One session treatment for dental phobia in an underserved population

服务欠缺人群的牙科恐惧症的一次疗程治疗

• 批准号: 10698001
• 负责人: THOMAS H. OLLENDICK
• 金额: $ 31.58万
• 依托单位: UNIVERSITY OF TEXAS RIO GRANDE VALLEY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10698001
• 关键词: Address; Adherence; Adolescence; Adolescent; Adult; Affect; Age; Anxiety; Anxiety Disorders; Appearance; Area; Automobile Driving; Award; Basic Science; Child; Childhood; Clinic; Clinical; Clinical Research; Clinical Trials; Communities; Controlled Study; Country; Data; Data Collection; Dental; Dental Anxiety; Dental Care; Dental Clinics; Dental Hygienists; Dental Offices; Dentists; Development; Diet; Disease; Dissemination and Implementation; Documentation; Eating; Ensure; Etiology; Evidence based treatment; Family; Feasibility Studies; Fright; Future; Goals; Good Clinical Practice; Grant; Health Professional; Healthcare; Hispanic; Hispanic Populations; Individual; Interdisciplinary Study; Interruption; Intervention; Intervention Studies; Knowledge; Label; Laboratories; Latino; Learning; Literature; Low income; Measures; Mediating; Mediator; Medical; National Institute of Dental and Craniofacial Research; Odontogenesis; Oral; Oral health; Pain; Participant; Patient Recruitments; Phase; Phobias; Prediction of Response to Therapy; Prevalence; Procedures; Quality of life; Randomized; Relaxation Therapy; Sampling; Shame; Specific Phobia; Testing; Tooth structure; Treatment outcome; Underserved Population; United States; Work; Youth; acceptability and feasibility; active control; anxious; behavioral clinical trial; childhood anxiety; clinical research site; community setting; comparative efficacy; effective therapy; efficacious treatment; efficacy evaluation; experience; high risk; implementation efforts; participant retention; patient response; psychoeducation; psychoeducational; recruit; retention rate; social; standard of care; success; theories; treatment arm; treatment effect; trial comparing

PROJECT SUMMARY/ABSTRACT Dental phobia is associated with avoidance of proper dental care, poor dental health, and decrements in social and oral quality of life. Although dental phobia may persist for many years, the disorder usually first manifests during childhood or adolescence. Hispanic youth may be at particularly high risk of developing dental phobia because Hispanic/Latino families are less likely to take a preventative stance toward dental health. This means that Hispanic youths’ first encounters with a dentist are more likely to be for treatment that is associated with pain, discomfort, or shame – the types of learning experiences related to the development of dental phobia. Although our knowledge about the etiology of dental phobia is well developed, we know considerably less about how to treat dental phobia in youth. Recently, a one-session exposure therapy treatment (OST) for specific phobias has proven successful in addressing a variety of phobias in children and adolescents. However, youth with dental/medical phobias have not been included in the trials assessing OST because of the need to include dental health professionals in the treatment. Therefore, the primary goal of this application is to prepare for and conduct a Stage III trial comparing OST for dental phobia in children and adolescents to an active control treatment in a predominantly Hispanic population and to examine inhibitory learning as the mechanism responsible for changes in anxiety and fear. The aims of the UG3 phase are to do the preparatory work needed for the trial, including the development of all study documentation and finalizing the clinical sites. Additional plans during the UG3 phase include the assessment of the acceptability and feasibility of the study procedures and a trial examining whether youth treated with OST show evidence of changes in inhibitory learning. The primary aim of the UH3 stage is to examine the efficacy of OST in a Stage III social/behavioral clinical trial in which OST is delivered by dental hygienists. This trial would randomize dental clinics to one of the two treatment arms (OST vs. Control) so that patient response and the hypothesized mechanism of treatment can be assessed. Factors related to future dissemination and implementation efforts will also be examined. It is hypothesized that OST can provide an efficacious treatment option that can be delivered by hygienists in the dental office. That is, that the treatment can decrease both anxiety and phobic avoidance in youth. Moreover, although exposure therapy has a high level of empirical support in youth and a good deal of laboratory work has been conducted to develop the theory to explains its effects, the main hypothesized mechanism of action – inhibitory learning – has not been studied as a mediator within the context of a clinical trial; therefore, this work could advance our understanding of the mechanism driving one of the most promising treatments for individuals with anxiety disorders.

项目总结/摘要 牙科恐惧症与避免适当的牙科护理，牙齿健康状况差以及社交能力下降有关。 和口腔生活质量。虽然牙科恐惧症可能会持续多年，但这种疾病通常首先表现为 在童年或青春期。西班牙裔年轻人患牙科恐惧症的风险特别高 因为西班牙裔/拉丁裔家庭不太可能对牙齿健康采取预防措施。这意味 西班牙裔年轻人与牙医的第一次接触更有可能是为了治疗与 疼痛、不适或羞耻--与牙科恐惧症发展相关的学习经历类型。 虽然我们对牙科恐惧症的病因学的知识是发达的，我们知道相当少， 如何治疗青少年的牙科恐惧症最近，一个疗程的暴露疗法治疗（OST）的具体 事实证明，“恐惧症”在解决儿童和青少年的各种恐惧症方面是成功的。然而，青年 牙科/医疗恐惧症患者没有被纳入评估OST的试验中，因为需要纳入 牙科保健专业人员在治疗。因此，本应用程序的主要目标是为 并进行第三阶段试验，比较OST对儿童和青少年牙齿恐惧症的治疗效果和积极控制效果。 治疗在一个主要的西班牙裔人口，并检查抑制性学习的机制， 负责焦虑和恐惧的变化。UG 3阶段的目标是完成所需的准备工作 包括所有研究文件的开发和临床研究中心的最终确定。额外 UG 3阶段的计划包括评估研究程序的可接受性和可行性 还有一项试验，检验接受OST治疗的年轻人是否表现出抑制性学习的变化。的 UH 3阶段的主要目的是在III期社会/行为临床试验中检查OST的疗效， 而OST是由牙科医生提供的。这项试验将牙科诊所随机分为两个 治疗组（OST与对照组），以便患者反应和假设的治疗机制可以 进行评估。还将审查与今后的传播和执行工作有关的因素。是 假设OST可以提供一种有效的治疗选择， 牙科诊所也就是说，这种治疗可以减少年轻人的焦虑和恐惧回避。此外，委员会认为， 尽管暴露疗法在青年中有很高的经验支持， 已经进行了发展的理论，以解释其影响，主要的假设机制的行动- 抑制性学习-尚未在临床试验的背景下作为中介进行研究;因此， 这项工作可以促进我们对驱动最有希望的治疗方法之一的机制的理解。 焦虑症患者