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

描述(由申请人提供)：KDH Research&Communications(KDHRC)建议开发和评估Dientes Fuertes，Vida Sana(DFVS)，这是一个具有文化能力的计划，旨在预防0至6岁低收入拉丁裔儿童的乳牙腐烂。为了有效地接触到低收入的拉丁裔儿童，DFVS将在为拉丁裔服务的社区组织(CBO)中培训推广员de salud(PS)，以向拉丁裔父母和监护人进行外联，以建立他们在以下方面的知识和技能：1)口腔健康素养，包括适当的刷牙、牙线、广告喂养做法，以防止乳牙龋齿；以及2)口腔医疗系统导航，包括何时、何地及如何寻求牙科护理和治疗以及克服牙科护理障碍的方法。DFVS解决了紧迫的公共卫生需求。公共卫生官员称，龋齿是一种无声的流行病，是儿童最大的未得到满足的健康需求。在个人层面上，儿童期的龋齿预示着持久和实质性的生理、心理和经济后果。在社会层面上，儿童龋齿每年花费纳税人数亿美元，主要是由于急诊室对可预防的牙痛的护理。DFVS将这一紧迫的公共卫生需求与PS干预模式相匹配，该模式已显示出有效性、文化竞争力和成本效益。DFVS在该领域是独一无二的。在这个项目完成后，我们将拥有完整的DFVS计划，其中将包括四个双语英语/西班牙语部分：1)为CBO协调员提供的培训指南(TG)，以进行八个、两个小时的课程，以准备PS与拉丁裔监护人的外联；2)多部分培训Telenovela，或戏剧性地展示拉丁裔口腔健康挑战的流媒体视频；3)实施指南(IG)，以建设CBO有效使用DFVS的能力；以及4)一个分销网站，以托管DFVS。更重要的是，我们将获得大量数据，说明DFVS作为一项具有文化能力的计划，在0至6岁的低收入拉丁裔儿童中预防乳牙龋齿的有效性。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CBO将采用的有用的、文化上合适的方案。它还将测试接触DFVS原型如何改变PS的知识，改善态度，并提高自我效能，以开展与拉丁裔监护人的接触。第二，结果评估将在一组CBO实施DFVS的有效性的两组、多阶段、对照试验中测试DFVS。综上所述，DFVS及其评估结果旨在通过创建一个以证据为基础、具有文化竞争力的计划来预防乳牙腐烂，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.