A Promotora Program to Prevent Primary Tooth Decay in Low-income Latino Children

描述（由申请人提供）：KDH研究与传播（KDHRC）提议开发和评估Dientes Fuertes， Vida Sana (DFVS)，这是一个文化主管计划，旨在预防0至6岁低收入拉丁裔儿童的初级蛀牙。为了有效地接触到低收入的拉丁裔儿童，DFVS将培训为拉丁裔服务的社区组织（cbo）的健康推广员（PS），向拉丁裔父母和监护人进行外展，以建立他们在以下方面的知识和技能：1)口腔健康素养，包括正确刷牙、使用牙线和喂养方法，以预防初级蛀牙；2)口腔保健系统导航，包括何时、何地、如何寻求牙科保健和治疗以及克服牙科保健障碍的方法。DFVS解决了一项紧迫的公共卫生需求。公共卫生官员称蛀牙是一种无声的流行病，是儿童最大的未满足的健康需求。在个人层面上，儿童蛀牙预示着持久和实质性的身体、社会心理和经济后果。在社会层面上，儿童蛀牙每年花费纳税人数亿美元，主要是由于可预防的牙痛的急诊室护理。DFVS通过PS干预模式满足了这一紧迫的公共卫生需求，该模式已证明具有有效性、文化竞争力和成本效益。DFVS在该领域是独一无二的。在该项目完成后，我们将拥有完整的DFVS计划，该计划将由四个英语/西班牙语双语部分组成：1)培训指南（TG），由首席运营官主持进行8次，每次2小时的会议，以准备PS向拉丁裔监护人进行外展；2)由多个部分组成的培训肥皂剧，或流媒体视频，戏剧性地说明拉丁裔口腔健康挑战，以供PS学习和讨论；3)一份实施指南（IG），以建立cbo有效使用DFVS的能力；4)一个分销网站来托管DFVS。更重要的是，我们将有关于DFVS的有效性的实质性数据，作为一个文化上有竞争力的项目，以防止0至6岁低收入拉丁裔儿童的初级蛀牙。这些数据将来自两个来源。首先，可行性评估将探讨DFVS在多大程度上是一个有用的、文化上适合cbo采用的项目。它还将测试接触DFVS原型如何改变PS的知识，改善态度，提高自我效能，以开展与拉丁裔监护人的联系。其次，结果评估将在两组、多阶段、对照试验中测试DFVS在一组cbo实施时的有效性。总而言之，DFVS及其评估结果旨在通过创建一个以证据为基础的文化主管项目来预防初级蛀牙，从而减少0至6岁低收入拉丁裔儿童的口腔健康差距。

DESCRIPTION (provided by applicant): KDH Research & Communication (KDHRC) proposes to develop and evaluate Dientes Fuertes, Vida Sana (DFVS), a culturally-competent program to prevent primary tooth decay in low-income Latino children ages zero to six. To effectively reach low-income Latino children, DFVS will train promotores de salud (PS) at Latino-serving community-based organizations (CBOs) to conduct outreach to Latino parents and guardians to build their knowledge and skills in 1) oral health literacy, including proper brushing, flossing, ad feeding practices to prevent primary tooth decay; and 2) oral healthcare system navigation, which includes when, where, and how to seek dental care and treatment and methods to overcome barriers to dental care. DFVS addresses a pressing public health need. Public health officials have called tooth decay a silent epidemic and the greatest unmet childhood health need. On an individual level, childhood tooth decay predicts lasting and substantive physical, psychosocial, and economic consequences. On a societal level, childhood tooth decay costs taxpayers hundreds of millions of dollars yearly, due mostly to emergency room care for preventable tooth pain. DFVS matches this pressing public health need with the PS intervention model, which has demonstrated effectiveness, culturally-competency, and cost-efficiency. DFVS is unique in the field. At the completion of this project, we will have the complete DFVS program, which will consist of four bilingual English/Spanish components: 1) a Training Guide (TG) for a CBO-based facilitator to conduct eight, two-hour sessions to prepare PS to conduct outreach to Latino guardians; 2) a multi-part training telenovela, or streaming video that dramatically illustrates Latino oral health challenges for PS learning and discussion; 3) an Implementation Guide (IG) to build CBOs' capacity to effectively use DFVS; and 4) a distribution website to host DFVS. What is more, we will have substantive data on DFVS's effectiveness as a culturally-competent program to prevent primary tooth decay in low-income Latino children ages zero to six. These data will stem from two sources. First, the feasibility evaluation will explore the extent to which DFVS is a useful, culturally- appropriate program that CBOs will adopt. It will also test how exposure to the DFVS prototype changes PS' knowledge, improve attitudes, and increase self-efficacy to conduct outreach to Latino guardians. Second, the outcome evaluation will test DFVS in a two group, multi-stage, controlled trial of DFVS's effectiveness when implemented by a group of CBOs. Taken together, DFVS and its evaluation results aim to reduce oral health disparities among low-income Latino children ages zero to six by creating an evidence-based, culturally- competent program to prevent primary tooth decay.