Community Oral Health Interventions Program

描述(由申请人提供)：拟议的社区口腔健康干预计划(COHIP)的目的是开发和实施一个减少口腔健康差距的综合模式。COHIP的愿景、使命和设计框架是根据社区合作伙伴的直接意见和底特律牙科健康项目(DDHP)的结果制定的，底特律牙齿健康项目是由NIH资助的差异研究中心。DDHP已经有了一个了解口腔健康差异决定因素的成功模式，并建立了强大的社区和组织基础。到目前为止，DDHP已经发表了19篇参考出版物，3篇博士论文和2篇硕士论文。此外，DDHP核心领导层在过去6年中管理了一个复杂的研究项目，重点是低收入非裔美国儿童的家庭。DDHP的调查结果强调了多层次干预的必要性。根据渥太华和雅加达的健康促进宣言，COHIP旨在干预口腔健康差异的关键社会、行为和临床因素。COHIP将专注于围绕两个联邦合格健康中心拥有的四家牙科诊所建立健康社区。在每个诊所周围，将选择最低收入人口普查区域，目标是16,023名0-11岁儿童及其照顾者。选定的地区将被分成几个小的家庭集群，并随机分为干预组和对照组。COHIP包括三个针对相同家庭的分组随机示范试验。一个项目将旨在干预龋齿的社会、行为和生物决定因素；另一个项目将专注于解决DDHP分析中发现的一个主要问题，即接受护理的儿童在2年内有很大比例的空洞牙齿表面未得到治疗；第三个项目将专注于通过干预牙周病的社会、行为和生物风险因素来减少成人牙周病方面的显著差异。COHIP组建了一支由社会、行为、生物、牙科、医学和组织研究人员组成的多学科团队。COHIP计划在社区和临床层面进行干预。COHIP模式的可持续性是社区合作伙伴的要求。COHIP正在与FQHC业务专家合作，并得到了HRSA区域办事处、密歇根大学(100万美元赠款)和NNHOA的支持。

DESCRIPTION (provided by applicant): The aim of the proposed Community Oral Health Interventions Program (COHIP) is to develop and implement an integrated model for reducing oral health disparities. COHIP's vision, mission, and design framework were developed with direct input from community partners and the findings for the Detroit Dental Health Project (DDHP), a disparity research center funded by NIH. The DDHP has had a successful model for understanding the determinants of oral health disparities and has built a strong community and organizational foundations. The DDHP has produced so far over 19 refereed publications, 3 PhD dissertations, and 2 MSc theses. Moreover, the DDHP core leadership has managed during the last 6 years a complex research project focusing on families of low-income African-American children. The findings from the DDHP underscore the need for multi-level interventions. Following the Ottawa and Jakarta Declarations for health promotion, COHIP was designed to intervene on key social, behavioral, and clinical factors of oral health disparities. The COHIP will focus on building healthy communities around four dental clinics owned by 2 Federally Qualified Health Centers. Around each clinic the lowest income census tracts will be selected to target a population of 16,023 children aged 0-11 years and their caregivers. The selected areas will be stratified into small clusters of households and randomized into intervention and comparison groups. COHIP includes three clustered randomized demonstration trials targeting the same families. One project will aim to intervene on the social, behavioral, and biological determinants of dental caries; another will focus on resolving a major problem identified in the DDHP analyses where children who get care have a significant proportion of their cavitated tooth surfaces left untreated within 2 years of follow-up; and the third will focus on reducing the significant disparities in periodontal diseases on adults by intervening on the social, behavioral, and biological risk factors of periodontal diseases. COHIP has assembled a multi-disciplinary team of social, behavioral, biological, dental, medical and organizational researchers. COHIP plans to intervene at the community and clinical levels. Sustainability of the COHIP model is a requirement demanded by the community partners. COHIP is collaborating with FQHC operational experts and has the support of HRSA regional office, University of Michigan ($1 Million grant), and the NNHOA.