Community Oral Health Interventions Program

描述（由申请人提供）：拟议的社区口腔健康干预计划（COHIP）的目的是开发和实施一个综合模型，以减少口腔健康的差距。COHIP的愿景、使命和设计框架是在社区合作伙伴的直接投入和底特律牙科健康项目（DDHP）的调查结果的基础上制定的，DDHP是一个由NIH资助的差异研究中心。DDHP有一个成功的模型来理解口腔健康差异的决定因素，并建立了强大的社区和组织基础。到目前为止，DDHP已经出版了19篇参考出版物，3篇博士论文和2篇硕士论文。此外，在过去6年中，DDHP核心领导层管理了一个复杂的研究项目，重点是低收入非洲裔美国儿童的家庭。DDHP的调查结果强调了多层次干预的必要性。根据渥太华和雅加达健康促进宣言，COHIP旨在干预口腔健康差异的关键社会，行为和临床因素。COHIP将专注于在2个联邦合格卫生中心拥有的4个牙科诊所周围建立健康的社区。在每个诊所周围，将选择收入最低的人口普查区，以16 023名0-11岁儿童及其照顾者为目标。选定的地区将被划分为家庭小组，并随机分为干预组和比较组。COHIP包括针对相同家庭的三个集群随机示范试验。一个项目旨在干预龋齿的社会、行为和生物决定因素;另一个项目将侧重于解决DDHP分析中确定的一个主要问题，即接受护理的儿童在随访2年内有很大比例的空洞牙齿表面未得到治疗;第三个将侧重于通过对牙周病的社会、行为和生物危险因素进行干预来减少成年人牙周病的显著差异。COHIP组建了一个由社会、行为、生物、牙科、医学和组织研究人员组成的多学科团队。COHIP计划在社区和临床层面进行干预。COHIP模式的可持续性是社区合作伙伴的要求。COHIP正在与美国国家卫生和公共卫生委员会的业务专家合作，并得到了美国卫生和安全管理局区域办事处、密歇根大学（100万美元赠款）和美国国家卫生和公共卫生机构联盟的支持。

DESCRIPTION (provided by applicant): The aim of the proposed Community Oral Health Interventions Program (COHIP) is to develop and implement an integrated model for reducing oral health disparities. COHIP's vision, mission, and design framework were developed with direct input from community partners and the findings for the Detroit Dental Health Project (DDHP), a disparity research center funded by NIH. The DDHP has had a successful model for understanding the determinants of oral health disparities and has built a strong community and organizational foundations. The DDHP has produced so far over 19 refereed publications, 3 PhD dissertations, and 2 MSc theses. Moreover, the DDHP core leadership has managed during the last 6 years a complex research project focusing on families of low-income African-American children. The findings from the DDHP underscore the need for multi-level interventions. Following the Ottawa and Jakarta Declarations for health promotion, COHIP was designed to intervene on key social, behavioral, and clinical factors of oral health disparities. The COHIP will focus on building healthy communities around four dental clinics owned by 2 Federally Qualified Health Centers. Around each clinic the lowest income census tracts will be selected to target a population of 16,023 children aged 0-11 years and their caregivers. The selected areas will be stratified into small clusters of households and randomized into intervention and comparison groups. COHIP includes three clustered randomized demonstration trials targeting the same families. One project will aim to intervene on the social, behavioral, and biological determinants of dental caries; another will focus on resolving a major problem identified in the DDHP analyses where children who get care have a significant proportion of their cavitated tooth surfaces left untreated within 2 years of follow-up; and the third will focus on reducing the significant disparities in periodontal diseases on adults by intervening on the social, behavioral, and biological risk factors of periodontal diseases. COHIP has assembled a multi-disciplinary team of social, behavioral, biological, dental, medical and organizational researchers. COHIP plans to intervene at the community and clinical levels. Sustainability of the COHIP model is a requirement demanded by the community partners. COHIP is collaborating with FQHC operational experts and has the support of HRSA regional office, University of Michigan ($1 Million grant), and the NNHOA.