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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

基本信息

批准号：
8525112
负责人：
LISA J. HEATON
金额：
$ 11.87万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-25 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8525112
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

项目摘要

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)：这项关于K23指导性患者导向研究职业发展奖的建议将为应聘者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精神健康问题之间复杂关系的风险因素。长期目标是，候选人通过了解心理社会因素如何影响个人参与口腔自我护理和牙科治疗寻求，成为减少口腔健康差距的领先独立调查员。这位候选人在肯塔基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。这一奖项将允许候选人发展成为一名独立的研究员，并将为候选人在口腔健康差异研究中成功指导MS和博士候选人做好准备。培训计划包括两个阶段：强调流行病学、生物统计学、研究方法和卫生服务研究课程的教学部分，以及调查导致心理健康问题和不良口腔健康结果之间复杂关系的因素的研究阶段，如避免预防性护理和延误必要的牙科治疗。在本培训申请中提出了四个具体目标。具体目标1将通过对全国卫生服务利用情况调查的回顾分析，审查非住院个人的精神健康问题和未得到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，审查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的调查，确定在这一服务不足的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将确定以药房为基础的口腔健康试点计划的可行性，个人服用精神药物。牙科公共卫生科学教授彼得·米尔格罗姆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剂系、卫生服务研究系、生物统计学系、牙科公共卫生科学系以及口腔和颌面外科系的教职员工组成。完成拟议的研究计划将提供关于心理健康问题和口腔健康不良之间复杂的、多因素的关系的宝贵信息。直接来说，精神药物会导致口腔干燥的症状，对口腔健康有害。间接地，情绪和焦虑症会干扰适当口腔卫生的动机和寻求预防性牙科治疗的意愿。许多有慢性精神健康问题的人来自弱势背景或残疾，在购买牙科护理方面面临经济障碍。然而，尚不清楚的是，有精神健康问题的人对自己的口腔健康风险了解多少，以及他们从牙科和非牙科保健提供者那里收到了关于这些风险的建议(如果有的话)。这项工作预计将表明，虽然有心理健康问题的人口腔健康结果不佳的风险增加，但这些人得不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R01应用程序，重点关注非牙科保健提供者在减少这一服务不足人群中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保健提供者向无法获得常规牙科保健的个人提供口腔健康咨询。这项提案中研究的完成将为未来的干预措施奠定基础，以增加服务不足人群中个人获得口腔卫生资源的机会。