Health Beliefs and Self Care Centered Oral Health Model

描述（由申请人提供）：口腔健康的现有概念模型试图描述心理社会、行为和环境因素与口腔健康之间的许多维度和复杂关系。然而，这种模型是有限的，因为它们狭隘地集中在人或环境作为预测健康行为变化的可能性的主导因素。他们没有认识到健康观念和信念的核心作用（例如，感知的风险、需求和益处），以及自我护理在描述大量预测因素和口腔健康结果之间的潜在复杂关系方面的作用。例如，传统的健康信念模型侧重于采取行动的可能性，但它们并不直接将信念和自我护理行动与口腔健康结果联系起来。相反，他们假设执行健康行为的概率是预期行为结果和与这些结果相关的价值的函数;所涉及的变量被假定为从一个人得知健康威胁的时间到采取健康行动的时间保持不变。最近的一个解释性口腔健康模型使用了一个生物心理社会框架，将健康，功能和残疾联系起来。虽然这一模式以国际功能残疾和健康分类为基础，但它使用人种学研究来了解对社会文化层面的个性化观点，如可能会造成污名的损伤、残疾和障碍。为了解决口腔健康中的许多复杂因素的挑战，并克服现有口腔健康模型的弱点，我们提出了一个口腔健康模型，为成人，这是由观念和信仰和自我保健驱动，并混淆个人和环境因素。使用国家健康和营养检查调查（NHANES）中现有的口腔健康数据，其中包含详细的自我报告，临床检查和实验室数据，拟议研究的总体目标是评估和测试新提出的口腔健康行为模型，该模型认为口腔健康的性质反映了健康观念和信念的核心作用，以及口腔健康的自我保健。具体而言，我们将：（1）就文化、个人身份认同、社会及健康资源、口腔健康信念、自我照顾及专业护理等范畴进行文献检讨，以确定量度各范畴的核心项目，并就各范畴完善及发展综合指数，该等综合指数可就同一概念从不同方面概括多个项目;（2）探讨个人特质、文化、个人认同、社会及健康资源、专业护理对口腔健康认知、信念及自我照顾的影响;（3）探讨口腔健康认知、信念及自我照顾对口腔健康结果的边际预测力;（4）评估口腔健康认知和信念以及自我保健对口腔健康的联合预测能力，控制个人特征、文化、个人身份、社会和健康资源以及专业护理。 公共卫生相关性：本计画提出并评估一个健康认知与信念，以及以自我照护为中心的口腔健康行为模式，以反映口腔健康的本质，并确认健康认知、信念与自我照护在个人特徴、文化、行为、社会与健康资源、专业照护与口腔健康结果之间的复杂关系中所扮演的关键角色。这个新提出的口腔健康行为模型的研究结果将为改善公众口腔健康提供必要和有效的干预措施。

DESCRIPTION (provided by applicant): Existing conceptual models of oral health have attempted to describe the many dimensions of and complex relationships between psychosocial, behavioral, and environmental factors and oral health. However, such models are limited because they narrowly focus on either the person or the environment as the dominant factor for predicting the likelihood of a change in health behavior. They fail to recognize the central role of health perception and belief (e.g., perceived risks, needs and benefits), and of self-care in delineating the underlying complex relationships between the large number of predictors and oral-health outcomes. Traditional health belief models, for example, focus on the likelihood of taking action, but they do not directly link beliefs and self-care actions with oral-health outcomes. Instead, they assume that the probability of performing a health behavior is a function of what is expected to be the outcome of behavior and the values related to those outcomes; the variables that are involved are presumed to remain constant from the time one learns of a health threat until the time that a health action is taken. A recent explanatory oral-health model has used a biopsychosocial framework that links health, function, and disablement. Although based upon the International Classification of Functioning Disability and Health, this model uses ethnographic research to understand personalized perspectives on sociocultural dimensions, such as impairment, disability, and handicap, which may be stigmatizing. To address the challenges of the many and complex factors in oral health and to overcome the weakness of existing oral-health models, we propose an oral- health model, for adults, that is driven by perceptions and beliefs and self-care and is confounded by personal and environmental factors. Using existing oral-health data from the National Health and Nutrition Examination Survey (NHANES), which contains detailed self-report, clinical-examination, and laboratory data, the overarching goals of the proposed study are to evaluate and test the newly proposed oral-health behavioral model, which considers the nature of oral health as reflecting the central role of health perceptions and beliefs, and self-care for oral health. Specifically, we will: (1) conduct literature reviews on domains of culture, personal identity, social and health resources, oral-health beliefs, and self-care and professional care to identify the core items that measure each domain, and to refine and develop composite indices, which can summarize multiple items from different aspects for the same concept, for each of these domains; (2) examine the effect of personal characteristics, culture, personal identity, social and health resources, and professional care on oral-health perceptions and beliefs and self-care; (3) examine the marginal predictive power of oral-health perceptions and beliefs, and self-care on oral health outcomes; and (4) evaluate the joint predictive power of oral-health perceptions and beliefs, and self-care on oral health, controlling for personal characteristics, culture, personal identity, social and health resources, and professional care. PUBLIC HEALTH RELEVANCE: This project proposes and evaluates a health perception and belief, and self-care centered oral health behavioral model that reflects the nature of oral health and recognizes the critical role of health perceptions, beliefs and self care among the complex relationships between personal characteristics, culture, behavior, social and health resources, professional care, and oral health outcomes. The findings from this newly proposed oral health behavioral model will inform the necessary and efficient interventions to improve public oral health.