Increasing Access to Oral Health Care: Evaluating the Outcomes of a Community He

贝尔纳普堡保护区3-6岁学前儿童口腔筛查的初步研究 显示47%的儿童有缺牙，67%有多个牙齿，43%有未经治疗的牙齿。 龋病这些数据向社会证实了他们的信念，即在 他们的孩子高得令人无法接受。这个拟议的CBPR项目将通过以下方式实现减少ECC的目标： 建立在现有的，长期的和信任的关系，建立在贝尔纳普堡之间， 密歇根州立大学护理学院（MSU’s College of Nursing，MSUCON）要通过一个 一项随机试验的结果是，拟议的社区口腔卫生工作者（COHW）模式将降低发病率 新的和未经治疗的蛀牙，并有积极的影响，照顾者报告的儿童口腔健康 实践COHW模式将通过一系列精心规划和商定的步骤实施， 将包括战略和创新目标：目标1：建立研究基础设施和战略 需要建立伙伴关系，使格罗斯和阿西尼博因部落和MSUCON创建和测试一个 可持续和有效的社区口腔健康工作者计划，以减轻ECC的负担。 目标2：在随机对照试验中开发和测试COHW实施的ECC的有效性 还原协议。一名贝尔纳普堡社区成员将接受培训，成为一名COHW， 敏感的健康行为改变咨询和个案管理。目标3：协助和支持Aaniiih Nakoda学院在发展必要的系统和基础设施，以建立一个认可的 社区牙科健康协调员培训计划。COHW模式的可持续性取决于 部落可靠地继续吸引合格的COHW的能力。COHW毕业于 获认可的学校，而不是接受在职培训（如目标2所建议），能够提供直接 代替牙医的收费牙科服务。协助部落获得经过正式培训的COHW （称为社区牙科健康协调员，或CDHC）和合格COHW的有限来源将 导致可持续的干预适应其他部落。

Preliminary studies of oral screening of 3-6 year old Head Start children at Fort Belknap Reservation revealed that 47% of children had missing teeth, 67% had multiple restorations, and 43% had untreated dental caries. The data confirmed to the community their belief that the prevalence and severity of ECC in their children was unacceptably high. This proposed CBPR project will address the goal of reducing ECC by building on an existing, longstanding, and trusting relationship established between the Fort Belknap community and MSU's College of Nursing (MSUCON). The a priori hypothesis to be tested through a randomized trial is that the proposed community oral health worker (COHW) model will reduce the incidence of new and untreated dental decay and have a positive impact on caregiver reported child oral health practices. The COHW model will be implemented in a series of carefully planned and agreed upon steps and will consist of strategic and innovafive aims: Aim 1: Build the research infrastructure and strategic partnerships needed to enable the Gros Ventre and Assiniboine Tribes and MSUCON to create and test a sustainable and effective Community Oral Health Worker program to reduce the burden of ECC. Aim 2: Develop and test in a randomized control trial the effectiveness of a COHW-implemented ECC reduction protocol. A Fort Belknap community member will be trained as a COHW to deliver culturally sensitive health behavior change counseling and case management. Aim 3: Assist and support the Aaniiih Nakoda College in the development of the systems and infrastructure necessary to establish an accredited Community Dental Health Coordinator training program. Sustainability ofthe COHW model depends on the ability of the Tribes to reliably continue to attract qualified COHWs. COHW's who graduate from an accredited school instead of receiving on-the-job training (as proposed in Aim 2) are able to provide direct billable dental services in lieu of a dentist. Assisting the Tribes in acquiring a COHW with formal training (termed a Community Dental Health Coordinator, or CDHC) and a confinued source of qualified COHWs will result in a sustainable intervention adaptable to other tribes.