Research Program and Administrative Center

摘要 拟议的社区口腔健康干预计划(COHIP或CO-HIP)是在#年设计的 与目前资助的底特律口腔健康研究中心的社区专利持有人合作 差异(又称底特律牙科健康项目(DDHP))。本文件描述了行政中心， COHIP的总体设计、管理和结构。并对研究型人才培养方案进行了描述。 COHIP建议开发和实施可持续健康社区模式，将 以社区为基础的口腔健康促进计划，由具有文化能力的社区卫生团队提供， 由在四个联邦医院工作的牙科临床医生提供循证临床和预防护理 底特律合格健康中心(FQHC)牙科诊所(COHIP诊所)(东区、诺兰、布鲁斯·道格拉斯、 和西娅·鲍曼)。COHIP模式的主要干预者将是社区卫生工作者 (CHWS)将由当地和国家专家团队进行培训。CHW们将接受培训，以便为 生活在低收入地区的0-11岁儿童的家庭和他们的照顾者，协调他们的牙齿 护理，提供激励干预以减少牙科焦虑和宿命论，制定预防计划， 管理糖尿病，改善他们的口腔卫生习惯，提高营养素养，并推广烟草 停止。中心会提供正式的社会支援，并会定期与家庭跟进。 为了制定这些干预措施，COHIP拥有社会干预、激励性访谈、 糖尿病教育、临床护理、口腔健康和健康知识；除了统计专家团队和 研究项目的经理。COHIP将与密歇根大学合作并共享资源 临床与转化科学奖(CTSA)和密歇根临床与健康研究所 在医学院。 COHIP将招募1,510个家庭，他们的孩子符合条件，居住在四家诊所周围的27个人口普查区域。这个 族位于这些区域内随机选择的线段中。数据段将被分配到 干预干预或比较武器。比较地区的家庭将由经过培训的研究人员进行访问 员工(非卫生福利院)，并获提供有关牙科护理的资料，但并非由员工安排探访 诊所。他们也不会在家里接受任何社会或行为干预。他们将接受治疗 诊所的正规牙科提供者将遵循他们现有的护理标准。对于那些生活在 在干预地区，卫生福利院将提供如上所述的综合激励干预措施。这些 家庭将由COHIP聘请的临床团队照顾，该团队将在4家FQHC诊所工作。团队将会 遵循新的诊断、风险评估、恢复性/外科护理方案，并提供基于证据的 基于每个参与者的风险状况的预防性护理。 COHIP管理层由一支经验丰富的团队组成，在协调方面具有丰富的现场经验 复杂的基于社区的干预措施以及观察性研究。这个团队在以下方面有经验 目前资助的差距中心的招聘、数据收集、分析和发布。COHIP将 目标11：减少儿童和成人照顾者之间的健康差距，取得有临床意义的成果。 COHIP研究培训计划将针对从中学水平到博士水平的学生和 将基于CTSA计划以及公共卫生学院提供的计划。 COHIP AS模式得到了卫生和资源服务处区域办事处的大力支持 国家口腔健康获取网络(NNOHA)，它引起了 来自医学院和公共卫生学院、社会研究所的研究人员以及几个 其他地方、国家和国际组织。可以利用COHIP模型来解决其他 健康差距，这在财政上是可持续的，基于招募符合医疗补助资格的家庭 在联邦合格的健康中心接受牙科护理。 最后，作为密歇根大学在拟议项目中的支持和信任，100万美元 将期待COHIP为其项目提供资金并支持其使命。COHIP团队带来了丰富的 制定和实施计划的专业知识，以显著减轻或消除 口腔健康不平等。

ABSTRACT The proposed Community Oral Health Interventions Program (COHIP or CO-HIP) was designed in collaboration with community patners of the currently-funded Detroit Center for Research on Oral Health Disparities (a.k.a Detroit Dental Health Project (DDHP)). This document describes the administrative center, overall design, management and structure of COHIP. It also describes the research training program. COHIP proposes to develop and implememt a sustainable healthy community model which integrates community-based oral health promotion programs, provided by culturally competent community health teams, with evidence-based clinical and preventive care provided by dental clinicians working in four Federally Qualified Health Centers' (FQHCs) dental clinics (COHIP clinics) in Detroit (Eastside, Nolan, Bruce Douglas, and Thea Bowman). The primary interveners in the COHIP model will be community health workers (CHWs) who will be trained by local and national team of experts. The CHWs will be trained to advcoate for the families of children aged 0-11 years and their caregivers living in low-income areas, coordinate their dental care, provide motivational interventions to reduce dental anxiety and fatalism, develop preventive plans, manage diabetes, improve their oral hygiene practices, increase nutritional literacy, and promote tobacco cessation. The CHWs will provide formal social support and will follow-up with the families on regular basis. To develop these interventions COHIP has teams of experts in social interventions, motivational interviewing, diabetes education, clinical care, oral health and health litearcy; in addition to teams of statistical experts and managers of research projects. COHIP will collaborate and share resoucres with the University of Michigan Clinical and Translational Science Award (CTSA) and the Michigan Institute for Clinical and Health Research at the School of Medicine. COHIP will recruit 1,510 famiilies with eligible children living in 27 census tracts around the four clinics. The families reside in randomly selected segments within these tracts. The segments will be assigned into either an intervention or comparison arms. The families in the comparison areas will by visited by trained research staff (not CHWs) and be provided with information on dental care but not scheduled by the staff to visit the clinics. They will also not receive any social or behavioral interventions at their homes. They will be treated by the regular dental providers at the clinics who will follow their existing standards of care. For the families in the intervenion areas, the CHWs will provide integrated motivational interventions as described above. These families will be cared for by a COHIP-hired clinical team that will work in the 4 FQHC clinics. The team will follow new protocols for diagnosis, risk assessment, restorative/surgical care and provide evidence-based preventive care based on risk status of each participant. COHIP management is comprised of an experienced team with extensive field experience in coordinating complex community-based interventions as well as observational studies. The team has experience in recruitment, data collection, analysis, and publications in the current funded disparity center. COHIP will target 11 clinically meaningful outcomes to reduce health disparities in children and adult caregivers. COHIP research training program will target students from the middle school level until the doctoral level and will be based on the CTSA program as well as those offered by the School of Public Health. COHIP as model has received strong support from the regional office of the Health and Resources Services Administration, the National Network for Oral Health Access (NNOHA), and it has generated an interest among researchers from the Schools of Medicine and Pubic Health, the Institute for Social Research, and several other local, national, and international organizations. The COHIP model can be leveraged to address other health disparities and it can be financially sustainable based on the recruitment of Medicaid eligible families to receive dental care at Federally Qualified Health Centers. Finally, as endorsement and trust that the University of Michigan has in the proposed program, a $1 Million gift will be awared to COHIP to fund its programs and support its mission. The COHIP team brings a wealth of expertise and knowledge to develop and implement programs to significantly reduce or eliminate the burden of oral health inequalities.