Modeling Complex Mechanisms Underlying Oral Health Disparities in Young Children and Their Caregivers

模拟幼儿及其照顾者口腔健康差异背后的复杂机制

• 批准号: 10893769
• 负责人: Brenda Heaton
• 金额: $ 49.82万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10893769
• 关键词: Address; Affect; Authorization documentation; Behavior; Behavior Therapy; Behavioral; Biological; Boston; Caregivers; Child; Communities; Complex; Data; Data Collection; Dental Care; Dental caries; Development; Disease; Disparity; Disparity population; Feedback; Funding; Goals; Health; Health Disparities Research; Health Status; Health behavior; Healthcare; Housing; Individual; Interdisciplinary Study; Intervention; Methods; Minority Groups; Modeling; Mouth Diseases; Oral health; Outcome; Pathway Analysis; Pathway interactions; Pattern; Perception; Population; Population Distributions; Population Dynamics; Population Group; Positioning Attribute; Poverty; Prevalence; Production; Public Housing; Recording of previous events; Research; Risk; Risk Factors; Role; Sampling; Science; Severities; Shapes; Social Development; Social Environment; Social Network; Structure; System; Testing; Work; authority; behavior change; burden of illness; care systems; design; dynamic system; early childhood; ethnic minority population; experience; family management; health care disparity; health disparity; improved; in silico; insight; interest; member; neighborhood disadvantage; programs; psychosocial; racial minority population; simulation; social; social influence; social relationships; social stigma; tool

We propose to use complex systems science methods to understand how social connectedness influences the utilization of dental care by young children and their caregivers. The overall goal of our research program is to address disparities in Early Childhood Caries (ECC) as it remains the most prevalent disease afflicting children, the consequences of which can be serious and long lasting. Social influence is an important moderator of the causes of disease, the population distribution of disease (e.g. disparities), and health-related behavior change via social networks. Understanding the role of social influence provides a potent perspective on why behavioral interventions aimed solely at individuals have often failed to produce meaningful results. For these reasons, interest in the development of social network interventions has grown, but much of the information necessary to develop and adequately tailor interventions to the underlying mechanisms responsible for disease production is severely lacking, especially for populations facing the greatest burdens of disease. Complex systems science approaches, such as agent-based modeling and social network analysis, can provide critical insights into the mechanisms responsible for the production of health disparities. Yet, applications to oral health are minimal. We propose to apply complex systems science methods to understand the mechanisms underlying population distributions of ECC. We propose the following specific aims: (1) Characterize the pathways by which social connectedness of caregivers interacts with individual-level perceptions of oral health status, behaviors and dental care practices to shape population patterns of ECC. (2) Evaluate social network structure and composition of caregivers of young children in relation to individual- level dental care utilization behaviors among a sample of Boston public housing residents. (3) Identify and test hypothetical interventions aimed at modifying the social-behavioral and caries risk mechanisms through the use of in silico experimentation (i.e., simulations). Outcomes of our research will inform the design of targeted interventions that respond to complex system dynamics of populations affected by health disparities. ECC prevalence and severity are disproportionately higher among children from disadvantaged groups, including the poor and certain racial/ethnic minority groups. Importantly, ECC is one of the largest unmet healthcare needs of children in the US, and significant disparities in care utilization exist. Public housing residents are a high impact population for the study of disparities. As a population group, they are characterized by spatial clustering of poverty and poor health and are ideally suited for the proposed work. Our results are expected to yield important insights into the strength of the interactions responsible for producing behavioral patterns and their consequences, and provided the necessary data for using social relationships as potential leverage points for interventions to improve oral health.

我们建议使用复杂的系统科学方法来理解社会联系如何影响 幼儿及其照顾者对牙科保健的利用情况。我们研究计划的总体目标是 解决儿童早期龋病(ECC)的差异，因为它仍然是困扰人们的最常见疾病 儿童，其后果可能是严重和持久的。 社会影响是疾病起因、疾病人口分布(例如 差异)，以及通过社交网络改变与健康相关的行为。理解社会影响力的作用 提供了一个有力的视角，解释了为什么只针对个人的行为干预往往无法 产生有意义的结果。出于这些原因，人们对社交网络干预的发展感兴趣 发展，但有许多必要的信息，以开发和充分定制干预措施，以适应潜在的 负责疾病产生的机制严重缺乏，特别是对于面临 疾病的最大负担。 复杂的系统科学方法，如基于代理的建模和社会网络分析，可以 对造成健康差距的机制提供关键的见解。然而， 对口腔健康的应用很少。我们建议应用复杂的系统科学方法来理解 ECC种群分布的潜在机制。我们提出了以下具体目标： (1)描述照顾者的社会联系与个人层面互动的途径 对口腔健康状况、行为和牙齿护理实践的认知，以塑造ECC的人群模式。 (2)评估社会网络结构和幼儿照顾者相对于个人的组成- 波士顿公共住房居民的牙科保健利用行为水平。 (3)确定和测试旨在改变社会行为和龋齿风险的假设干预措施 通过在计算机实验(即模拟)中使用的机制。 我们的研究结果将为设计针对复杂系统的有针对性的干预措施提供参考 受健康差距影响的人口动态。ECC的患病率和严重性不成比例 弱势群体的儿童，包括穷人和某些种族/少数民族群体的儿童比例较高。 重要的是，ECC是美国最大的未得到满足的儿童医疗保健需求之一，而且存在显著差异 在护理利用方面存在。公房居民是一个受影响较大的人群，对于差异的研究。作为一名 作为人口群体，他们的特点是贫困和健康状况不佳的空间集聚，非常适合 为拟议的工作。我们的结果有望对相互作用的强度产生重要的见解 负责产生行为模式及其后果，并为 利用社会关系作为干预措施的潜在杠杆，以改善口腔健康。