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

贝尔纳普堡保护区3-6岁儿童口腔筛查的初步研究 据透露，47%的儿童牙齿缺失，67%的儿童多次修复，43%的儿童未经治疗 龋齿。这些数据向社区证实了他们的信念，即ECC的患病率和严重性在 他们的孩子长得高得令人无法接受。这一拟议的CBPR项目将通过以下方式解决减少ECC的目标 建立在贝尔纳普堡之间现有的、长期的和信任的关系上 社区和密歇根州立大学护理学院(MSUCON)。先验假设将通过一个 随机试验是，建议的社区口腔卫生工作者(COHW)模式将降低发病率 新的和未经治疗的龋齿的风险，并对照顾者报告的儿童口腔健康产生积极影响 练习。COHW模式将通过一系列精心规划和商定的步骤和 将由战略和创新组成五个目标：目标1：建立研究基础设施和战略 需要建立伙伴关系，使Gros Ventre和Assiniboine部落以及MSUCON能够创建和测试 可持续和有效的社区口腔卫生工作者计划，以减轻ECC的负担。 目标2：开发并在随机对照试验中测试COHW实施的ECC的有效性 简化协议。贝尔纳普堡社区成员将接受COHW培训，以提供文化上的 敏感的健康行为改变咨询和病例管理。目标3：协助和支持Aaniiih Nakoda学院在开发必要的系统和基础设施方面建立了经认可的 社区牙科健康协调员培训计划。COHW模型的可持续性取决于 部落继续可靠地吸引合格的COHW的能力。COHW从一所 经认可的学校而不是接受在职培训(如目标2所建议的)能够直接提供 代替牙医的收费牙科服务。协助部落获得正规培训的COHW (称为社区牙科健康协调员或CDHC)和受限制的合格COHW来源将 结果是一种可持续的干预措施，适用于其他部落。

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.