Hollywood Smiles

描述（由申请人提供）：与全国非裔美国人相比，非裔美国人（AA）格勒人的口腔健康（OH）差异率更高。这一群体的OH差异可归因于几个因素，包括恐惧、对提供者缺乏信任、过去的负面经历、获得护理和文化信仰。拟议的研究将测试一个捆绑的、多层次的干预的可行性，其设计是基于目标农村格勒人口的偏好。如果这项研究证明了可行性，我们将在全州其他格勒社区扩大未来R01的招募范围。我们的长期合作目标是在好莱坞与MUSC牙科学生和教师建立一个社区诊所。这是一个可持续发展的模式，学生将更多地参与和接触到治疗农村社区，社区将有更多的机会和可接受的和相关的OH护理。这个项目的目的是：1。在教堂设置中开发一种新颖的，社区首选的OH多层次干预（好莱坞微笑- hs）；2. 评估HS干预的可行性，包括干预剂量和保真度，以及目标结果和成本的监测和测量；3. 评估HS的初步疗效指征，并估计为后续干预疗效研究计算样本量所需的结果测量变异性。提出了一个社会生态模型来指导干预，为在多个影响层面（个人、同伴和组织）干预OH行为提供了一个框架。通过投掷硬币的方式，将2个教堂分配到干预组（HS） （n=30）和对照组（CG） （n=30），总共有60名参与者。所有参与者将在社区牙科诊所接受初级标准护理牙科治疗，并为每次牙科就诊提供交通通行证。HS组的参与者，教会成员也将接受为期3个月的多层次干预，包括与社区OH促进者（COHP）的1:1接触，同伴教育会议和教会层面的干预。根据目标的规定和概念框架的指导，结果测量将包括：a)口腔健康的因变量；B)干预中介变量（口腔健康行为报告、口腔健康素养、口腔健康自我效能感和牙科焦虑水平）；d)自变量（人口统计和生理指标）和教会气氛。将进行系统的过程评估，可行性措施包括招募、依从性（剂量/保真度）、退学比例、可接受性、教会顾问委员会满意度和干预的范围。

DESCRIPTION (provided by applicant): The African American (AA) Gullah population has a higher rate of oral health (OH) disparities when compared to AAs nationally. OH disparities among this group can be attributed to several factors including fear, lack of trust in providers, past negative experiences, access to care and cultural beliefs. The proposed study will test the feasibility of a bundled, multi-level intervention, whose design is based on the preferences of the targeted rural Gullah population. If this study demonstrates feasibility we will broaden our recruitment for future R01 with other Gullah communities statewide. Our long-term partnership goal is to have a community clinic in Hollywood with MUSC dental students and faculty. This is a sustainable model where the students would be more engaged and exposed to treating the rural community and the community would have increased access and acceptable and relevant OH care. The aims of this project are to: 1. Develop a novel, community preferred OH multi-level intervention (Hollywood Smiles-HS) in church settings; 2. Evaluate the HS intervention feasibility including intervention dosage and fidelity as well as monitoring and measurement of target outcomes and cost; 3. Evaluate preliminary efficacy indications of the HS and estimate outcome measurement variability needed to calculate sample size for a subsequent study of intervention efficacy. A social-ecological model is proposed to guide the intervention, providing a framework for intervening at multiple levels of influence (individual, peer and organizational) on OH behaviors. Cluster randomization will be used to assign 2 churches to an intervention (HS) group (n=30) and a control group (CG) (n=30), thru a coin- toss procedure, for a total of 60 participants. All participants will receive primary standard of care dental therapy at a community dental clinic and transportation passes for each of the dental visits. Participants, members of the church in the HS group will also receive a 3-month multi-level intervention that will include 1:1 contact with a community OH promoter (COHP), peer educational sessions, and church level interventions. As specified by the aims and guided by the conceptual framework, the outcome measures will include: a) dependent variables of oral health; b) intervention mediator variables (oral health behavior report, oral health literacy, oral health self-efficacy and dental anxiety level); and, d) independent variables (demographic and physiologic measures) and church climate. A systematic process evaluation will be conducted and measures of feasibility will include recruitment, adherence (dosage/fidelity), dropout proportions, acceptability, Church Advisory Board satisfaction, and reach of the intervention. PUBLIC HEALTH RELEVANCE: The public health relevance of this application relates to the use of a non-dental community oral health promoter to improve oral health literacy and access to dental care in their community. The goal of this study is to educate and provide needed direction and assistance in accessing oral health care. Developing an intervention that promotes oral health literacy is necessary to help reduce disparities in this population.