Dental Service Utilization for Foreign and Native-born Children in America

美国外国和本土出生儿童的牙科服务利用情况

• 批准号: 9374382
• 负责人: Christopher Okunseri
• 金额: $ 17.1万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9374382
• 关键词: 18 year old; Acculturation; Address; Adult; Affect; American; Americas; Birth; Censuses; Characteristics; Child; Child health care; Communities; Community Healthcare; Country; Cultural Diversity; Data; Databases; Demographic Factors; Dental; Dental Care; Dental Care Delivery; Dental Insurance; Development; Eligibility Determination; Equation; Exhibits; Expenditure; Face; Family; Formulation; Goals; Guidelines; Health; Health Professional; Health Services; Health Services Accessibility; Health Status; Healthcare; Healthcare Systems; Home environment; Immigrant; Immigration; Individual; Intervention; Knowledge; Language; Left; Length of Stay; Literature; Logistic Regressions; Mediating; Medicaid; Medical; Medicine; Modeling; Mouth Diseases; National Health Interview Survey; Native-Born; Oral health; Outcome; Parents; Pattern; Persons; Policies; Population; Population Group; Population Surveillance; Prevalence; Preventive dental care; Public Health; Publishing; Quality of Care; Research; Research Personnel; Sample Size; Societies; Socioeconomic Factors; Socioeconomic Status; Surveys; System; Time; Time trend; Tooth Diseases; United States; Variant; base; burden of illness; demographics; disparity reduction; ethnic minority population; experience; health disparity; health seeking behavior; migration; multidisciplinary; programs; racial and ethnic; racial minority; service utilization; social; statistics; stressor; uptake

Project Summary Children from immigrant families constitute one of the largest and fastest growing racial and ethnic minority population groups in the United States. Yet, immigrant children's oral health status, dental needs and dental service utilization are understudied and poorly understood. Few published studies on oral health of immigrant adults and children are based on convenience and small sample sizes or Medicaid data from a single state and all have provided mixed results. The specific characteristics within the foreign-born population that could explain any differential uptake in dental service utilization to address disparity is limited. In addition, existing literature on oral health disparities have focused on socioeconomic factors and do not include social and cultural determinants of oral health such as immigration status. This gap in knowledge specifically hampers the development and implementation of appropriate policies and programs that could achieve positive oral health outcomes for immigrant children. Immigrant oral health is influenced by individual, community and healthcare system factors both before and after immigration, yet it is unclear how these factors contribute to overall oral health disparities. Immigrant children's oral health is a growing dental public health concern due to the significant consequences of common oral diseases if left untreated. The overall goal of this project is to address the gap in knowledge related to immigrant children's oral health and to explore how immigrant children's oral health characteristics contribute to oral health disparities. In addition, this study will identify specific characteristics and health care level factors required for appropriate intervention to reduce these disparities. The specific aims of this study are: (1) to determine the patterns and time trend of dental services utilization and unmet dental needs of foreign-born children from 2002 to 2014; and (2) to examine the extent to which immigrant status factors such as length of stay, language spoken at home and other person-level demographic factors explain variations in dental access, utilization and unmet dental needs of foreign-born children compared to native-born children from 2002 to 2014. This project will be conducted by a team of multidisciplinary researchers using two nationally representative databases: the 2001-2013 National Health Interview Survey (NHIS) and the 2002-2014 Medical Expenditure Panel Survey (MEPS). Descriptive statistics will be conducted to provide estimates of counts and rates of dental services utilization and unmet dental needs. Logistic regression models will then be fit to determine outcome variables associated with other covariates. Structural equation modeling (SEM) will be used to describe the relationship between latent phenomena captured by multiple related variables, such as acculturation. Findings from this project will be used to inform the development of priorities and policies directed at immigrant children's oral health and oral health disparities.

项目摘要 来自移民家庭的孩子构成了种族和少数民族人口最大，最快的种族和少数民族之一 在美国。然而，移民儿童的口腔健康状况，牙科需求和牙科服务利用率是 研究了，理解不足。关于移民成年和儿童口腔健康的发表研究很少是基于 便利性和单个状态的小样本量或医疗补助数据都提供了不同的结果。具体 外国出生人群中的特征可以解释牙科服务利用中的任何差异吸收 地址差异是有限的。此外，现有有关口腔健康差异的文献集中在社会经济上 因素，不包括口腔健康的社会和文化决定因素，例如移民身份。这个差距 知识专门阻碍了适当的政策和计划的制定和实施 为移民儿童取得积极的口腔健康结果。移民口腔健康受个人的影响， 移民前后的社区和医疗保健系统因素，但尚不清楚这些因素如何贡献 总体口腔健康差异。移民儿童口腔健康是由于 如果未治疗，普通口腔疾病的重大后果。该项目的总体目标是解决差距 与移民儿童口腔健康有关的知识，并探讨移民儿童口腔健康特征 导致口腔健康差异。此外，这项研究将确定特定特征和医疗保健水平 适当干预需要减少这些差异所需的因素。这项研究的具体目的是：（1） 确定牙科服务利用的模式和时间趋势以及外国出生儿童未满足的牙科需求 2002年至2014年； （2）检查移民身份因素的程度，例如住院时间，语言在 家庭和其他人级的人口因素解释了牙齿通道，利用和未满足的牙齿需求的变化 与2002年至2014年的原住民儿童相比，外国出生的孩子。该项目将由一个团队进行 多学科研究人员使用两个国家代表性数据库：2001-2013国家健康访谈 调查（NHIS）和2002 - 2014年医疗支出小组调查（MEPS）。描述性统计将进行 提供牙科服务利用率和未满足牙科需求的计数和速度的估计。逻辑回归模型 然后将适合确定与其他协变量相关的结果变量。结构方程建模（SEM）将 用于描述由多个相关变量捕获的潜在现象之间的关系，例如 适应。该项目的调查结果将用于告知针对针对的优先事项和政策 移民儿童口腔健康和口腔健康差异。