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Testing a Multi-behavioral Intervention to Improve Oral Health Behaviors in the Pediatric Dental Surgery Population

测试多种行为干预措施以改善儿童牙科手术人群的口腔健康行为

基本信息

批准号：
10707399
负责人：
JOANNA BUSCEMI
金额：
$ 31.11万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-20 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10707399
关键词：
Address Adherence Adult Affect Anesthesiology Bacteria Behavior Behavior Therapy Behavioral Calories Caregivers Child Child Behavior Child Health Child Rearing Childhood Chronic Disease Clinical Community Health Aides Consumption Data Dental Dental caries Dentistry Development Diet Dietary Intervention Disease Dissemination and Implementation Dose Effectiveness of Interventions Enrollment Etiology Event Family Frequencies Future General Anesthesia Goals Health Status Health behavior Health behavior change Household Iatrogenesis Inequity Intake Intervention Knowledge Life Link Low income Measurement Measures Mediation Mediator Medicaid Mental Health Minority Modeling Monitor Motivation Nursery Schools Nutritional Science Operative Surgical Procedures Oral health Outcome Parents Participant Pathway interactions Pediatrics Perioperative Persons Phase Pilot Projects Population Population Intervention Preschool Child Prevalence Preventive dental care Protocols documentation Provider Psychology Qualitative Research Quality of life Randomized Randomized, Controlled Trials Recurrence Recurrent disease Reporting Research Research Personnel Ribosomal RNA Risk Role Safety Schedule School-Age Population Self Efficacy Target Populations Telephone Testing Text Messaging Time Toothbrushing Training Work acceptability and feasibility behavior change behavior influence burden of illness catalyst clinical development dental surgery disorder risk early childhood efficacy testing ethnic minority population evidence base experience feasibility testing follow-up health knowledge high risk improved intervention delivery longitudinal analysis lower income families minority children nutrition obesity in children operation oral microbiome prevent primary outcome psychosocial psychosocial wellbeing racial minority population randomized, clinical trials recruit remote assessment rural area rural dwellers saliva sample secondary outcome social social cognitive theory stressor sugar treatment as usual treatment comparison treatment group

项目摘要

Project Summary. Vulnerable (Medicaid enrolled, low-income, minoritized, urban/rural resident) children are at high risk for severe early childhood caries (S-ECC). Treating young children for S-ECC often requires dental surgery under general anesthesia (DGA). Unfortunately, surgery is not an effective cure. A DGA event does not address underlying oral health behaviors such as tooth brushing and diet, so caries commonly recurs. Changing oral health behaviors is challenging, as parents struggle with concurrent life stressors. However, parents want to change their child’s oral health behaviors and identify that they need help to enact change at the time of a DGA event. We propose a behavioral parenting intervention to support oral health behavior change within families whose children experience the most severe disease burden at a critical point in their child’s oral health. We will develop and test the efficacy of PROTECT (Preventing Recurrent Operations Targeting Early Childhood Caries Treatment), a community health worker (CHW)-delivered, behavioral parenting intervention for preschool-aged children scheduled for DGA. The primary outcomes are frequency of tooth brushing and percent of total calorie intake from added sugar. The first session will occur in person at the time of surgery (60 minutes) and the remaining 10 sessions (30 minutes) will be delivered by phone to address barriers to engagement. The intervention will take place over a 6-month period, starting with the surgical event, with assessments measuring primary and secondary outcomes at baseline, 2 weeks, 6 months and 12-month follow up. Our investigators are experts in clinical (anesthesiology, dentistry, pediatrics, psychology, nutrition) and scientific realms (randomized controlled trials, management and analysis of longitudinal behavioral, psychosocial, and clinical outcomes, nutrition science, development of clinical interventions, dissemination and implementation). During the UG3 phase, we aim to develop PROTECT and test for feasibility and acceptability. The development of PROTECT will be informed by behavior change mechanisms of Social Cognitive Theory (SCT; e.g., positive parenting, self-efficacy, knowledge) and evidence-based behavioral parenting and dietary interventions, along with stakeholder (caregivers, providers, CHWs) input. We will identify barriers to recruitment, retention, intervention delivery, and outcome measurements. During the UH3 phase, we will test the efficacy of PROTECT compared to Usual Care (UC) to improve oral health behaviors. Participants will be randomized to receive PROTECT (n = 210) or UC (n = 210). We hypothesize that participants in the PROTECT group will increase tooth brushing and decrease added sugar intake to a greater degree than those in the UC group. Secondary outcomes and hypothesized SCT mechanisms of intervention effectiveness will also be tested. As an exploratory aim, saliva samples will be collected to assess changes to the oral microbiome from baseline to 6 months. This work fits within our broad research goal to improve children’s oral health, starting with the surgical population and potentially extending to children and adults within households.

项目摘要。弱势群体（参加医疗补助、低收入、少数民族、城市/农村居民）儿童严重儿童早期龋齿 (S-ECC) 的风险较高。治疗幼儿 S-ECC 通常需要牙科治疗全身麻醉（DGA）下的手术。不幸的是，手术并不是有效的治疗方法。 DGA 事件不解决潜在的口腔健康行为，例如刷牙和饮食，因此龋齿通常会复发。改变口腔健康行为具有挑战性，因为父母要与并发的生活压力作斗争。然而，家长们希望改变孩子的口腔健康行为，并确定他们需要帮助才能在发生改变时做出改变 DGA 活动。我们提出了一种行为养育干预措施，以支持口腔健康行为的改变孩子在口腔健康关键时刻承受最严重疾病负担的家庭。我们将开发并测试PROTECT（预防复发性操作，针对早期目标）的功效儿童龋齿治疗），社区卫生工作者 (CHW) 提供的行为育儿干预适用于计划参加 DGA 的学龄前儿童。主要结果是刷牙的频率和来自添加糖的总卡路里摄入量的百分比。第一次会议将在手术时亲自进行（60 分钟），其余 10 场会议（30 分钟）将通过电话进行，以解决障碍订婚。干预将在 6 个月的时间内进行，从手术事件开始，评估基线、2周、6个月和12个月随访时的主要和次要结局向上。我们的研究人员是临床（麻醉学、牙科、儿科、心理学、营养学）和科学领域（随机对照试验、纵向行为的管理和分析、社会心理和临床结果、营养科学、临床干预措施的发展、传播和执行）。在UG3阶段，我们的目标是开发PROTECT并测试可行性和可接受性。 PROTECT 的发展将受到社会认知理论的行为改变机制的影响（SCT；例如，积极养育、自我效能、知识）以及基于证据的行为养育和饮食干预措施，以及利益相关者（护理人员、提供者、社区卫生工作者）的意见。我们将找出招聘障碍，保留、干预实施和结果测量。在UH3阶段，我们将测试以下功效： PROTECT 与常规护理 (UC) 相比可改善口腔健康行为。参与者将被随机分配到接收保护 (n = 210) 或 UC (n = 210)。我们假设 PROTECT 组的参与者将与 UC 组相比，增加刷牙次数并减少添加糖的摄入量。次要结果和假设的 SCT 干预效果机制也将得到测试。作为作为一个探索性目标，将收集唾液样本来评估口腔微生物组从基线到 6个月。这项工作符合我们改善儿童口腔健康的广泛研究目标，从外科手术开始人口，并可能扩展到家庭内的儿童和成人。