Family intervention with caregivers of children with urgent dental needs

2至11奥尔兹儿童的蛀牙在全国范围内增加，特别是在贫困和少数民族人口中，不太可能实现2020年健康人的目标。公立小学儿童的牙科筛查已在12个州得到授权，并得到美国和国际组织的认可。然而，尽管人们对这一概念充满热情，但筛查和转诊作为让父母和照顾者带孩子去看牙医的工具一直是无效的。本申请旨在支持II期随机临床试验的规划，以评估转诊方法在有紧急/恢复需求的市中心城市小学儿童中增加牙科就诊（接受护理）的有效性。要测试的干预依赖于两个理论框架-自我调节的常识模型（CSM）和计划行为理论（TPB），可以与基于学校的计划中的儿童水平的干预结合使用。R34研究的目标将分两个阶段进行：（1）试验阶段，验证龋齿的改良疾病感知问卷-修订版（IPQ-RD）、干预措施的可接受性和实施情况、获得护理的调解人和调节人;社区组织和提供者的重点小组，以确定实验干预措施中应包括的支持资源;以及测试关于教育材料的适当性/准确性的实验干预;（2）计划阶段，主要致力于U 01提交所需的主要计划活动，包括制定研究方案、操作手册和机构审查委员会申请及其相关材料。R34的样本量包括120名幼儿园、一年级和二年级学生的照顾者，他们是从俄亥俄州克利夫兰市中心城区的5所小学招募来的，还有10到20名来自几个社区机构或供应商的关键信息提供者。数据收集包括半结构化的一对一访谈和对照顾者的问卷答复，以及对社区/提供者提供信息者的重点小组。数据分析将采用混合方法设计（扎根理论和理论驱动）用于定性数据，并采用描述性/分析性统计用于定量数据。这种行为方法有可能改变公共卫生标准的做法，通过利用具有成本效益，易于运输，可持续的转诊方法的筛查计划。跨学科研究小组包括凯斯西储社区牙科系和华盛顿大学西北减少口腔健康差异中心的教师。

DESCRIPTION (provided by applicant): Tooth decay in 2 to 11 year olds is increasing nationally especially among poor and minority populations, and it is unlikely that Healthy People 2020 goals will be met. Dental screening of children in public elementary schools has been mandated in 12 states and endorsed by U.S. and international organizations. Nevertheless, in spite of enthusiasm for the concept, screening and referral has been ineffective as a tool to get parents and caregivers to take children to the dentist. This application is to support planning of a Phase II randomized clinical trial to assess the effectiveness of a referral approach to increase dental attendance (for receipt of care) among inner-city urban elementary school children with urgent/restorative needs. The intervention to be tested relies on two theoretical frameworks -Common Sense Model of Self-Regulation (CSM), and the theory of Planned Behavior (TPB) that could be used in conjunction with child-level interventions in a school-based program. The objectives of the R34 study will occur in two phases: (1) pilot phase to validate the modified illness perception questionnaire -Revised (IPQ-RD) for dental caries, acceptability and delivery of the intervention, mediators and moderators for accessing care; focus groups of community organizations and providers to identify enabling resources to be included in the experimental intervention; and testing the experimental intervention regarding appropriateness/accuracy of educational materials; (2) planning phase primarily devoted to the major planning activities required for a U01 submission including development of the study protocol, manual of operations, and Institutional Review Board application and its associated materials. The sample size for the R34 includes 120 caregivers of KG, first, and second grade school children recruited from among 5 elementary schools in an urban inner-city school district in Cleveland, OH, and 10 to 20 key informants from several community agencies or providers. Data collection involves semi-structured one-to-one interviews and questionnaire responses for caregivers and focus groups for community/provider informants. Data analysis will utilize a mixed method design (grounded theory and theory driven) for qualitative data, and descriptive/analytical statistics for quantitative data. This behavioral approach has the potential to change the public health standard of practice for screening programs by utilizing a cost-effective, easily transportable, and sustainable referral approach. The transdiscipilinary research team includes faculty from Department of Community Dentistry at Case Western Reserve and the Northwest Center to Reduce Oral Health Disparities at the University of Washington.