Hollywood Smiles

描述(由申请者提供)：与全国非裔美国人(AA)相比，古拉族非洲裔美国人(AA)的口腔健康(OH)不平等的比率更高。这一群体之间的差异可以归因于几个因素，包括恐惧、对提供者缺乏信任、过去的负面经历、获得护理的机会和文化信仰。拟议的研究将测试捆绑、多层次干预的可行性，其设计是基于目标农村古拉族人口的偏好。如果这项研究证明了可行性，我们将与全州其他古拉族社区一起，为未来的R01扩大招募范围。我们的长期合作目标是在好莱坞与MUSC牙科学生和教职员工建立一家社区诊所。这是一种可持续的模式，在这种模式下，学生将更多地参与和接触到农村社区的治疗，社区将增加获得机会以及可接受和相关的职业卫生保健。本项目的目的是：1.开发一种新颖的、社区喜欢的教会环境中的OH多水平干预(好莱坞微笑-HS)；2.评估HS干预的可行性，包括干预剂量和保真度，以及监测和测量目标结果和成本；3.评估HS的初步疗效指标，并估计结果测量变异性，以计算后续干预效果研究所需的样本量。提出了一个社会生态模型来指导干预，提供了一个在多个层面上(个人、同伴和组织)影响远程教育行为的干预框架。本研究将采用整群随机方法，将两个教会分成干预组(HS)(n=30)和对照组(CG)(n=30)，通过掷硬币的方式，共有60名参与者。所有参与者都将在社区牙科诊所接受基本标准的护理、牙科治疗和每次牙科就诊的交通通行证。参与者、HS组的教会成员也将接受为期3个月的多层次干预，包括与社区OH发起人(COHP)的1：1接触、同伴教育会议和教会层面的干预。根据目标的具体规定和概念框架的指导，结果测量将包括：a)口腔健康的因变量；b)干预中介变量(口腔健康行为报告、口腔健康素养、口腔健康自我效能和牙科焦虑水平)；以及d)自变量(人口统计和生理测量)和教堂气氛。将进行系统的过程评估，可行性的衡量标准将包括招募、坚持(剂量/保真度)、辍学比例、可接受性、教会顾问委员会的满意度以及干预的范围。

DESCRIPTION (provided by applicant): The African American (AA) Gullah population has a higher rate of oral health (OH) disparities when compared to AAs nationally. OH disparities among this group can be attributed to several factors including fear, lack of trust in providers, past negative experiences, access to care and cultural beliefs. The proposed study will test the feasibility of a bundled, multi-level intervention, whose design is based on the preferences of the targeted rural Gullah population. If this study demonstrates feasibility we will broaden our recruitment for future R01 with other Gullah communities statewide. Our long-term partnership goal is to have a community clinic in Hollywood with MUSC dental students and faculty. This is a sustainable model where the students would be more engaged and exposed to treating the rural community and the community would have increased access and acceptable and relevant OH care. The aims of this project are to: 1. Develop a novel, community preferred OH multi-level intervention (Hollywood Smiles-HS) in church settings; 2. Evaluate the HS intervention feasibility including intervention dosage and fidelity as well as monitoring and measurement of target outcomes and cost; 3. Evaluate preliminary efficacy indications of the HS and estimate outcome measurement variability needed to calculate sample size for a subsequent study of intervention efficacy. A social-ecological model is proposed to guide the intervention, providing a framework for intervening at multiple levels of influence (individual, peer and organizational) on OH behaviors. Cluster randomization will be used to assign 2 churches to an intervention (HS) group (n=30) and a control group (CG) (n=30), thru a coin- toss procedure, for a total of 60 participants. All participants will receive primary standard of care dental therapy at a community dental clinic and transportation passes for each of the dental visits. Participants, members of the church in the HS group will also receive a 3-month multi-level intervention that will include 1:1 contact with a community OH promoter (COHP), peer educational sessions, and church level interventions. As specified by the aims and guided by the conceptual framework, the outcome measures will include: a) dependent variables of oral health; b) intervention mediator variables (oral health behavior report, oral health literacy, oral health self-efficacy and dental anxiety level); and, d) independent variables (demographic and physiologic measures) and church climate. A systematic process evaluation will be conducted and measures of feasibility will include recruitment, adherence (dosage/fidelity), dropout proportions, acceptability, Church Advisory Board satisfaction, and reach of the intervention.