Addressing Oral Health Disparities in Medicaid-Enrolled Special Needs Children wi

简介(申请人提供)：K08临床科学家导师研究职业发展奖的申请由曾接受过儿科牙科和牙科公共卫生高级临床培训的牙医唐纳德·齐提交。池博士目前是爱荷华大学口腔卫生服务研究的博士生。这一奖项将使池博士能够实现他的长期目标，即成为一名独立资助的临床医生学者，并开展一个跨学科研究计划，解决口腔健康方面的差异，并为有特殊医疗需求的儿童提供牙科护理。他的直接职业目标是通过开发、测试和提炼一个关于获得牙科护理的新的多层次概念模型，来扩展他关于医疗补助登记的慢性病儿童获得牙科护理的论文研究。池博士提出了与他的职业发展相关的以下五个目标：(1)提高对低收入有特殊需要儿童的护理机会的概念性理解；(2)学习和应用基于学科和理论的新研究方法；(3)为未来的R01应用收集试点数据；(4)提高写作技能和专业网络；(5)发展指导技能。此外，他还将测试拟议研究计划的中心假设，即医疗保健系统、社区、提供者、家庭和儿童层面获得牙科护理的决定因素是复杂的、相互关联的，并且相对重要性因被检查的渠道类型而异：(1)使用行政数据确定参加医疗补助计划的慢性病儿童获得牙科护理的多层次决定因素；(2)使用调查数据评估行为因素与参加医疗补助计划的慢性病儿童获得牙科护理的程度相关；以及(3)使用临床数据评估获得牙科护理的机会与患有慢性病的医疗补助登记儿童的牙科需求未得到满足程度之间的关系。这项研究将指导未来关于获取和帮助开发多层次干预措施的研究，这些干预措施将改善参加医疗补助计划的慢性病儿童的口腔健康。拟议的职业发展和研究活动将在高度支持、研究密集的环境中进行。DDS和Colleen Huebner博士是各自领域的国家专家，也是华盛顿大学牙学院西北减少口腔健康差距中心的主任，他们将监督池博士的研究和职业发展活动。此外，许博士还将接受约翰·内夫医学博士(临床风险分组软件的共同开发者)、劳埃德·曼克尔博士(生物统计学家)和伊丽莎白·莫曼尼博士(爱荷华州医疗补助数据专家)的咨询建议。最后，所有活动将由一个外部咨询委员会监督，委员会成员包括：Jeffrey Murray医学博士(爱荷华大学儿科教授)；Peter Damiano，DDS，公共卫生硕士(爱荷华大学预防和社区牙科教授)；Diane Martin，博士(华盛顿大学卫生服务教授)。这一跨机构、跨学科的导师团队将促进池博士从当前的研究经验自然地发展到临床科学家的指导发展阶段，然后走向独立。

DESCRIPTION (provided by applicant): The proposed application for a K08 Mentored Clinical Scientist Research Career Development Award is being submitted by Donald Chi, a dentist with advanced clinical training in pediatric dentistry and dental public health. Dr. Chi is currently a PhD candidate in Oral Health Services Research at the University of Iowa. This award will allow Dr. Chi to meet his long-term goal of becoming an independently-funded clinician scholar with an interdisciplinary research program that addresses disparities in oral health and access to dental care for children with special health care needs. His immediate career goal is to extend his dissertation research on access to dental care for Medicaid-enrolled children with a chronic condition by developing, testing, and refining a new multi-level conceptual model on access. Dr. Chi proposes the following five aims related to his career development: (1) improve conceptual understanding of access to care for low-income children with special needs; (2) learn and apply new discipline- and theory-based research methods; (3) collect pilot data for a future R01 application; (4) improve writing skills and professional networks; and (5) develop mentorship skills. In addition, he will test the central hypothesis of the proposed research plan - that the health care system-, community-, provider-, family-, and child-level determinants of access to dental care are complex, interrelated, and vary in relative importance depending on type of access being examined - through the following three research aims: (1) identify the multi-level determinants of access to dental care for Medicaid-enrolled children with a chronic condition using administrative data; (2) evaluate the extent to which behavioral factors are associated with access to dental care for Medicaid-enrolled children with a chronic condition using survey data; and (3) assess the relationship between access to dental care and the level of unmet dental need for Medicaid-enrolled children with a chronic condition using clinical data. This research will guide future studies on access and help in the development of multi-level interventions that will improve the oral health of Medicaid-enrolled children with a chronic condition. The proposed career development and research activities will take place in highly supportive, research-intensive environments. Peter Milgrom, DDS and Colleen Huebner, PhD, national experts in their respective fields and Directors of the Northwest Center to Reduce Oral Health Disparities at the University of Washington School of Dentistry, will supervise Dr. Chi's research and career development activities. In addition, Dr. Chi will receive consulting advice from John Neff, MD (co-developer of Clinical Risk Grouping software); Lloyd Mancl, PhD (biostatistician); and Elizabeth Momany, PhD (Iowa Medicaid data expert). Finally, all activities will be overseen by an External Advisory Committee consisting of Jeffrey Murray, MD (Professor of Pediatrics, University of Iowa); Peter Damiano, DDS, MPH (Professor of Preventive and Community Dentistry, University of Iowa); and Diane Martin, PhD (Professor of Health Services, University of Washington). This cross-institutional, interdisciplinary mentorship team will facilitate Dr. Chi's natural progression from current research experiences to the mentored clinical scientist development phase and then to independence.