Parent-Focused Intervention to Improve Oral Health in Young Children

描述（由申请人提供）：幼儿蛀牙率大幅上升，特别是少数族裔和低收入家庭的儿童。这种增加在很大程度上是由于不良的口腔卫生和相关行为。虽然有希望的干预措施可以促进这方面的行为改变，但这些计划几乎完全集中在教父母或孩子刷牙技巧上，而没有考虑到行为管理和激励策略。为了解决这一差距，并响应RFA-DE-12-001，我们计划开发一个简短的以家长为中心的干预措施，解决刷牙互动的技术和行为方面的问题。在现有的针对儿童行为问题的行为干预的基础上，该干预将教会家长如何给孩子刷牙，以及如何管理孩子在刷牙时的不服从行为，如何鼓励孩子过渡到独立刷牙。我们预计，这种干预将导致儿童口腔健康的更持久的改善，特别是那些有特殊保健需求或行为问题使儿童行为管理复杂化的儿童。在这项治疗发展研究中，我们建议开发和测试一种观察工具，作为确定干预目标的方法，并作为干预研究的主要结果衡量标准。参与者将包括132名24至60个月的儿童和他们的主要照顾者，从儿科牙科中心（CPD）招募。这些数据将用于建立测量的可靠性和有效性，检查亲子刷牙互动的差异作为儿童，父母和家庭特征的函数，并支持我们提出的干预措施的理论基础和假定的作用机制。该研究的其他有形“产品”包括我们的调查团队的发展，包括威斯康星大学和苏黎世大学牙医、牙科研究人员和发展心理学家之间的新合作；初步数据支持通过CPD诊所招收低收入、多种族家庭的可行性；还有一份研究方案和治疗手册，其中包括干预措施，这些干预措施将遵循我们研究第一阶段收集的观察数据。这些数据将为一项随机对照试验（RCT）提供基础，以测试一种新颖的、以父母为中心的行为干预对改善早期儿童口腔健康的效果。

DESCRIPTION (provided by applicant): The rate of tooth decay has increased substantially in young children, particularly among ethnic minorities and those from low-income families. This increase is due, in large part, to poor oral hygiene and associated behaviors. Although promising interventions exist to promote behavior change in this regard, these programs focus almost entirely on teaching parents or children tooth brushing technique, without regard for behavior management and motivational strategies. To address this gap, and in response to RFA-DE-12-001, we plan to develop a brief parent-focused intervention that addresses both the technical and behavioral aspects of tooth brushing interactions. Based on existing behavioral interventions for child behavior problems, this intervention will teach parents how to brush their child's teeth as well as how to manage child non-compliance during brushing and how to encourage the child's transition to independent tooth brushing. We anticipate that such an intervention will lead to more lasting improvements in child oral health, particularly among those with special healthcare needs or behavior problems that complicate child behavior management. In this treatment development study, we propose to develop and test an observational tool to be used as a method for identifying targets for intervention and as a primary outcome measure in intervention research. Participants will include 132 children ages 24 to 60 months and their primary caregivers, recruited from the Center for Pediatric Dentistry (CPD). These data will be used to establish the reliability and validity of the measure, to examine differences in parent-child tooth brushing interactions as a function of child, parent, and family characteristics, and to support the theoretical rationale and presumed mechanisms of action underlying our proposed intervention. Other tangible 'products' from the study include the development of our investigative team, featuring new collaborations between UW and SCH dentists, dental researchers and developmental psychologists; preliminary data to support the feasibility of recruiting low-income, ethnically diverse families through the CPD clinic; and a study protocol and treatment manual with interventions that will follow from the observational data collected in this first phase of our research. These data will provide the foundation for a randomized controlled trial (RCT) testing the efficacy of a novel, parent-focused behavioral intervention to improve early childhood oral health.