SAN FRANCISCO MATERNAL AND CHILD ORAL HEALTH "PRIME" PROJECT

描述（由申请人提供）：幼儿龋齿（ECC）在幼儿中非常普遍，特别是在服务不足的人群中。然而，既没有很好的工具来识别有风险的儿童个体，也没有很好的方法来改善父母的预防性口腔健康行为。这项名为“预防、风险、干预、管理和评估”（PRIME）项目的研究将a)寻求为0-5岁儿童龋齿风险评估工具建立科学基础；b)确定龋齿风险因素的识别是否与激励母亲改善与儿童有关的口腔健康行为有关。本建议的主要目标是为母亲/照料者和婴儿的龋齿风险评估工具测试并建立可靠的科学基础。我们将对目前用于成人的《龋齿风险管理评估工具》（CAMBRA）进行修改，并对0-3岁儿童进行修改。对婴儿评估的修改建议包括使用唾液细菌分析。我们将“测试”细菌唾液检测作为前置-处理模型中的强化因子（见B5）。我们已经制定了一项策略，让母亲和婴儿一起作为参与配对的核心的一部分。这一策略将有助于了解需要为母亲和婴儿制定统一的方法，作为婴儿口腔护理访问和风险评估的一部分。通过开发一种特定年龄的风险评估方法，将风险因素、保护因素和临床结果与二联体的唾液分析结合起来，我们将开发一种促进健康和预防疾病的前瞻性综合干预措施，适用于我们服务不足的城市社区的美洲原住民和西班牙裔妇女及其婴儿。本提案的目的是检查基线龋齿风险状况与基线口腔健康状况之间的关联，这些儿童已被分类为经修改的龋齿管理风险评估工具（CAMBRA），该工具目前用于成人，针对0-5岁儿童及其母亲使用现有数据。我们将确定父母对特定口腔健康行为的偏好，这些行为与CAMBRA家庭护理工具的总体评估相对应，并将其转化为照顾者的自我管理目标，以改善其婴儿的口腔健康状况。此外，我们将分析收到父母和儿童口腔细菌水平的结果对父母在评估时以及在收到细菌水平结果的3个月后随访访问时对其子女口腔卫生习惯偏好的影响。早期筛查和识别龋齿发展的迹象，从生命的第一年开始，将识别有发展ECC风险的婴幼儿，并将有助于提供适当的治疗计划和周期量表。早期筛查和识别龋齿发展的迹象，从生命的第一年开始，将识别有发展ECC风险的婴幼儿，并将有助于提供适当的治疗计划和周期量表。长期目标有两个：(1)为0-5岁儿童开发一种全面的龋齿风险评估CAMBRA工具；(2)为纵向前瞻性研究创建框架，在该研究中，特定的行为模型得到测试和成功实施。

DESCRIPTION (provided by applicant): Early childhood caries (ECC) is very prevalent among young children, particularly in underserved populations. However, neither good tools for identifying individual children at risk nor methods for improving parental preventive oral health behaviors are well developed. This study, "Prevention, Risk, Intervention, Management and Evaluation" (PRIME) Project will a) seek to develop a scientific foundation for a caries risk assessment tool for 0-5 year old children and b) determine if identification of caries risk factors can be tied to motivating mothers to improve child-related oral health behaviors. The major goals of this proposal are to test and establish a credible scientific foundation for a caries risk assessment tool for mothers/caregivers and infants. We will modify the Caries Management by Risk Assessment tool (CAMBRA) currently used for adults and modify it for children aged 0-3 years. Suggestions for modifications for assessment of infants include the use of salivary bacterial assays. We would "test" bacterial salivary assays as reinforcing factors in the Precede-Proceed model (See B5). We have developed a strategy for "dyads" of mother and infant together as part of a nucleus of participating pairs. This strategy would help understand the need to develop a uniform approach for mother and infant together as part of an Infant Oral Care visit and risk assessment. By developing an age-specific approach of risk assessment that incorporates risk factors, protective factors and clinical findings with salivary assays of the dyads, we would then develop a prospective comprehensive intervention on health promotion and disease prevention that is appropriate for our underserved, urban community of Native Americans and Hispanic women and their infants. The aims of this proposal will be to examine the association between baselines caries risk status compared to baseline oral health status of young children who have been classified with a modified Caries Management by Risk Assessment tool (CAMBRA), which is currently used for adults, targeting 0-5 year olds and their mothers using extant data. We will determine parental preferences for specific oral health behaviors that correspond to the overall assessment of the CAMBRA instrument for homecare translated into self management goals for the caregiver targeted to improve the oral health status of their infants. In addition we will analyze the influence of receiving the results of the parent(s)' and children's oral bacterial levels on parent's preferences of oral health practices for their children at the time of their assessment and at a follow-up 3 months later visit, while receiving the bacterial level results. Early screening and recognition for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing appropriate treatment plan and periodicity scale. Early screening and recognition for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing appropriate treatment plan and periodicity scale. The long term goals are dual: (1) to develop a comprehensive caries risk assessment CAMBRA instrument for 0-5 year olds and (2) to create the framework for a longitudinal prospective study where specific behavioral models are tested and implemented successfully.