的口腔健康促进和寻求护理行为。好了！ 与公共健康相关：人口结构的变化，包括老龄化和更具种族和民族多样性的人口，加上医疗保健政策环境的持续变化，要求牙科专业改变方向并扩大其重点。这项研究在利用社会学和系统科学探索社区老年人初级和口腔健康筛查的综合模式方面具有独到之处。