Hollywood Smiles

描述（由申请人提供）：非洲裔美国人（AA）Gullah人口的口腔健康（OH）差异率高于全国AA。这一群体中的OH差异可归因于几个因素，包括恐惧、对提供者缺乏信任、过去的负面经历、获得护理的机会和文化信仰。拟议的研究将测试捆绑式多层次干预的可行性，其设计是基于目标农村Gullah人口的偏好。如果这项研究证明可行性，我们将扩大我们的招聘未来R 01与其他古拉社区全州。我们的长期合作伙伴关系的目标是有一个社区诊所在好莱坞与MUSC牙科学生和教师。这是一个可持续的模式，学生将更多地参与和接触治疗农村社区和社区将有更多的机会和可接受的和相关的OH护理。该项目的目标是：1。开发一种新的，社区首选的OH多层次干预（好莱坞微笑-HS）在教会设置; 2。评估HS干预的可行性，包括干预剂量和保真度，以及监测和测量目标结果和成本; 3.评价HS的初步疗效指征，并估计为后续干预疗效研究计算样本量所需的结局测量变异性。提出了一个社会生态模型来指导干预，提供了一个框架，在多个层次的影响（个人，同行和组织）OH行为的干预。将采用分组随机化，通过掷硬币程序将2个教会分配到干预组（HS）（n=30）和对照组（CG）（n=30），共计60名参与者。所有参与者将在社区牙科诊所接受初级标准护理牙科治疗，每次牙科就诊都有交通通行证。参与者，HS小组的教会成员也将接受为期3个月的多层次干预，其中包括与社区OH促进者（COHP）的1：1接触，同伴教育会议和教会层面的干预。根据目标的规定和概念框架的指导，结果测量将包括：a）口腔健康的因变量; B）干预中介变量（口腔健康行为报告，口腔健康素养，口腔健康自我效能和牙科焦虑水平）;和，d）自变量（人口统计学和生理测量）和教会气氛。将进行系统的过程评估，可行性措施将包括招募、坚持（剂量/忠诚度）、辍学比例、可接受性、教会咨询委员会满意度和干预范围。

DESCRIPTION (provided by applicant): The African American (AA) Gullah population has a higher rate of oral health (OH) disparities when compared to AAs nationally. OH disparities among this group can be attributed to several factors including fear, lack of trust in providers, past negative experiences, access to care and cultural beliefs. The proposed study will test the feasibility of a bundled, multi-level intervention, whose design is based on the preferences of the targeted rural Gullah population. If this study demonstrates feasibility we will broaden our recruitment for future R01 with other Gullah communities statewide. Our long-term partnership goal is to have a community clinic in Hollywood with MUSC dental students and faculty. This is a sustainable model where the students would be more engaged and exposed to treating the rural community and the community would have increased access and acceptable and relevant OH care. The aims of this project are to: 1. Develop a novel, community preferred OH multi-level intervention (Hollywood Smiles-HS) in church settings; 2. Evaluate the HS intervention feasibility including intervention dosage and fidelity as well as monitoring and measurement of target outcomes and cost; 3. Evaluate preliminary efficacy indications of the HS and estimate outcome measurement variability needed to calculate sample size for a subsequent study of intervention efficacy. A social-ecological model is proposed to guide the intervention, providing a framework for intervening at multiple levels of influence (individual, peer and organizational) on OH behaviors. Cluster randomization will be used to assign 2 churches to an intervention (HS) group (n=30) and a control group (CG) (n=30), thru a coin- toss procedure, for a total of 60 participants. All participants will receive primary standard of care dental therapy at a community dental clinic and transportation passes for each of the dental visits. Participants, members of the church in the HS group will also receive a 3-month multi-level intervention that will include 1:1 contact with a community OH promoter (COHP), peer educational sessions, and church level interventions. As specified by the aims and guided by the conceptual framework, the outcome measures will include: a) dependent variables of oral health; b) intervention mediator variables (oral health behavior report, oral health literacy, oral health self-efficacy and dental anxiety level); and, d) independent variables (demographic and physiologic measures) and church climate. A systematic process evaluation will be conducted and measures of feasibility will include recruitment, adherence (dosage/fidelity), dropout proportions, acceptability, Church Advisory Board satisfaction, and reach of the intervention.