Impact of Family Functioning and Violence on Adults' and Children's Oral Health

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Oral health is an important component of overall health (e.g., Tabak, 2008; U.S. Department of Health and Human Services [USDHHS], 2000a) and is one of 28 focus areas in U.S. Government's Healthy People 2010 public health strategy (USDHHS, 2000b). Oral diseases are the most common human chronic diseases (Sheiham, 2005), with dental caries - both infectious and transmissible -being the most prevalent (USDHHS, 2000b). Despite its widespread occurrence, efforts to control caries - especially among diverse ethnic, social, and economic populations - continue to elude clinicians. Research clearly documents that couples conflict has profound effects on the immune and endocrine systems of adults and children. Likewise, parenting problems are a chronic emotional and behavioral stressor on both adults and children, with serious attendant health effects related to chronic arousal (e.g., Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002). We hypothesize that the same mechanisms that result in effects on general health also result in specific effects on oral health. We propose to collect an additional wave of data (including parent reports of child and adult oral health and related behaviors) on a sample of 400 families with young children (now 4-11 years old) who have already completed two waves of assessments in a family study (NICHD grant R01 HD046901). Originally designed to examine the effects of family violence exposure on children and adults, that data set includes family and individual potential mediators and moderators and a range of health and functioning outcomes, but not oral health information. This project has the following specific aims: #1: Test the first hypothesized pathway by establishing the effect sizes of relations between (a) family functioning;(b) child and adult oral health behaviors; [and (c) test whether parental socialization of oral health behaviors mediates these associations in children.] #2: Test the second hypothesized pathway by establishing the effect sizes of relations between (a) family functioning and (b) child and adult oral health outcomes. Test both the direct effects of family function behaviors and whether these effects are mediated by oral health behaviors [and socialization of these behaviors in children]. #3: By applying a moderational framework to identify what makes family functioning sometimes predict oral health and other times not, we can more specifically determine under what conditions which aspects of family functioning predict child or adult oral health outcomes. #4: Determine the extent to which effects of violence exposure in the family on oral health are mediated by (a) non-abusive couple conflict, (b) inept parenting, or (c) both.[#5: Test the hypotheses of Aims 1 - 4 longitudinally to predict change in oral health.]