Birth to Three – Cavity Free: Effectiveness of a Psychoeducational Intervention for ECC Prevention

项目摘要/摘要 幼儿龋病(ECC)是一种潜在的疼痛和虚弱的疾病，它代表着一种 儿童中的重大公共卫生问题。在ECC经历中存在着严重的差异 因此，来自少数族裔和低收入家庭的儿童遭受不成比例的疾病 负担。高ECC风险幼儿的父母在牙科机构寻求预防的可能性很低； 因此，有必要在这些儿童已经寻求健康的地方增加预防性牙科机会。 护理服务。特别是，迫切需要开发和评估ECC行为干预措施 在高危儿童参加的公共卫生环境中使用。许多作者建议尽早实施 口腔健康教育是预防口腔癌的一种手段。然而，在口腔健康中讨论的主要问题 推广文献涉及到仅基于教育的计划缺乏有效性，以及缺乏 使用循证心理和行为策略的高质量预防性干预。 我们的研究团队率先将自决引入ECC预防领域 激励、内化和健康运作的理论(SDT)，被证明在促进积极方面是有效的 其他几个领域的行为变化，包括口腔保健。我们已经证明了SDT有很好的 根据我们的R21(R21-DE016483)的结果，通过提供证据来承诺作为激励方法 研究了SDT在改变几种理想的口腔健康行为以预防ECC方面的有效性。 在过去几年的严谨经验和形成研究工作的基础上，我们 提出一个第二阶段的NIH模式研究项目，该项目将比较支持自主的效果 将SDT框起来的口腔健康信息录制成更传统的中性视频信息。我们打算 招募634名孕妇参加爱荷华州妇女、婴儿和儿童(WIC)补充营养 计划，并遵循这些计划，直到他们未来的孩子36个月大。感兴趣的主要结果将是 儿童的龋齿状况。次要结果将是有利于儿童口腔健康行为的改变 更好的口腔卫生和饮食习惯，以及较低的牙菌斑和变形链球菌水平。

PROJECT SUMMARY/ABSTRACT Early childhood caries (ECC) is a potentially painful and debilitating disease, which represents a significant public health problem among young children. There are profound disparities in ECC experiences such that children from minority and low-income families suffer a disproportionate share of the disease burden. The likelihood of parents of high-ECC risk young children seeking prevention in dental facilities is low; therefore, there is a need to increase preventive dental opportunities where these children already seek health care services. In particular, there is an urgent need to develop and evaluate ECC behavioral interventions for use in public health settings attended by high-risk children. Many authors recommend early implementation of oral health education as one means of preventing ECC. However, major issues discussed in the oral health promotion literature involve a lack of effectiveness among programs based on education alone, as well as a lack of high quality preventive interventions using evidence-based psychological and behavioral strategies. Our research team has been the first to introduce to the ECC prevention arena the self-determination theory (SDT) of motivation, internalization, and healthy functioning, proven effective in promoting positive behavioral changes in several other fields, including oral health care. We have demonstrated that SDT has great promise as a motivational approach by providing evidence, based on results from our R21 (R21-DE016483) study, of the effectiveness of SDT in changing several desirable oral health behaviors for ECC prevention. Building upon the rigor of our previous experience and formative research work in the past several years, we propose a Stage II NIH Model research project that will compare the efficacy of autonomy-supportive videotaped oral health messages framed by SDT to more traditional neutral videotaped messages. We intent to recruit 634 pregnant mothers enrolled in Iowa Women, Infants and Children (WIC) Supplemental Nutrition Programs and follow them until their future child is 36 months old. The primary outcome of interest will be children's caries status. Secondary outcomes will be changes in children's oral health behaviors conducive to better oral hygiene and dietary habits, as well as lower levels of dental plaque and mutans streptococci.