Development and Evaluation of School-based Digital Adolescent Oral Health Promotion Program for the Reduction of Oral Health Disparities

旨在减少口腔健康差异的校本数字青少年口腔健康促进计划的开发和评估

• 批准号: 10745029
• 负责人: EDWARD GUSTAV FEIL
• 金额: $ 30.84万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745029
• 关键词: Address; Adolescence; Adolescent; Adolescent Behavior; Adult; Advisory Committees; African American; African American population; Attitude; Behavior; Behavior Therapy; Behavioral; Black Populations; Black race; COVID-19 pandemic; Caries prevention; Child; Chronic Disease; Clinical; Cognition; Collaborations; Communities; Consultations; Consumption; Control Groups; Dental; Dental Care; Dental Hygienists; Dental caries; Development; Devices; Diet; E-learning; Ensure; Evaluation; Fluorides; Focus Groups; Goals; Habits; Health; Health Promotion; Health behavior; Hispanic; Internet; Intervention; Latinx; Longevity; Low income; Minority; Modeling; Mouth Diseases; Not Hispanic or Latino; Online Systems; Oral; Oral health; Orthodontic Appliances; Outcome; Persons; Phase; Planning Theory; Population; Prevalence; Prevention; Prevention Research; Prevention strategy; Primary Prevention; Process; Program Acceptability; Public Health; Quality of life; Randomized; Randomized Controlled Clinical Trials; Randomized, Controlled Trials; Recommendation; Research; Risk; Sampling; School-Age Population; Schools; Self Care; Speed; Students; Subgroup; Target Populations; Technology; Teenagers; Testing; Time; Tobacco use; Toothbrushing; Toothpaste; U-Series Cooperative Agreements; United States National Institutes of Health; Waiting Lists; Work; Youth; access disparities; behavior change; cost; design; digital; digital intervention; digital platform; disparity reduction; eighth grade; ethnic disparity; ethnic diversity; health disparity; health knowledge; health management; improved; income disparities; intervention program; online delivery; permanent tooth; prevent; programs; prototype; racial disparity; racial diversity; randomized, clinical trials; satisfaction; secondary outcome; seventh grade; student participation; substance use; sugar; sweetened beverage; teacher; therapy design; usability; vaping; web-based intervention; willingness

PROJECT SUMMARY Dental caries, or tooth decay, is a highly prevalent chronic disease afflicting a significant proportion of the U.S. population, including a majority of youth and adults. Health disparities in oral health have persisted for decades, with lower-income youth, Black/African Americans and Latinx minorities being especially at risk for dental caries. Although adolescence is an ideal time to implement healthy behavioral habits that will be sustained into adulthood, there is a dearth of effective dental health programs for at-risk adolescents. Research has shown that primary oral health promotion strategies during adolescence include improving dental health behaviors, abstaining from tobacco use and vaping, and reducing sugar consumption. Following these recommendations and informed by our formative research findings, our proposed digital dental program for adolescents will target three oral health behavior domains: twice-daily tooth brushing with fluoride toothpaste, abstaining from tobacco use, including vaping, and reducing consumption of sugar-sweetened beverages. Grounded in the Theory of Planned Behavior, augmented by the Prototype/Willingness Model for adolescents, the proposed cross-platform digital program will target theoretically based mechanisms to promote these three targeted oral health behaviors. It will include engaging video and interactive game components. Thus, in this UG3/UH3 application, we will develop and evaluate a theoretically based digital dental health promotion program designed to engage lower income Black/African Americans, Latinx/Hispanic, and white non-Hispanic 7th and 8th grade students. In the UG3 phase, we propose to conduct formative work to iteratively develop a school-based, web-based oral health promotion program. In the UH3 phase, we will conduct a clinical randomized control trial (RCT) in schools, to evaluate “real world” program efficacy. In the RCT, we will assess program acceptability, feasibility, usability, satisfaction, and engagement, as well as the three primary behavioral and clinical health outcomes. Secondary outcomes are the theoretically based mechanisms the program targets for behavior change. Seventh and 8th grade students (N = 2,000) from 40 lower-income schools across multiple states will be randomized to receive the program intervention or to be on the waitlist (control condition). Participating students will complete assessments at three time points (baseline, six weeks post-baseline, and six months post-baseline) to evaluate both short- and long-term program outcomes. If effective, this comprehensive digital behavioral dental health program would greatly impact public health by decreasing persistent oral health disparities. Delivering the program via schools will address disparities in access to such programs, as students will access the program via school internet and school-owned digital devices. A web-based intervention is also easily scalable and can be widely disseminated at little cost, reaching adolescent populations most at risk for dental caries. The long- term goal is to facilitate healthy dental habits and related oral health behaviors for adolescents to attain a lifetime free from preventable oral disease.

项目总结 龋齿，或龋齿，是一种高度流行的慢性疾病，困扰着美国相当大一部分人。 人口，包括大多数青年和成年人。口腔健康方面的健康差距已经持续了几十年， 低收入青年、黑人/非裔美国人和拉丁裔少数族裔患龋齿的风险尤其大。 尽管青春期是实现健康行为习惯的理想时期，但这种习惯将持续到 在成年后，缺乏有效的针对高危青少年的牙齿健康计划。研究表明， 青春期的主要口腔健康促进策略包括改善牙齿健康行为， 戒除烟草使用和蒸发，并减少糖的消耗。遵循这些建议 受我们形成性研究结果的启发，我们为青少年提出的数字牙科计划将针对 三个口腔健康行为领域：每天两次用含氟牙膏刷牙，戒烟 使用，包括蒸发，并减少含糖饮料的消费。植根于 计划的行为，以青少年原型/意愿模型为补充，拟议的跨平台 数字计划将针对基于理论的机制来促进这三种有针对性的口腔健康行为。 它将包括引人入胜的视频和互动游戏组件。因此，在此UG3/UH3应用程序中，我们将 开发和评估基于理论的数字牙科健康促进计划，旨在更低的参与度 收入黑人/非裔美国人、拉丁裔/西班牙裔和非西班牙裔白人7年级和8年级学生。在UG3中 阶段，我们建议进行形成性工作，反复开发以学校为基础、基于网络的口腔健康 推广计划。在UH3阶段，我们将在学校进行临床随机对照试验，以 评估“现实世界”项目的效果。在RCT中，我们将评估程序的可接受性、可行性、可用性、 满意度和参与度，以及三个主要的行为和临床健康结果。次要的 结果是项目目标行为改变的理论基础机制。第七和第八 来自多个州的40所低收入学校的2,000名年级学生将被随机分配到 程序干预或被列入等待名单(控制条件)。参赛学生将完成 在三个时间点(基线、基线后六周和基线后六个月)进行评估，以进行评估 短期和长期项目结果。如果有效，这种全面的数字行为牙齿健康 该计划将通过减少持续存在的口腔健康差距来极大地影响公众健康。正在交付 通过学校的计划将解决在获得此类计划方面的差距，因为学生将获得该计划 通过学校互联网和学校拥有的数字设备。基于Web的干预也很容易扩展，并且可以 以很低的成本广泛传播，接触到患龋齿风险最高的青少年人群。长的- 学期目标是帮助青少年养成健康的口腔习惯和相关的口腔健康行为 没有可预防的口腔疾病。