Oral Health Advocates in Public Housing

公共住房中的口腔健康倡导者

• 批准号: 8065534
• 负责人: Michelle M Henshaw
• 金额: $ 115.1万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8065534
• 关键词: Academy; Address; Advocacy; Advocate; Affect; Age; Age-Months; American; Asthma; Behavioral; Birth; Boston; Caregivers; Caring; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Chronic; Chronic Disease; Clinical; Communicable Diseases; Communities; Community Health; Control Groups; Counseling; Dental; Dental Care; Dental Hygiene; Dental caries; Development; Diabetes Mellitus; Dietary Practices; Disadvantaged; District of Columbia; Effectiveness; Event; Feedback; Fluoride Varnishes; Fluorides; Focus Groups; Fostering; Funding; Goals; Health; Health Promotion; Household and Family; Housing; Incidence; Individual; Institutes; Intervention; Intervention Studies; Life; Long-Term Effects; Mental Depression; Minority Groups; Modeling; Monitor; Nature; New York; Oral health; Pediatric Dentistry; Pit and Fissure Sealants; Prevalence; Prevention; Prevention Research; Preventive; Process; Public Health; Public Housing; Randomized; Research; Responsible Person; Risk Factors; Role; Screening procedure; Site; Testing; Time; Tooth structure; Toothpaste; Translational Research; Water fluoridation; Work; abstracting; aged; authority; base; chronic care model; community based participatory research; community intervention; deciduous tooth; design; early childhood; improved; innovation; meetings; motivational enhancement therapy; population based; prevent; programs; skills; tooth surface

Oral Health Advocates in Public Housing Abstract Dental caries is the most common, chronic disease of childhood, is increasing in prevalence and disproportionately affects individuals who are financially disadvantaged and from racial and ethnic minority groups. Given the chronic nature of dental caries, clinically based preventive and restorative care alone will be inadequate to decrease disparities in ECC prevalence. Instead, we posit that a multimodal communitybased approach, which addresses the chronic, infectious and multifactorial nature of dental caries, will be more effective than behavioral counseling and the chemotherapeutic effects of fluoride, either alone or in combination. A successful community-based multimodal intervention will incorporate these strategies, but will also need to equip caregivers with the skills to become involved in the prevention and management of ECC as well as to foster community and environmental support for decreasing ECC risk factors. Similar strategies have been applied successfully to a variety of chronic diseases such as asthma, diabetes, and depression, with most studies showing significant short and long term effects. This project, using community based participatory research principles to decrease disparities in early childhood caries, extends the work of the ongoing partnership of the "Center for Research to Evaluate and Eliminate Dental Disparities" [CREEDD], the CDC funded "Partners in Health and Housing Prevention Research Center" [PHH-PRC], the Boston Housing Authority (BHA) and the Community Committee for Health Promotion (CCPH). This approach is synergistic not only with the goals of all partners, but also with the goal of our campus wide clinical and translational science institute, particularly the CTSI's focus on community involvement in research. In order to facilitate the ongoing collaborative working relationships with the public housing communities and other partners, Dr. Henshaw, the project PI will serve as the specific key person responsible for the project's coordination with community partners. Dr. Henshaw has successfully served in this role for the past 2 years, during which time the research team has collaborated with the public housing community through conduct of pilot intervention studies, participation in community committee meetings, special community sessions and events, and the conduct of focus groups to obtain community input in all aspects of the proposed research. The work will build on the Expanded Chronic Care Model, and will test if a community-based multimodal intervention will reduce the 2-year ECC incidence of children aged 0-5 living in public housing developments. The intervention combines evidentiary components (motivational interviewing delivered by oral health advocates, oral health assessment and referral, care management and community health promotion) and a unique delivery setting (public housing). We hypothesize that because of the counseling activities, the experimental group will not only be more likely to reduce individual behavioral risk factors for ECC, but will be more likely to access both primary dental care and the community-based fluoride applications that will be available at both the experimental and control sites, leading to a greater incidence of ECC reduction in the experimental group. The specific aims of the proposed research are to: Specific Aim 1: Determine if a multimodal intervention (oral health assessment and feedback, fluoride varnish application, motivational interviewing delivered by oral health advocates and a community-based oral health promotion program), built upon the chronic care model, can reduce incidence of ECC compared with a matched control group that receives dental screening and fluoride varnish application alone. Specific Aim 2: Determine if the multimodal intervention can reduce ECC behavioral risk factors in the domains of tooth monitoring, oral hygiene and dietary practices compared with a matched control group that receives dental screening and fluoride varnish application alone. Specific Aim 3: Evaluate facilitators and barriers to the multimodal intervention in public housing sites. This study is well poised for dissemination and will utilize process-related project findings from years 1-4 to conduct targeted expansion in years 5, 6 and 7 in which implementation will occur in 3 housing authorities located in New York, NY, Washington, D.C. and Columbus, OH where similar advocacy models are in place. Ultimately, this work could be disseminated through the Boston Housing Authority's network of nationwide contacts and could potentially improve the oral health of over 500,000 family households and over 1 million children living in public housing.

