Center to Address Disparities in Children's Oral Health

解决儿童口腔健康差异中心

• 批准号: 8277076
• 负责人: STUART A GANSKY
• 金额: $ 363.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-24 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8277076
• 关键词: 3 year old; 6 year old; Address; Blinded; California; Caries prevention; Child; Childhood; Chronic; Clinic; Communities; Counseling; Data Coordinating Center; Dental; Dental caries; Dentists; Development; Disease; Economically Deprived Population; Education; Effectiveness; Federally Qualified Health Center; Fluoride Varnishes; Fluorides; Fostering; Incidence; Infant; Intervention Studies; Low income; Medical; Methodology; Methods; Mexico; Oral health; Population; Preventive; Primary Health Care; Protocols documentation; Provider; Randomized; Randomized Clinical Trials; Relative (related person); Research; Research Personnel; Site; Social Work; Telephone; Woman; base; career development; clinical efficacy; early childhood; evidence base; experience; glass ionomer; health disparity; nutrition; prevent; programs; statistics; teledentistry

DESCRIPTION (provided by applicant): Early childhood caries (ECC) is the most prevalent chronic childhood disease in the U.S., particularly among economically disadvantaged, underserved children. We propose to continue our existing Center to Address Disparities in Children's Oral Health (U54DE014251) and its efforts to understand, prevent, and reduce oral health disparities, with a focus on preventing ECC. The themes of our collaborative, community-based program are (1) to provide the high-quality evidence base for new methods to prevent ECC in populations experiencing oral-health disparities and (2) to identify the most effective dissemination methods for delivering fluoride varnish (FV), an efficacious preventive method. We will actively engage California communities and providers in two large-scale intervention studies utilizing randomized clinical trial (RCT) methodology, stratified by settings, to assess the effectiveness or clinical efficacy of different preventive methods on caries incidence and increment among low-income children. Using the RE-AIM framework, Project 1 will identify the most effective setting (medical, social service agency or dental) to disseminate FV to the greatest number of 1-3-year-old children. Stratifying on setting, a parallel groups practical RCT will be conducted in 24 community-based primary care clinics (CPCCs) from the UCSF primary care collaborative research network, and 24 California Special Supplemental Nutrition Programs for Women, Infants and Children (WICs). Each non-dental site (CPCC or WIC) will be randomized to a program of parental counseling and onsite FV application or to parental counseling and referral to a dentist for child's FV application. We will also compare two automated telephone counseling methods and utilize teledentistry approaches for blinded caries assessments. Project 2 is an intervention study to be conducted in dental and non-dental settings, both affiliated with Federally Qualified Health Centers near the US-Mexico border, to compare the relative caries prevention efficacy of four protocols in 3-6 year-old children: 1) parental oral-health counseling (C) alone; 2) C+ FV; 3) C+ fluoride-releasing, glass ionomer (Gl) sealants applied to primary molars, and 4) C+FV+ Gl. Our Administrative Core, Statistics and Data Coordinating Center, and Community Liaison Program will support our two RCTs and developmental projects. These endeavors, with other education and career development activities, will foster new investigators to increase oral-health-disparity research capacity.

描述（由申请人提供）：幼儿龋齿（ECC）是美国最流行的慢性儿童疾病，特别是在经济上处于不利地位、得不到充分服务的儿童中。我们建议继续我们现有的中心，以解决儿童口腔健康的差异（U 54 DE 014251），并努力了解，预防和减少口腔健康的差异，重点是预防ECC。我们的合作，以社区为基础的计划的主题是（1）提供高质量的证据基础，为新的方法，以防止在人口经历口腔健康的差异和（2）确定最有效的传播方法提供氟化物清漆（FV），一种有效的预防方法。我们将积极与加州社区和医疗服务提供者进行两项大规模的干预研究，采用随机临床试验（RCT）方法，按环境分层，以评估不同预防方法对低收入儿童龋齿发病率和增量的有效性或临床疗效。利用RE-AIM框架，项目1将确定最有效的环境（医疗，社会服务机构或牙科），以向最多的1-3岁儿童传播FV。根据设置分层，将在来自UCSF初级保健合作研究网络的24个社区初级保健诊所（CPCC）和24个加州妇女、婴儿和儿童特殊补充营养计划（WIC）中进行平行组实用RCT。每个非牙科研究中心（CPCC或WIC）将被随机分配到一个父母咨询和现场FV应用程序或父母咨询和转诊到牙医进行儿童的FV应用。我们还将比较两种自动电话咨询方法，并利用远程牙科方法进行盲法龋齿评估。项目2是一项干预性研究，将在美国-墨西哥边境附近的联邦合格卫生中心附属的牙科和非牙科环境中进行，以比较3-6岁儿童四种方案的相对龋齿预防效果：1）单独的父母口腔健康咨询（C）; 2）C+ FV; 3）C+释放氟化物的玻璃离聚物（GI）密封剂施加到乳磨牙，和4）C+FV+ GI。我们的行政核心，统计和数据协调中心，社区联络计划将支持我们的两个随机对照试验和发展项目。这些努力，与其他教育和职业发展活动，将培养新的研究人员，以提高口腔健康差异的研究能力。