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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。弱势儿童（参加医疗补助计划的儿童、低收入儿童、少数民族儿童、城市/农村居民儿童）严重幼儿龋齿（S-ECC）的高风险。治疗S-ECC的幼儿通常需要牙科全身麻醉下手术（DGA）。不幸的是，手术不是有效的治疗方法。DGA事件不解决潜在的口腔健康行为，如刷牙和饮食，所以龋齿通常复发。改变口腔健康行为是具有挑战性的，因为父母与并发的生活压力作斗争。然而，家长们希望改变他们孩子的口腔健康行为，并确定他们需要帮助，以制定改变时， DGA事件。我们提出了一种行为父母干预，以支持口腔健康行为的改变，在儿童口腔健康的关键时刻，其子女经历最严重疾病负担的家庭。我们将开发和测试预防复发性手术的有效性（预防复发性手术，儿童龋齿治疗），社区卫生工作者（CHW）提供的行为育儿干预为学龄前儿童安排DGA。主要结果是刷牙的频率，从添加糖中摄取的总热量的百分比。第一次会议将在手术时亲自进行（60 其余10节（30分钟）将通过电话进行，以解决订婚干预将在6个月内进行，从手术事件开始，在基线、2周、6个月和12个月随访时测量主要和次要结局的评估起来我们的研究人员是临床（麻醉学，牙科，儿科，心理学，营养学）专家，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、临床干预措施的制定、传播和执行）。在UG 3阶段，我们的目标是开发可接受性测试和测试的可行性和可接受性。社会认知理论中的行为改变机制将为认知行为疗法的发展提供信息 (SCT;例如，积极的养育，自我效能，知识）和循证的行为养育和饮食干预措施，沿着利益相关者（护理者、提供者、社区卫生工作者）的投入。我们将找出招聘的障碍，保留，干预交付和结果测量。在UH 3阶段，我们将测试与口腔护理（UC）相比，口腔护理可以改善口腔健康行为。受试者将被随机分配至分别接受抗血小板T（n = 210）或UC（n = 210）治疗。我们假设，参与者在CRTT组将增加刷牙和减少添加糖的摄入量，其程度大于UC组。还将检验次要结局和假设的SCT干预有效性机制。作为作为探索性目的，将收集唾液样本，以评估口腔微生物组从基线至 6个月这项工作符合我们广泛的研究目标，以改善儿童的口腔健康，从手术开始，人口，并可能扩大到家庭内的儿童和成人。