Birth to Three – Cavity Free: Effectiveness of a Psychoeducational Intervention for ECC Prevention

项目总结/摘要 项目名称：“无三腔分娩：心理教育干预的有效性 ECC预防” 幼儿龋齿（ECC）是一种潜在的痛苦和衰弱的疾病，它代表了一个 这是一个严重公共卫生问题。幼儿保育的经验有很大的差异 少数民族和低收入家庭的儿童患这种疾病的比例过高 负担高ECC风险幼儿的父母在牙科设施寻求预防的可能性很低; 因此，有必要在这些儿童已经寻求健康的地方增加预防性牙科机会 护理服务。特别是，迫切需要开发和评估ECC行为干预措施， 在有高危儿童的公共卫生环境中使用。许多作者建议尽早实施 口腔健康教育作为预防ECC的一种手段。然而，在口腔健康讨论的主要问题 推广文学涉及缺乏有效性的计划，仅基于教育，以及缺乏 高质量的预防性干预措施，使用循证心理和行为策略。 我们的研究团队是第一个将自我决定引入ECC预防竞技场的 理论（SDT）的动机，内化，和健康的运作，证明有效地促进积极的 在其他几个领域的行为改变，包括口腔保健。我们已经证明，SDT具有很大的 根据我们的R21（R21-DE 016483）结果，通过提供证据承诺作为激励方法 研究，SDT在改变几种理想的口腔健康行为以预防ECC方面的有效性。 基于我们过去几年的经验和形成性研究工作的严谨性， 提出了一个第二阶段NIH模型研究项目，将比较的疗效， 由SDT框架的口腔健康信息录像到更传统的中性录像信息。我们打算 招募634名孕妇参加爱荷华州妇女、婴儿和儿童（WIC）补充营养 程序和遵循他们，直到他们未来的孩子是36个月大。关注的主要结果将是 儿童龋齿状况。次要结果将是儿童口腔健康行为的变化， 更好的口腔卫生和饮食习惯，以及更低的牙菌斑和变形链球菌水平。

PROJECT SUMMARY/ABSTRACT Project Title: “Birth to Three – Cavity Free: Effectiveness of a Psychoeducational Intervention for ECC Prevention” Early childhood caries (ECC) is a potentially painful and debilitating disease, which represents a significant public health problem among young children. There are profound disparities in ECC experiences such that children from minority and low-income families suffer a disproportionate share of the disease burden. The likelihood of parents of high-ECC risk young children seeking prevention in dental facilities is low; therefore, there is a need to increase preventive dental opportunities where these children already seek health care services. In particular, there is an urgent need to develop and evaluate ECC behavioral interventions for use in public health settings attended by high-risk children. Many authors recommend early implementation of oral health education as one means of preventing ECC. However, major issues discussed in the oral health promotion literature involve a lack of effectiveness among programs based on education alone, as well as a lack of high quality preventive interventions using evidence-based psychological and behavioral strategies. Our research team has been the first to introduce to the ECC prevention arena the self-determination theory (SDT) of motivation, internalization, and healthy functioning, proven effective in promoting positive behavioral changes in several other fields, including oral health care. We have demonstrated that SDT has great promise as a motivational approach by providing evidence, based on results from our R21 (R21-DE016483) study, of the effectiveness of SDT in changing several desirable oral health behaviors for ECC prevention. Building upon the rigor of our previous experience and formative research work in the past several years, we propose a Stage II NIH Model research project that will compare the efficacy of autonomy-supportive videotaped oral health messages framed by SDT to more traditional neutral videotaped messages. We intent to recruit 634 pregnant mothers enrolled in Iowa Women, Infants and Children (WIC) Supplemental Nutrition Programs and follow them until their future child is 36 months old. The primary outcome of interest will be children's caries status. Secondary outcomes will be changes in children's oral health behaviors conducive to better oral hygiene and dietary habits, as well as lower levels of dental plaque and mutans streptococci.