SAN FRANCISCO MATERNAL AND CHILD ORAL HEALTH "PRIME" PROJECT

描述（由申请人提供）：幼儿龋齿（ECC）在幼儿中非常普遍，特别是在服务不足的人群中。然而，既没有好的工具，以确定个别儿童的风险，也没有方法，以改善家长的预防性口腔健康行为的发展。这项研究，“预防，风险，干预，管理和评估”（PRIME）项目将a）寻求为0-5岁儿童的龋齿风险评估工具建立科学基础，B）确定龋齿风险因素的识别是否可以与激励母亲改善与儿童相关的口腔健康行为联系起来。该提案的主要目标是测试和建立一个可信的科学基础，为母亲/护理人员和婴儿的龋齿风险评估工具。我们将修改目前用于成人的龋齿管理风险评估工具（CAMBRA），并将其修改为0-3岁的儿童。对婴儿评估的修改建议包括使用唾液细菌测定。我们将在Precede-Proceed模型中“测试”细菌唾液测定作为强化因子（参见B5）。我们已经制定了一个战略，“二人组”的母亲和婴儿一起作为一个核心的参与对。这一策略将有助于理解需要为母亲和婴儿制定统一的方法，作为婴儿口腔护理访视和风险评估的一部分。通过开发一种特定年龄的风险评估方法，将风险因素，保护因素和临床结果与唾液分析的二分体，我们将制定一个前瞻性的全面干预健康促进和疾病预防，是适合我们的服务不足，城市社区的美洲原住民和西班牙裔妇女和他们的婴儿。该提案的目的是检查基线龋齿风险状态与幼儿基线口腔健康状态之间的相关性，这些幼儿已使用修改后的龋齿风险评估管理工具（CAMBRA）进行分类，该工具目前用于成人，使用现有数据针对0-5奥尔兹及其母亲。我们将确定父母对特定口腔健康行为的偏好，这些行为与CAMBRA家庭护理工具的总体评估相对应，并转化为护理人员的自我管理目标，以改善婴儿的口腔健康状况。此外，我们还将分析收到父母和儿童的口腔细菌水平结果对父母在评估时和3个月后的随访访视时对其子女口腔健康实践偏好的影响，同时收到细菌水平结果。从出生后第一年开始，早期筛查和识别龋齿发展迹象，将识别出有患ECC风险的婴儿和幼儿，并将有助于提供适当的治疗计划和周期性量表。从出生后第一年开始进行早期筛查和识别龋齿发展的迹象，将识别有发展ECC风险的婴儿和幼儿，并将有助于提供适当的治疗计划和周期量表。长期目标是双重的：（1）为0-5奥尔兹开发一个全面的龋齿风险评估CAMBRA工具;（2）为纵向前瞻性研究创建框架，在该框架中，成功地测试和实施特定的行为模型。

DESCRIPTION (provided by applicant): Early childhood caries (ECC) is very prevalent among young children, particularly in underserved populations. However, neither good tools for identifying individual children at risk nor methods for improving parental preventive oral health behaviors are well developed. This study, "Prevention, Risk, Intervention, Management and Evaluation" (PRIME) Project will a) seek to develop a scientific foundation for a caries risk assessment tool for 0-5 year old children and b) determine if identification of caries risk factors can be tied to motivating mothers to improve child-related oral health behaviors. The major goals of this proposal are to test and establish a credible scientific foundation for a caries risk assessment tool for mothers/caregivers and infants. We will modify the Caries Management by Risk Assessment tool (CAMBRA) currently used for adults and modify it for children aged 0-3 years. Suggestions for modifications for assessment of infants include the use of salivary bacterial assays. We would "test" bacterial salivary assays as reinforcing factors in the Precede-Proceed model (See B5). We have developed a strategy for "dyads" of mother and infant together as part of a nucleus of participating pairs. This strategy would help understand the need to develop a uniform approach for mother and infant together as part of an Infant Oral Care visit and risk assessment. By developing an age-specific approach of risk assessment that incorporates risk factors, protective factors and clinical findings with salivary assays of the dyads, we would then develop a prospective comprehensive intervention on health promotion and disease prevention that is appropriate for our underserved, urban community of Native Americans and Hispanic women and their infants. The aims of this proposal will be to examine the association between baselines caries risk status compared to baseline oral health status of young children who have been classified with a modified Caries Management by Risk Assessment tool (CAMBRA), which is currently used for adults, targeting 0-5 year olds and their mothers using extant data. We will determine parental preferences for specific oral health behaviors that correspond to the overall assessment of the CAMBRA instrument for homecare translated into self management goals for the caregiver targeted to improve the oral health status of their infants. In addition we will analyze the influence of receiving the results of the parent(s)' and children's oral bacterial levels on parent's preferences of oral health practices for their children at the time of their assessment and at a follow-up 3 months later visit, while receiving the bacterial level results. Early screening and recognition for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing appropriate treatment plan and periodicity scale. Early screening and recognition for signs of caries development, starting from the first year of life, will identify infants and toddlers who are at risk of developing ECC and will assist in providing appropriate treatment plan and periodicity scale. The long term goals are dual: (1) to develop a comprehensive caries risk assessment CAMBRA instrument for 0-5 year olds and (2) to create the framework for a longitudinal prospective study where specific behavioral models are tested and implemented successfully.