Complex Systems Science Approaches to Addressing Oral Health Disparities

解决口腔健康差异的复杂系统科学方法

• 批准号: 9751645
• 负责人: Brenda Heaton
• 金额: $ 24.27万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9751645
• 关键词: Address; Adult; Affect; Applied Research; Behavior; Boston; Caregivers; Characteristics; Child; Child Health; Communities; Complex; Computer Simulation; Computers; Consumption; Data; Data Collection; Dental; Dental Care; Development; Diffusion; Disadvantaged; Disease; Dissection; Epidemiologist; Epidemiology; Etiology; Feedback; Geography; Goals; Health; Health Status; Health behavior; Housing; Individual; Intervention; Investments; Low income; Measures; Mentors; Methods; Minority Groups; Modeling; Network-based; Oral health; Outcome; Pathway Analysis; Pathway interactions; Performance; Pharmaceutical Preparations; Phase; Population; Population Dynamics; Population Group; Poverty; Probability; Property; Public Housing; Quality of life; Research; Resources; Risk; Sampling; Science; Shapes; Social Environment; Social Interaction; Social Network; Social Processes; Structure; System; Testing; Time; Training; Work; base; behavior change; behavioral health; burden of illness; career; computerized tools; design; disadvantaged population; disorder prevention; experience; health disparity; improved; instrument; member; models and simulation; multidisciplinary; population health; racial and ethnic; simulation; skills; social; social movement; social stigma; sugar; sweetened beverage; theories; tool

Oral health disparities, particularly among children, continue to be a pressing problem in the US. While the oral health of children has improved overall, those from disadvantaged population groups continue to suffer from a greater than average disease burden. Oral health disparities reflect a complex set of pathways and mechanisms with bidirectional associations (feedback loops) that traverse the macro- and micro-levels of disease causation. The overall goal of this proposal is to facilitate the candidate’s long term career goal of becoming an independent social epidemiologist capable of investigating disease causation and prevention through a complex systems-based perspective. The current proposal aims to provide the candidate with the opportunity to develop the necessary skills and experience to achieve research independence by extending their formal training in epidemiology and applied experiences in oral health disparities research. Development activities proposed during the mentored phase are related to training the candidate in Complex Systems Science (CSS) approaches, namely social network analysis (SNA) and agent-based modeling (ABM). Training will occur through coursework, multidisciplinary mentoring and applied research experiences. The primary vehicle for development is the research plan. The proposed research aims to use CSS approaches to better understand the factors and mechanisms underlying oral health among a disadvantaged population, and to improve the strategies aimed at improving oral health, thereby reducing observed disparities. These approaches facilitate an understanding of the population, social interaction and environmental influence simultaneously and can explore interactions, feedback loops and reciprocity between independent and dependent variables. The first phase of the proposed work aims to develop a detailed conceptual model of oral health disparities that captures the multi-level mechanisms and will be used to inform the development of an agent-based model. ABM refers to the use of stochastic computer simulations to understand how the distribution of health and disease on a population level emerge from explicitly programmed health behaviors, social interactions and movements of simulated individuals over simulated time. An ABM of oral health and social networks among residents of public housing will be developed and utilized to identify viable intervention targets. The second phase of the work proposes to conduct a longitudinal SNA of adult caregivers of young children residing in public housing. SNA is an empirical tool that has been utilized to better understand the social context within which individuals interact. The planned analysis will serve to provide longitudinal data that can be used to validate the estimates of intervention targets obtained from the agent-based model. Additionally, the feasibility and acceptability of a potential network-based intervention will be evaluated within the sample. Completion of the described aims will represent one of the first applications of complex systems science methods to oral health disparities and demarcate the independent research career of the candidate.

口腔健康差异，特别是儿童之间的差异，仍然是美国的一个紧迫问题。虽然口头 儿童的健康状况总体上得到改善，但弱势群体儿童的健康状况继续恶化， 高于平均疾病负担。口腔健康差异反映了一系列复杂的途径， 具有双向关联（反馈回路）的机制，这些机制贯穿宏观和微观层面， 致病原因本提案的总体目标是促进候选人的长期职业目标， 成为独立的社会流行病学家，能够调查疾病的原因和预防 通过一个复杂的基于系统的视角。目前的建议旨在为候选人提供 有机会发展必要的技能和经验，以实现研究的独立性，通过扩大 他们在流行病学方面的正规培训和在口腔健康差异研究方面的应用经验。发展 在指导阶段提出的活动与对候选人进行复杂系统方面的培训有关 科学方法，即社会网络分析（SNA）和基于代理的建模（ABM）。培训 将通过课程，多学科指导和应用研究经验发生。主 发展的动力是研究计划。拟议的研究旨在使用CSS方法更好地 了解弱势群体口腔健康的因素和机制， 改进旨在改善口腔健康的战略，从而减少观察到的差距。这些 方法有助于了解人口、社会互动和环境影响 同时，可以探索相互作用，反馈回路和相互作用之间的独立和 因变量第一阶段的拟议工作旨在制定一个详细的概念模型的口头 健康差距，抓住了多层次的机制，并将用于告知发展， 基于Agent的模型ABM指的是使用随机计算机模拟来了解 健康和疾病在人群水平上的分布来自明确规划的健康行为， 社会互动和运动的模拟个人在模拟的时间。口腔健康的ABM 发展和利用公共住房居民之间的社交网络，以确定可行的干预措施 目标的第二阶段的工作建议对年轻人的成年照顾者进行纵向国民账户体系， 住在公共房屋的儿童。国民账户体系是一种经验工具，用于更好地了解 社会环境中的个人互动。计划进行的分析将提供纵向数据， 可用于验证从基于代理的模型获得的干预目标的估计。 此外，将在以下范围内评估潜在的基于网络的干预措施的可行性和可接受性： 示例.上述目标的完成将是复杂系统的首批应用之一 科学的方法，以口腔健康的差距和划定候选人的独立研究生涯。