SAN FRANCISCO MATERNAL AND CHILD ORAL HEALTH "PRIME" PROJECT

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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.