Linking Mother and Child Access to Dental Care

描述(由调查员提供)：背景。2010年健康人报告和美国卫生局局长的报告《美国口腔健康》表明，龋病是低收入、少数族裔学龄前儿童的严重口腔健康问题，再加上获得牙科保健的机会较少，这一问题更加严重。这一问题的潜在解决办法可能存在于母亲和儿童获得牙科保健之间的联系。如果低收入母亲有固定的牙齿护理来源(RSDC)，母亲和孩子可能会通过生物和牙齿护理机制获得口腔健康益处，但对这些联系知之甚少。 目标。在华盛顿州参加医疗补助牙科保险的3至6岁儿童(N=115,853)中，研究目标是：1)测量患有RSDC的母亲的百分比，并确定患有RSDC的母亲的决定因素；2)在母亲中，确定是否有RSDC与更多的牙科知识、口腔健康行为、牙齿满意度、更好的自我报告口腔健康、以及较少的修复性治疗和因牙齿护理而造成的工作损失有关；3)在儿童中，确定母亲患有RSDC是否与更多的牙科保健利用和更好的口腔健康相关；以及4)在儿童中，确定母亲失去牙齿保险的儿童是否比其他儿童的牙齿利用率低。 方法：研究方法。目标将通过前瞻性队列研究设计实现，该研究设计包括对母亲的基线调查和对儿童从医疗补助牙科索赔中获得的牙齿利用情况的一年跟踪调查。不成比例的分层随机抽样将在四个种族/族裔阶层(白人、非西班牙裔(n=3,050)、西班牙裔(n=4,511)、非裔美国人(n=6,100)和其他种族/族裔(n=4,518))中选择有3至6岁子女的医疗补助家庭。至少有780名被抽样的母亲将完成一项基线电话或邮件调查。一年后，将为抽样儿童提取为期一年的调查前/调查后的医疗补助牙科索赔。将对每个种族/族裔阶层进行单独的回归分析。目标1的分析将确定与母亲患有呼吸道合并症相关的因素。目的2对母亲的分析将确定具有RSDC与有关牙科保健、口腔健康行为和牙齿利用的知识和态度之间的关联。目的3对儿童的分析将确定母亲患有呼吸道合并症是否与未来一年更高的牙齿利用率有关。目的4对儿童的分析将确定母亲失去牙科保险是否会导致儿童牙科利用减少。

DESCRIPTION (provided by investigator): Background. Healthy People 2010 and the U.S. Surgeon General's report, Oral Health in America, indicate that caries is a severe oral health problem among low-income, minority preschool children that is compounded by low access to dental care. Potential solutions to this problem may exist in the linkage between mother and child access to dental care. If low-income mothers have a regular source of dental care (RSDC), oral health benefits may accrue to both mother and child through biological and dental care mechanisms, but little is known about these associations. Aims. Among children aged three-to-six years old and enrolled in Medicaid dental insurance in Washington state (N=115,853), study aims are: 1) to measure the percentage of mothers with a RSDC and identify the determinants of mothers having a RSDC; 2) among mothers, to determine whether having a RSDC is associated with greater dental knowledge, oral health behaviors, dental satisfaction, better self-reported oral health, and less reparative treatment and work loss due to dental care; 3) among children, to determine whether having a mother with a RSDC is associated with greater utilization of dental care and better oral health; and 4) among children, to determine whether children with mothers losing dental coverage have less dental utilization than other children. Methods. Aims will be achieved through a prospective cohort study design composed of a baseline survey of mothers and one-year follow-up of children's dental utilization from Medicaid dental claims. Disproportionate stratified random sampling will select Medicaid households with children aged three-to-six years in four racial/ethnic strata (White non-Hispanic (n=3,050), Hispanic (n=4,511), African-American (n=6,100), and other race/ethnic groups (n=4,518). At least 780 sampled mothers will complete a baseline telephone or mail survey. One year later, Medicaid dental claims for one-year pre/post-survey will be extracted for sampled children. Separate regression analyses will be conducted for each racial/ethnic stratum. Aim 1 analyses will identify factors associated with mothers having a RSDC. Aim 2 analyses of mothers will determine the association between having a RSDC and knowledge and attitudes about dental care, oral health behaviors, and dental utilization. Aim 3 analyses of children will determine whether having a mother with a RSDC is associated with greater dental utilization in the prospective year. Aim 4 analyses of children will determine whether mothers' loss of dental insurance results in fewer children dental utilization.