Integrating Social, Behavioral & Preventive Sciences to Reduce Children's Caries

描述（由申请人提供）：我们的长期目标是改善夏威夷儿童的口腔健康和减少差异。我们假设，有效的以学校为基础的龋齿预防项目的范围和影响可以通过利用社会网络来改变行为来定量地增加。1. 意义：美国小学适龄儿童中有1000万（约20%）患有未经治疗的龋齿。在健康方面的差距是显著的，在美洲印第安人/美洲原住民中上升到72%。有效的以学校为基础的预防措施是可用的，但没有得到充分利用或无法获得。夏威夷有很多牙医，但很少有人接受医疗补助；龋齿率超过全国平均水平；没有以学校为基础的龋齿预防项目。2. 创新：将社会网络分析、行为改变和龋齿预防结合起来，这是以前从未尝试过的。如果成功，在全州范围内预防龋齿将有助于在2020年之前实现“健康人2020”的目标。3. 方法：生成MOP和初步数据。具体目标是：为试点项目创建程序手册（MOP），以NIDCR模型为基础，在PI目前成功但独立的项目基础上进行修改，重点关注社会网络分析、行为改变和龋齿预防。与两个课后组织合作，开展试点项目，生成和分析初步数据。我们将确定所有现场协调员（约100人）以及4所试点学校（约400名家长和孩子）的家长和孩子的社交网络和行为意图。两组学校校长、家长和孩子将接受有针对性的行为改变（实验）；另外两组没有行为改变（控制）。所有四所学校的儿童都将接受全面的龋齿预防。主要结果将是RE-AIM定义的项目影响。准备U01申请。我们将使用结果、RE-Aim、马尔可夫链/蒙特卡罗模型、经济评估和功率计算来生成预测模型。这将使我们能够修改MOP并准备一个U01应用程序，以便在整个夏威夷群岛实施。研究人员：四位独特内容领域的专家将在这个团队科学项目中合作，协调社会网络分析、行为意图和变化、龋齿预防以及统计和经济分析方面的专业知识。5. 环境：夏威夷是一个小州，有大量的医疗保健需求，没有以学校为基础的龋齿预防计划。因此，拟议的项目结合了一个高需求的环境，以及来自具有非凡深度的机构的研究人员。

DESCRIPTION (provided by applicant): Our long-term goal is to improve the oral health and reduce disparities of children in Hawai'i. We hypothesize that the reach, and impact, of effective school-based caries prevention programs can be quantitatively increased by leveraging social networks to target behavioral change. 1. Significance: 10 million children (>20%) of U.S. elementary school age children have untreated dental decay. The disparity in health is notable, rising to 72% for American Indians/Native Americans. Effective school-based preventions are available but underutilized or unavailable. In Hawai'i there are: an abundance of dentists, but few accepting Medicaid; caries rates exceeding national averages; and no school-based caries prevention programs. 2. Innovation:Integrating social network analysis, behavior change and caries prevention has not before been attempted. If successful, a state-wide caries prevention could facilitate exceeding the goals of Healthy People 2020 prior to 2020. 3. Approach: Generate MOP and preliminary data. The specific aims are to: Create a manual of procedures (MOP) for pilot program, based on the NIDCR model, and modified from the PI's current successful, but independent, programs focusing social network analysis, behavioral change, and caries prevention. Carry out pilot program to generate and analyze preliminary data, working with two after school organizations. We will determine the social network and behavioral intent of all site coordinators (~100), and both parents and children in 4 pilot schools (~400 parents and children). Two sets of school's directors, parents, and children will receive targeted behavior change (experimental); the other two sets will receive no behavior change (control). Children in all four schools will receive comprehensive caries prevention. The primary outcome will be program impact, defined by RE-AIM. Prepare U01 application. We will use outcomes, RE-Aim, Markov Chain/Monte Carlo modeling, economic assessments, and power calculations to generate predictive models. These will allow us to revise the MOP and prepare a U01 application for implementation across the Hawai'ian Islands. 4. Investigators: Four experts in unique content areas will collaborate in this team science program, coordinating expertise in social network analysis, behavioral intent and change, caries prevention, and statistical and economic analysis. 5. Environment: Hawai'i is a small state with substantial health care needs and no school-based caries prevention program. The proposed program therefore coalesces an environment with high need, and investigators from institutions with extraordinary depth. PUBLIC HEALTH RELEVANCE: To improve the oral health and reduce disparities of children in Hawaii, we will implement an effective school-based caries prevention program that leverages social networks to effect social change.