Pathways to Oral Health Among Low-income Pregnant Urban Women

项目摘要/摘要 少数族裔和低收入妇女在怀孕期间最容易受到口腔健康状况不佳的影响。 与白人和高收入女性相比，这些易受伤害的女性在 怀孕了。然而，怀孕往往是这些妇女唯一可以通过 医疗补助计划。国家循证指南倡导孕期牙齿护理以改善 口腔健康。然而，旨在提高弱势群体牙齿利用率的产前口腔健康计划 孕妇的结果令人失望。识别上游障碍的主要障碍是 下游牙科保健在怀孕期间的利用缺乏预测因素的纵向数据 弱势妇女的牙科保健利用与口腔健康。这项研究的灵感来自于 受限的选择(Bird&Rieker，1999)，它假设女性创造健康生活方式的机会 由于与生物过程相互作用的社会和性别相关过程(例如， 怀孕)。这项研究将利用纽约大学之间正在进行的跨专业合作 大学牙科学院和贝尔维尤医院妇产科服务。我们会收集 第一年这些易受伤害妇女普遍存在的社会行为和心理社会因素的调查数据 怀孕三个月。我们将进行临床口腔检查，以评估牙齿脱落、龋齿、 牙周炎和牙周炎，并将转介所有妇女进行牙科护理。我们将重新调查和重新检查这些 并将使用医疗补助索赔来评估牙齿护理的利用情况。 我们将使用横截面和纵向结构方程模型来识别社会行为和 孕期口腔保健利用和口腔健康的心理社会预测因子。这个项目明确了 S呼吁研究性别和性别对口腔健康和口腔疾病的影响，并 扩大对妇女特有状况和疾病的研究，包括生殖阶段、产妇和 妇科健康。这项研究将阐明在设计干预措施时必须考虑哪些因素 改善口腔高危孕妇的牙科保健利用率和口腔健康状况 疾病。这项研究是解决我们改善弱势群体口腔健康的长期目标的第一步 在怀孕期间对妇女进行干预。

Project Summary/Abstract Racial/ethnic minority and low-income women are most vulnerable to poor oral health during pregnancy. These vulnerable women are less likely than White and higher-income women to utilize dental care during pregnancy. However, pregnancy is often the only time when these women can access dental care through the Medicaid program. National evidence-based guidelines advocate for dental care during pregnancy to improve oral health. However, prenatal oral health programs designed to increase dental utilization among vulnerable pregnant women have had disappointing results. The major obstacle to identifying upstream barriers to downstream dental care utilization during pregnancy is the lack of longitudinal data on factors that predict dental care utilization and oral health in vulnerable women. This study is informed by the Theory of Constrained Choice (Bird & Rieker, 1999), which posits that women’s opportunities to create a healthy lifestyle are constrained due to social and gender-related processes that interact with biological processes (e.g., pregnancy). This study will leverage an ongoing interprofessional collaboration between the New York University College of Dentistry and the Bellevue Hospital Obstetrics and Gynecology Service. We will collect survey data on socio-behavioral and psychosocial factors common in these vulnerable women during the first trimester of pregnancy. We will conduct clinical oral examinations to evaluate tooth loss, dental caries, gingivitis and periodontitis and will refer all women for dental care. We will re-survey and re-examine these women during the third trimester of pregnancy and will use Medicaid claims to evaluate dental care utilization. We will use cross-sectional and longitudinal structural equation modeling to identify socio-behavioral and psychosocial predictors of dental care utilization and oral health during pregnancy. This project explicitly addresses RFA-OD-19-029’s call to examine sex and gender influences on oral health and oral disease and expand research on female-specific conditions and diseases, including reproductive stages and maternal and gynecologic health. This research will elucidate which factors must be addressed when designing interventions to improve dental care utilization and oral health outcomes among pregnant women at elevated risk for oral disease. This study is the first step in addressing our long-term goal to improve the oral health of vulnerable women by intervening during pregnancy.