Community Oral Health Interventions Program

描述（由申请人提供）：拟议的社区口腔健康干预计划（COHIP）的目的是开发和实施一个减少口腔健康差距的综合模型。COHIP的愿景、使命和设计框架是在社区合作伙伴的直接投入和底特律牙科健康项目（dhp）的研究结果的基础上制定的，该项目是由美国国立卫生研究院资助的一个差距研究中心。dhp在了解口腔健康差异的决定因素方面建立了一个成功的模式，并建立了强大的社区和组织基础。发表学术论文19篇，博士论文3篇，硕士论文2篇。此外，dhp核心领导层在过去6年中管理了一个复杂的研究项目，重点关注低收入非洲裔美国儿童的家庭。dhp的研究结果强调了多层次干预的必要性。继渥太华和雅加达健康促进宣言之后，COHIP旨在干预口腔健康差异的关键社会、行为和临床因素。COHIP将侧重于围绕两家联邦合格医疗中心拥有的四家牙科诊所建立健康社区。在每个诊所周围，将选择收入最低的人口普查区，以16023名0-11岁的儿童及其照顾者为目标。选定的地区将分层为小户群，并随机分为干预组和对照组。COHIP包括针对同一家庭的三个集群随机示范试验。其中一个项目旨在干预龋齿的社会、行为和生物学决定因素；另一个重点是解决dhp分析中确定的一个主要问题，即接受护理的儿童在2年随访期间有很大比例的蛀牙表面未得到治疗；第三个重点是通过干预牙周病的社会、行为和生物学风险因素来减少成人牙周病的显著差异。COHIP组建了一个由社会、行为、生物、牙科、医学和组织研究人员组成的多学科团队。COHIP计划在社区和临床层面进行干预。COHIP模式的可持续性是社区合作伙伴所要求的。COHIP正在与FQHC的业务专家合作，并得到了HRSA区域办事处、密歇根大学（100万美元赠款）和NNHOA的支持。

DESCRIPTION (provided by applicant): The aim of the proposed Community Oral Health Interventions Program (COHIP) is to develop and implement an integrated model for reducing oral health disparities. COHIP's vision, mission, and design framework were developed with direct input from community partners and the findings for the Detroit Dental Health Project (DDHP), a disparity research center funded by NIH. The DDHP has had a successful model for understanding the determinants of oral health disparities and has built a strong community and organizational foundations. The DDHP has produced so far over 19 refereed publications, 3 PhD dissertations, and 2 MSc theses. Moreover, the DDHP core leadership has managed during the last 6 years a complex research project focusing on families of low-income African-American children. The findings from the DDHP underscore the need for multi-level interventions. Following the Ottawa and Jakarta Declarations for health promotion, COHIP was designed to intervene on key social, behavioral, and clinical factors of oral health disparities. The COHIP will focus on building healthy communities around four dental clinics owned by 2 Federally Qualified Health Centers. Around each clinic the lowest income census tracts will be selected to target a population of 16,023 children aged 0-11 years and their caregivers. The selected areas will be stratified into small clusters of households and randomized into intervention and comparison groups. COHIP includes three clustered randomized demonstration trials targeting the same families. One project will aim to intervene on the social, behavioral, and biological determinants of dental caries; another will focus on resolving a major problem identified in the DDHP analyses where children who get care have a significant proportion of their cavitated tooth surfaces left untreated within 2 years of follow-up; and the third will focus on reducing the significant disparities in periodontal diseases on adults by intervening on the social, behavioral, and biological risk factors of periodontal diseases. COHIP has assembled a multi-disciplinary team of social, behavioral, biological, dental, medical and organizational researchers. COHIP plans to intervene at the community and clinical levels. Sustainability of the COHIP model is a requirement demanded by the community partners. COHIP is collaborating with FQHC operational experts and has the support of HRSA regional office, University of Michigan ($1 Million grant), and the NNHOA.