SAN FRANCISCO MATERNAL AND CHILD ORAL HEALTH "PRIME" PROJECT

描述(由申请人提供)：幼儿龋齿(ECC)在幼儿中非常普遍，特别是在服务不足的人群中。然而，无论是识别处于危险中的儿童个体的好工具，还是改善父母预防性口腔健康行为的方法都没有得到很好的发展。这项名为“预防、风险、干预、管理和评估”(PRIME)项目将a)寻求为0-5岁儿童的龋病风险评估工具开发科学基础，b)确定龋病风险因素的识别是否可以与激励母亲改善与儿童相关的口腔健康行为联系在一起。这项建议的主要目标是为母亲/照顾者和婴儿的龋齿风险评估工具测试和建立一个可信的科学基础。我们将修改目前用于成人的龋病风险评估工具(CAMBRA)，并将其修改用于0-3岁的儿童。修改婴儿评估的建议包括使用唾液细菌分析。我们将“测试”细菌唾液分析作为强化因素在前面的模型中(见B5)。我们已经开发了一种策略，将母亲和婴儿的“二元组”一起作为参与配对的核心的一部分。这一战略将有助于理解需要为母亲和婴儿共同制定统一的方法，作为婴儿口腔护理访问和风险评估的一部分。通过开发一种特定年龄的风险评估方法，将风险因素、保护因素和临床结果与唾液检测结合起来，我们将开发一种前瞻性的全面干预措施，促进健康和疾病预防，适合我们服务不足的城市社区的印第安人和西班牙裔妇女及其婴儿。这项提案的目的将是检查基线龋齿风险状况与幼儿基线口腔健康状况之间的关系，这些幼儿已经使用改进的龋齿管理风险评估工具(Cambra)进行分类，该工具目前用于成人，使用现有数据针对0-5岁儿童及其母亲。我们将确定父母对特定口腔健康行为的偏好，这些行为与Cambra家庭护理工具的总体评估相对应，转化为照顾者的自我管理目标，旨在改善其婴儿的口腔健康状况。此外，我们还将分析在接受评估时和3个月后的随访中，收到家长(S)的结果和孩子的口腔细菌水平对父母对孩子口腔健康行为偏好的影响。从出生第一年开始，及早筛查和识别龋齿发展的迹象，将有助于确定有患ECC风险的婴儿和幼儿，并有助于提供适当的治疗计划和周期量表。从出生第一年开始，及早筛查和识别龋齿发展的迹象，将有助于确定有患ECC风险的婴儿和幼儿，并有助于提供适当的治疗计划和周期量表。长期目标是双重的：(1)为0-5岁儿童开发一个全面的龋齿风险评估工具Cambra；(2)为成功测试和实施特定行为模型的纵向前瞻性研究创建框架。

DESCRIPTION (provided by applicant): Early childhood caries (ECC) is very prevalent among young children, particularly in underserved populations. However, neither good tools for identifying individual children at risk nor methods for improving parental preventive oral health behaviors are well developed. This study, "Prevention, Risk, Intervention, Management and Evaluation" (PRIME) Project will a) seek to develop a scientific foundation for a caries risk assessment tool for 0-5 year old children and b) determine if identification of caries risk factors can be tied to motivating mothers to improve child-related oral health behaviors. The major goals of this proposal are to test and establish a credible scientific foundation for a caries risk assessment tool for mothers/caregivers and infants. We will modify the Caries Management by Risk Assessment tool (CAMBRA) currently used for adults and modify it for children aged 0-3 years. Suggestions for modifications for assessment of infants include the use of salivary bacterial assays. We would "test" bacterial salivary assays as reinforcing factors in the Precede-Proceed model (See B5). We have developed a strategy for "dyads" of mother and infant together as part of a nucleus of participating pairs. This strategy would help understand the need to develop a uniform approach for mother and infant together as part of an Infant Oral Care visit and risk assessment. By developing an age-specific approach of risk assessment that incorporates risk factors, protective factors and clinical findings with salivary assays of the dyads, we would then develop a prospective comprehensive intervention on health promotion and disease prevention that is appropriate for our underserved, urban community of Native Americans and Hispanic women and their infants. The aims of this proposal will be to examine the association between baselines caries risk status compared to baseline oral health status of young children who have been classified with a modified Caries Management by Risk Assessment tool (CAMBRA), which is currently used for adults, targeting 0-5 year olds and their mothers using extant data. We will determine parental preferences for specific oral health behaviors that correspond to the overall assessment of the CAMBRA instrument for homecare translated into self management goals for the caregiver targeted to improve the oral health status of their infants. In addition we will analyze the influence of receiving the results of the parent(s)' and children's oral bacterial levels on parent's preferences of oral health practices for their children at the time of their assessment and at a follow-up 3 months later visit, while receiving the bacterial level results. Early screening and recognition for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing appropriate treatment plan and periodicity scale. Early screening and recognition for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing appropriate treatment plan and periodicity scale. The long term goals are dual: (1) to develop a comprehensive caries risk assessment CAMBRA instrument for 0-5 year olds and (2) to create the framework for a longitudinal prospective study where specific behavioral models are tested and implemented successfully.