公共房屋的口腔健康倡导者 摘要 龋齿是儿童期最常见的慢性疾病，患病率正在增加， 对经济上处于不利地位的人以及少数种族和族裔的人的影响尤其严重 组鉴于龋齿的慢性性质，仅基于临床的预防和恢复护理将是 不足以缩小幼儿保育普及率的差距。相反，我们认为，一个多模式的社区为基础的 方法，解决了慢性，传染性和多因素的性质龋齿，将是 比行为咨询和氟化物的化疗效果更有效，无论是单独使用还是联合使用。 组合.一个成功的以社区为基础的多模式干预将包括这些战略，但将 还需要使护理人员具备参与幼儿保育预防和管理的技能， 以及促进社区和环境支持，以减少幼儿保育的风险因素。类似的策略有 已成功应用于各种慢性疾病，如哮喘、糖尿病和抑郁症， 大多数研究显示了显著的短期和长期影响。 该项目利用基于社区的参与性研究原则， 儿童龋齿，扩展了正在进行的合作伙伴关系的工作“中心的研究，以评估和 消除牙齿差异”[CREEDD]，疾病预防控制中心资助的“健康和住房预防合作伙伴 研究中心”[PHH-PRC]、波士顿住房管理局（BHA）和社区卫生委员会 晋升（公共卫生协调会）。这一办法不仅与所有伙伴的目标，而且与 我们的校园广泛的临床和转化科学研究所，特别是CTSI的重点是社区 参与研究。为了促进与联合国的持续合作关系， 公共住房社区和其他合作伙伴，亨肖博士，该项目PI将作为具体的 负责与社区合作伙伴协调项目的关键人员。 博士Henshaw在过去的2年里成功地担任了这一角色，在此期间，研究团队 与公共住房社区合作，通过进行试点干预研究，参与 在社区委员会会议、特别社区会议和活动以及焦点小组的开展中 以获得社区对拟议研究的各个方面的投入。这项工作将建立在扩大的 慢性病护理模式，并将测试基于社区的多模式干预是否会减少2年ECC 居住在公屋的0至5岁儿童的发病率。干预措施结合了证据 组成部分（口腔健康倡导者提供的动机访谈，口腔健康评估和转诊， 护理管理和社区健康促进）和独特的交付环境（公共住房）。我们 假设由于咨询活动，实验组不仅更有可能 减少ECC的个人行为风险因素，但更有可能获得初级牙科保健， 实验地点和对照地点都将提供基于社区的氟化物应用， 导致实验组中ECC减少的发生率更高。建议的具体目标 具体目标1：确定多模式干预（口腔健康评估和 反馈，氟化物保护漆的应用，由口腔健康倡导者提供的动机访谈， 以社区为基础的口腔健康促进计划），建立在慢性病护理模式，可以减少发病率 ECC与接受牙齿筛查和氟化物保护漆应用的匹配对照组进行比较 一个人具体目标2：确定多模式干预是否可以减少ECC的行为风险因素， 与匹配的对照组相比， 仅接受牙科筛查和氟化物保护漆。具体目标3：评估辅导员， 在公共住房场所进行多模式干预的障碍。 这项研究已做好传播的准备，并将利用1-4年级至12 - 1-4年级与进程有关的项目结果。 在第5、第6和第7年进行有针对性的扩展，在3个住房管理局实施 位于纽约州纽约、华盛顿，华盛顿特区和俄亥俄州哥伦布，这些地方都有类似的宣传模式。 最终，这项工作可以通过波士顿住房管理局的全国网络传播， 接触，并可能改善超过50万个家庭和超过100万个家庭的口腔健康。 住在公共住房的儿童。