Planning for International Studies of Population Oral Health Determinants

描述（由申请人提供）：健康有强大的“宏观层面”决定因素，这些决定因素在人群中是固定的，但在人群之间是不同的。我们假设可以确定可量化的国家宏观层面的决定因素，这些决定因素将解释口腔健康的变化，而不仅仅是归因于国家内部个人特征的变化。目的：响应PAR-06-219，这个为期两年的计划项目的目标是制定研究方案和资助申请，以调查口腔健康相关生活质量（OHRQoL）的宏观水平决定因素。该项目有四个具体目标：1)组建一个合作的研究团队，他们已经在六个国家调查中测量了OHRQoL；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层面的决定因素；3)对每个国家假设的口腔健康宏观决定因素进行初步研究；4)制定详细的研究方案，对现有的具有多层次健康决定因素的数据集进行分析。相关性：这些目标与NIH/NIDCR战略计划的目标7直接相关，该计划旨在“评估口腔疾病的社会、教育和经济影响……”《2010年健康人》的目标是“帮助所有年龄段的人延长预期寿命并改善其生活质量”。研究设计：在NIH资助的第一年，我们将在申请人之间举行一次面对面的研究者会议和每月的电话会议。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奥卢）进行试验性研究，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)编写描述六个国家现有口腔健康调查项目和宏观层面变量的数据词典；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拨款申请的试点研究。在扩大的调查小组第二次面对面会议上，将审查第一年进行的试点调查。这些结果也将有助于最后确定在第一年开始的概念框架。我们将在今年剩余的时间里与新招募的研究人员合作，从他们自己的学科（如地理、经济学）中确定数据源，这些数据源将包括在第二年的资助申请中。我们也将完成一年级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。项目说明：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的“宏观层面”特征。宏观层面决定因素的例子包括公共和私营部门的社会服务和卫生方案。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.