Understanding Barriers to Oral Health Care In Pregnancy: The First Step to Improv

描述(由申请人提供)：口腔健康疾病，如儿童龋齿和牙周病，是普遍存在的疾病，对种族/族裔少数群体和弱势个人的影响不成比例。龋齿是最常见的儿童慢性疾病，儿童患龋率是哮喘的5倍。龋齿会导致牙齿脱落，从而带来营养和社会后果。成人牙周病影响多达40%的育龄妇女，并与早产、胎儿生长受限和先兆子痫等不良妊娠结局有关。已有有效的预防和治疗措施来减少龋齿和牙周病的发病率，数据表明，母亲口腔疾病的治疗可能会改善后代的口腔健康，并降低不良妊娠结局的风险。然而，尽管采取了这些循证干预措施来预防或减轻儿童和妇女的口腔疾病负担，但龋齿和牙周病仍然很普遍，特别是在低收入家庭和少数族裔成员中。我们的长期目标是降低孕妇及其子女的口腔疾病发病率，消除口腔健康方面的差距。我们假设，母亲对口腔健康的知识和态度，以及缺乏获得口腔健康服务的机会，极大地影响了促进母亲及其子女口腔健康的母亲行为。这项研究的主要目的是找出孕妇，特别是少数族裔和社会经济地位较低者的口腔保健障碍，然后制定干预策略，以消除或降低这些障碍，以便更有效地应用现有的循证干预措施。我们将通过实现以下具体目标来实现这一目标：1.收集和分析数据，以了解孕妇目前在最佳牙齿健康方面的做法、态度和感知的系统障碍。2.测试四到八种潜在干预措施的可行性、可接受性和可能性，以消除和/或减少障碍并鼓励改进口腔健康实践。3.对目标2中制定的一项或多项干预措施进行试点研究。这项建议汇集了一支在孕期口腔健康、公共卫生规划、行为研究、定性分析和公共政策方面实力雄厚的多学科团队。这项研究的结果将为制定创新的、对文化敏感的战略和方法提供框架，通过减少口腔保健的障碍来改善母亲及其子女的健康和福祉。口腔健康疾病是普遍存在的疾病，对种族/族裔少数群体和处境不利的个人造成不成比例的影响。尽管有循证干预措施和有效的预防和治疗措施，口腔疾病仍然很普遍。我们的长期目标是减少孕妇及其子女的口腔疾病发病率，并确定口腔保健的障碍，这将为制定创新的、对文化敏感的战略和方法提供框架，通过减少口腔保健的障碍来改善母亲及其子女的健康和福祉。

DESCRIPTION (provided by applicant): Oral health diseases such as childhood caries and periodontal diseases are prevalent conditions that disproportionately affect racial/ethnic minorities and disadvantaged individuals. Dental caries is the most common chronic childhood disease, affecting 5 times more children than asthma. Caries leads to tooth loss, with subsequent nutritional and social consequences. Adult periodontal disease affects up to 40% of reproductive age women, and is associated with adverse pregnancy outcomes such as preterm birth, fetal growth restriction and preeclampsia. Effective preventive and treatment measures to reduce the morbidity of caries and periodontal disease exist, and data suggest that treatment of maternal oral disease may improve the oral health of the offspring and reduce risk for adverse pregnancy outcome. However, despite the presence of these evidence-based interventions to prevent or reduce the burden of oral diseases among children and women, both caries and periodontal disease remain prevalent, particularly among low-income families and members of racial and ethnic minorities. Our long-term goal is to reduce morbidity of oral diseases among pregnant women and their children, and to eliminate disparities in oral health. We hypothesize that maternal knowledge about and attitudes toward oral health, as well as lack of access to oral health services, greatly affect maternal behaviors that promote the oral health of both the mother and her offspring. The primary objective of this study is to identify barriers to oral health care among pregnant women, particularly racial and ethic minorities and those of lower socio-economic status, and then develop intervention strategies for removing or lowering the barriers so that existing evidence-based interventions can be more effectively applied. We will pursue this objective by achieving the following specific aims: 1. Collect and analyze data to understand pregnant women's current practices, attitudes, and perceived system barriers regarding optimal dental health. 2. Test the feasibility, acceptability, and likely use of four to eight potential interventions to remove and/or reduce barriers and encourage improved oral health practices. 3. Conduct pilot study of one or more interventions developed in aim 2. This proposal brings together a multidisciplinary team with strength in oral health in pregnancy, public health programming, behavioral research, qualitative analysis and public policy. Findings from this research will provide the framework for development of innovative, culturally sensitive strategies and approaches to improve the health and well-being of mothers and their children by reducing barriers to oral health care. Oral health diseases are prevalent conditions that disproportionately affect racial/ethnic minorities and disadvantaged individuals. Despite the presence of evidence-based interventions and effective preventive and treatment measures, oral diseases remain prevalent. Our long-term goal is to reduce morbidity of oral diseases among pregnant women and their children and identify barriers to oral health care which will provide the framework for development of innovative, culturally sensitive strategies and approaches to improve the health and well-being of mothers and their children by reducing barriers to oral health care.