Contra Caries: Preventing ECC Using a Promotora Model for Rural Latino Families

Contra Caries：使用 Promotora 模型为农村拉丁裔家庭预防 ECC

• 批准号: 7659306
• 负责人: JUDITH C. BARKER
• 金额: $ 26.38万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7659306
• 关键词: 5 year old; 8 year old; Address; Adult; Affect; Age; Age-Years; Agriculture; Area; Bacteria; Beds; Behavior; Belief; Breast Feeding; California; Caregivers; Child; Child Development; Childhood; Communicable Diseases; Communities; Dental; Dental Care; Dental Hygiene; Dental caries; Development; Diet; Educational Curriculum; Educational Intervention; Eligibility Determination; Enrollment; Evaluation; Family; Fluoride Varnishes; Fluorides; Focus Groups; Frequencies; Funding; Future; Goals; Habits; Health; Health Insurance; Health Knowledge, Attitudes, Practice; Health Professional; Health Status; Health education; Healthcare; Home environment; Hour; Intake; Intervention; Intervention Studies; Knowledge; Latino; Learning; Leisure Activities; Life; Liquid substance; Location; Low income; Mastication; Methods; Mexican; Modeling; Nursery Schools; Oral; Oral cavity; Oral health; Outcome; Pain; Parents; Participant; Pilot Projects; Pre-Post Tests; Prevalence; Preventive; Process; Program Evaluation; Qualitative Research; Randomized; Research; Research Methodology; Role; Rural; Sampling; Self Efficacy; Services; Severities; Staging; Surgeon; Testing; Time; Toothbrushing; Toothpaste; Training; Vertical Disease Transmission; Visit; Water; Work; Writing; aged; base; care seeking; cariogenic bacteria; design; early childhood; efficacy testing; experience; health disparity; improved; intervention program; meetings; prevent; programs; public health relevance; rural area; skills; social cognitive theory; sugar; toothbrush

DESCRIPTION (provided by applicant): This R21 application is to support pilot work examining the acceptability and feasibility of a culturally-appropriate, rigorously designed, implemented and evaluated, trained community-based Latino lay health worker (promotora) educational intervention. This intervention aims to reduce oral health disparities due to prevalence of early childhood caries (ECC) in children in rural, Latino families. ECC, (baby bottle tooth decay or cavities) the most common infectious disease of childhood (Surgeon General 2000) and a major unmet health care need (Newacheck et al 2000), is highly prevalent among low- income, rural preschool aged children, especially those of Mexican-origin. The proposed study will occur in two stages. Stage 1 addresses development, refinement and acceptability of the program and evaluation methods to promotoras, participants and the community using focus groups and other qualitative research methods. The curriculum is guided by Social Cognitive Theory. Stage 2 addresses feasibility and fidelity issues by implementing and evaluating the promotora training and pilot interactive oral health education program for 100 parents of children aged 1 to 5 years in Salinas, CA, a predominantly Latino agricultural community. We aim to assess, via pre-test post-test changes (at completion of program and 3-months after completion), whether the proposed intervention program: 1) Increases parental understanding of the mechanism and consequences of caries, knowledge of effective preventive activities including the role of fluoride, and understanding and knowledge about oral health generally including access to and use of oral health professionals, 2) Increases parental knowledge, skills and sense of self-efficacy with respect to their role in affecting their children's oral health care at home, including where, when and how to enroll children for oral services. The direction and amount of change in parental knowledge, attitude, practices and self- efficacy will be assessed. Rigorous process and outcome evaluation strategies will be used. If, in addition to meeting the stated objectives, the program is acceptable to the community and its delivery feasible, then an RO1 will be written in the future to support the program with a larger sample of Latino families in a rural location as a randomized rigorously designed, controlled intervention study. PUBLIC HEALTH RELEVANCE: The proposed research involves a culturally-appropriate educational intervention focused on parents of Latino children living in a rural area. It addresses Early Childhood Caries (ECC), a major oral health disparity experienced by children under five years of age. The intervention aims to reduce the number of children with ECC through improving parental understanding of its causes, mechanisms, and preventive activities - particularly improved oral hygiene (tooth brushing). The intervention enhances parents' ability to assist and better manage children's oral health care behaviors.

描述（由申请人提供）：本R21申请旨在支持试点工作，以检查文化上适当的、严格设计、实施和评估的、经过培训的社区拉丁裔非专业卫生工作者（促进者）教育干预的可接受性和可行性。该干预措施旨在减少农村拉丁裔家庭儿童早期龋齿（ECC）患病率导致的口腔健康差异。乳齿病是儿童最常见的传染病（外科医生，2000年），也是未得到满足的主要保健需求（Newacheck等，2000年），在低收入农村学龄前儿童，特别是墨西哥裔儿童中非常普遍。拟议的研究将分两个阶段进行。第一阶段涉及项目的发展、完善和可接受性，以及使用焦点小组和其他定性研究方法来促进参与者和社区的评估方法。课程以社会认知理论为指导。第二阶段解决可行性和保真度问题，通过实施和评估促进培训和试点交互式口腔健康教育计划，100名1至5岁儿童的父母在萨利纳斯，CA，主要是拉丁裔农业社区。我们的目的是通过测试前和测试后的变化（项目完成时和项目完成后3个月）来评估拟议的干预项目是否：1)增加父母对龋齿的机制和后果的了解，了解有效的预防活动，包括氟化物的作用，以及对口腔健康的了解和知识，包括获得和使用口腔卫生专业人员；2)增加父母对其在家庭中影响儿童口腔保健方面的作用的知识、技能和自我效能感，包括在何处、何时和如何为儿童登记接受口腔服务。评估家长在知识、态度、行为及自我效能方面的改变方向及程度。将采用严格的过程和结果评估策略。如果除了达到既定目标外，该项目还能为社区所接受，并且其实施是可行的，那么未来将编写一份RO1，以支持该项目，并在农村地区的拉丁裔家庭中进行更大的样本，作为一项随机严格设计的对照干预研究。公共卫生相关性：拟议的研究涉及一项文化上适当的教育干预，重点是生活在农村地区的拉丁裔儿童的父母。它解决了幼儿龋齿（ECC），这是五岁以下儿童口腔健康的主要差异。干预措施的目的是通过提高家长对其病因、机制和预防活动的了解，特别是改善口腔卫生（刷牙），来减少患ECC的儿童人数。干预提高了家长协助和管理儿童口腔保健行为的能力。