Planning for International Studies of Population Oral Health Determinants

描述（由申请人提供）：有强大的“宏观层面”的健康决定因素，是固定的人口，但不同的人口之间。我们假设，可量化的国家宏观层面的决定因素，可以确定，将解释口腔健康的变化以上和超越变化归因于国家内的个人特征。目的：为了响应PAR-06-219，这个为期两年的规划项目的目标是制定一项研究方案和资金申请，以调查口腔健康相关生活质量（OHRQoL）的宏观决定因素。该项目有四个具体目标：1）在六个国家调查中测量OHRQoL的研究人员组成一个合作团队; 2）与其他学科的研究人员建立新的合作关系，以便我们能够确定一套全面的宏观水平决定因素; 3）对每个国家的假设口腔健康宏观水平决定因素进行初步研究;以及4）制定详细的研究方案，对具有多层次健康决定因素的现有数据集进行分析。相关性：这些目标与NIH/NIDCR战略计划的目标7直接相关，该战略计划旨在“评估口服避孕药的社会、教育和经济影响”。2010年《健康人》旨在“帮助所有年龄段的人延长预期寿命，提高生活质量”。研究设计：在NIH资助的第一年，我们将举行一次面对面的研究者会议，并在申请人之间每月举行一次电话会议。这些会议将主要涉及假设的产生和数据来源的确定。在两次会议之间，将在每个申请机构（澳大利亚阿德莱德、联合王国纽卡斯尔和芬兰欧卢）进行试点研究，以解决方法问题。第一年的主要成果将是：a）扩大调查小组，增加五名顾问; B）汇编一本数据词典，描述六个国家现有的口腔健康调查项目和宏观变量; c）在三个合作国家进行方法学试点研究，审查口腔健康的宏观决定因素。在第二年，我们将确定新的背景变量，最终确定假设，并完成第二年赠款申请的试点研究。在调查员扩大小组第二次面对面会议上，将审查第一年进行的试点调查。这些成果还将有助于最后确定第一年启动的概念框架。我们将花费今年的剩余时间与新招募的研究人员合作，以确定他们自己的学科（例如地理，经济学）的数据源，这些数据源将包含在第二年的资助申请中。我们还将完成第一年开始的手稿，并提交出版。最后，我们计划向至少两个支持国际合作研究的机构提交资助申请。项目叙述：该项目与公共卫生有关，因为它将开展一项研究，确定影响人口口腔健康的国家“宏观”特征。宏观一级的决定因素包括公共和私营部门的社会服务和保健方案。除了确定国家内部健康差异的上游原因外，计划中的研究还可以指出改善这些国家健康状况所需的卫生政策干预措施。

DESCRIPTION (provided by applicant): There are powerful "macro-level" determinants of health that are fixed within populations, but which vary between populations. We hypothesize that quantifiable national macro-level determinants can be identified that will explain variation in oral health above and beyond variation attributable to characteristics of individuals within nations. Objectives: In response to PAR-06-219, the goals of this two-year planning project are to develop a study protocol and funding applications to investigate macro-level determinants of oral health related quality of life (OHRQoL). The project has four Specific Aims: 1) to assemble a collaborative team of researchers who have measured OHRQoL in six national surveys; 2) to establish new collaborations with researchers from other disciplines so that we can identify a comprehensive set of macro-level determinants; 3) to undertake preliminary studies of hypothesized macro-level determinants of oral health from each country; and 4) to develop a detailed study protocol that would undertake analysis of available datasets with multiple levels of health determinants. Relevance: These aims are of direct relevance to Goal 7 of the NIH/NIDCR strategic plan that seeks to "Assess the social, educational and economic impact of oral ... conditions" and of Healthy People 2010 which aims "to help individuals of all ages increase life expectancy and improve their quality of life". Research design: During the first year of NIH funding, we will hold one face-to-face investigators' meeting and monthly teleconference calls among the applicants. The meetings will be concerned primarily with hypothesis generation and identification of data sources. Between meetings, pilot studies will be undertaken to address methodology at each of the applicant institutions (Adelaide, Australia; Newcastle, UK; and Oulu, Finland). The primary outcomes for Year 1 will be: a) expansion of the team of investigators to include five additional consultants; b) compilation of a data dictionary describing oral health survey items and macro-level variables available in six countries; and c) methodological pilot studies examining macro-level determinants of oral health within three of the collaborating countries. In Year 2, we will identify new contextual variables, finalize hypotheses and complete pilot studies for the Year 2 grant application. At the second face-to-face meeting of the expanded group of investigators, pilot investigations conducted during Year 1 will be reviewed. Those results will also help finalization of the conceptual framework that was initiated in Year 1. We will spend the remainder of the year working with newly-recruited investigators to identify data sources from their own disciplines (e.g. geography, economics) that will be included in the Year 2 grant application. We will also complete the manuscript begun in Year 1 and submit it for publication. Finally, we plan to submit funding applications to at least two agencies that support international collaborative studies. Project Narrative: This project is relevant to public health because it will develop a study identifying "macro-level" features of nations that influence population oral health. Examples of macro-level determinants include social services and health programs, both in the public and private sector. In addition to identifying upstream causes of health disparities within countries, the planned study can point to health policy interventions needed to improve health in those nations.