Relationship of Parental Health Literacy with Change Over Time in Oral Health Outcomes Among American Indian Children

项目摘要 “健康素养”（HL）是指“获得、处理和理解基本健康信息的能力 以及做出适当健康决定所需的服务。”在美洲印第安人和阿拉斯加原住民中， 48%的成年人有有限的HL。考虑到限制性HL与以下因素有关，这种高限制率令人担忧： 不良的健康相关知识、态度、行为和结果。虽然很明显，HL的局限性 与儿童的次优结果有关，很少有研究探讨了 父母HL（PHL）和儿童口腔健康。此外，由于先前的研究使用了横截面数据， 目前尚不清楚PHL是否与儿童口腔健康随时间的变化有关。该项目的目标是 研究PHL与儿童口腔健康结果随时间变化的相关性，并阐明 解释PHL-结果关系的机制。PHL的作用将在以下样本中进行探讨： 美国印第安人，口腔健康状况不佳的风险人口。事实上，到5岁时，75%的土著儿童 蛀牙利用NIDCR资助的项目“促进口腔行为改变”的次级数据， 美国印第安母亲和儿童的健康”（PBC; U 54 DE 019259），研究小组将使用先进的 分析技术，以测试一个理论框架，旨在澄清机制，通过PHL是 与儿童口腔健康结果有关。父母口腔健康知识、态度、 行为将被检查。PBC项目是一项随机对照试验，旨在测试 对父母口腔健康知识、态度、行为和儿科口腔的动机性访谈干预 健康成果。分析样本将包括575个父母-孩子二人组，当孩子是一个 新生儿，随访3年。本研究的具体目的如下：（1）利用基线数据， 评估PHL与父母口腔健康知识、态度和行为的关系;（2）使用 纵向数据，确定基线PHL与父母口腔健康随时间变化的关系 知识，态度和行为，并与儿科口腔健康结果;和（3）确定是否 提出的理论框架准确地解释了基线PHL之间的关系;父母的口腔健康 知识，态度和行为;和儿科口腔健康结果。该项目将是第一个 研究PHL与儿童口腔健康结果随时间变化的关系，并阐明 解释这种关系的机制。由于PHL综合概念模型的测试尚未 该研究的结果将推进与PHL相关的科学，并为有效的 美国印第安人和其他高危人群的口腔健康干预措施。此外，这项工作将 提供PHL在土著社区口腔健康中发挥作用的关键评估， 有限的PHL和儿童口腔健康结果差。该项目涉及NIDCR的目标， 口腔健康的差异，并检查风险因素和口腔健康行为改变的机制。

Project Summary “Health literacy” (HL) refers to “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” Among American Indians and Alaska Natives, 48% of adults have limited HL. This high rate of limitations is concerning given that restricted HL is related to poor health-related knowledge, attitudes, behaviors, and outcomes. Although it is clear that HL limitations among parents are related to suboptimal outcomes in children, few studies have examined the link between parental HL (PHL) and children's oral health. Further, because prior studies have used cross-sectional data, it is unclear whether PHL is related to change over time in children's oral health. The objective of the project is to investigate the association of PHL with change over time in pediatric oral health outcomes and to clarify the mechanisms that explain the PHL-outcomes relationship. The role of PHL will be explored in a sample of American Indians, a population at risk for poor oral health. Indeed, by age 5, 75% of Native children have dental decay. Using secondary data from the NIDCR-funded project “Promoting Behavioral Change for Oral Health in American Indian Mothers and Children” (PBC; U54DE019259), the research team will use advanced analytic techniques to test a theoretical framework designed to clarify the mechanisms through which PHL is linked to pediatric oral health outcomes. The mediating roles of parental oral health knowledge, attitudes, and behavior will be examined. The PBC project is a randomized controlled trial designed to test the impact of a motivational interviewing intervention on parental oral health knowledge, attitudes, behavior, and pediatric oral health outcomes. The analysis sample will include 575 parent-child dyads recruited when the child was a newborn and followed for 3 years. The specific aims of the study are the following: (1) Using baseline data, assess the relationship of PHL with parental oral health knowledge, attitudes, and behavior; (2) Using longitudinal data, determine the relationship of baseline PHL with change over time in parental oral health knowledge, attitudes, and behavior, and with pediatric oral health outcomes; and (3) Determine whether the proposed theoretical framework accurately explains the relationships among baseline PHL; parental oral health knowledge, attitudes, and behavior; and pediatric oral health outcomes. The proposed project will be the first to examine the association of PHL with change over time in children's oral health outcomes and to clarify the mechanisms that explain that relationship. As testing of a comprehensive conceptual model of PHL has not been conducted, the study's results will advance science related to PHL and inform development of effective oral health interventions for American Indians and other high-risk populations. In addition, this work will provide a critical evaluation of the role PHL plays in the oral health of Native communities, a population at risk for limited PHL and poor pediatric oral health outcomes. The project addresses NIDCR's aims to overcome disparities in oral health and to examine risk factors and mechanisms of behavior change in oral health.