Examining impacts of structural racism and discrimination on Hispanic treatment differences and oral health disparities; known internally as "Smiles of Hope - Proyecto Hispanico de Esperanza" (SoPHE)

项目摘要/摘要（30行文本）：西班牙裔人口最多（>18%） 美国人口增长最快的非多数族裔群体，其中约一半是 非美国出生。西班牙裔儿童患龋齿的可能性高出三倍 比白色儿童，影响生活质量和学校学习和准备。电流 西班牙裔人群的口腔健康知识检查了个体因素， 文化和文化适应，但关于结构性种族主义和 缺乏对口腔健康治疗和结果的性别歧视（SRD）因素。虽然 西班牙裔儿童患龋率较高，初步研究显示， 白色和西班牙裔儿童的预防和牙科治疗就诊率。的目标 该提案旨在评估西班牙裔美国人在口腔健康治疗方面的地区差异 儿童与非西班牙裔白色儿童相比，作为个体水平上SRD的衡量标准 随后的龋齿发病率和增量，通过两个定量（二级数据分析） 以社区为基础的定性方法（焦点小组）。我们的研究将是第一个 使用有待验证的邮政编码级别的措施评估SRD对口腔健康的影响 与种族/民族居住隔离有关。该项目旨在研究 提供的口腔健康治疗（例如，预防、恢复、约束、镇静、提取）， 作为SRD指标，并对西班牙裔儿童的口腔健康结果产生影响 与使用多州纵向口腔健康数据集的白色儿童相比。研究人员将 还评估邮政编码级SRD变量（例如，儿童机会指数，种族/民族机会 差距、公民身份和有限的英语熟练程度百分比）作为潜在的效应修饰语 作为SRD措施提供的口腔健康治疗与 西班牙裔儿童的口腔健康结果（龋齿发病率）。焦点小组将 与西班牙裔家庭（包括移民，英语能力有限的人， 和非公民），以更深入地了解多层次的SRD因素是如何 成年人为自己和子女所遭受的痛苦，特别是在获得 牙科护理，治疗方案和口腔健康结果;以及家庭，组织， 社区和社区保护因素帮助人们克服SRD障碍， 优化口腔健康。这项研究具有重要意义，因为它将提供更深入的 了解SRD如何影响西班牙裔口腔健康，并确定潜在的保护因素 这可以为制定干预措施提供信息，以解决与口腔护理不公平有关的问题。

Project Summary/Abstract (30 lines of text): The Hispanic population is the largest (>18%) and fastest growing non-majority ethnic group in the United States (US), about half of whom are non-US born. Hispanic children are three times more likely to have dental caries experience than White children, impacting quality of life and school learning and readiness. Current knowledge around oral health in Hispanic populations examines individual factors such as culture and acculturation, but research regarding the effect of structural racism and discrimination (SRD) factors on oral health treatments and outcomes is lacking. Although Hispanic children have higher rates of caries, initial research shows a discrepancy between rates of preventive and dental treatments visits for White and Hispanic children. The objective of this proposal is to evaluate area-level differences in oral health treatments provided to Hispanic children compared to non-Hispanic White children as a measure of SRD on individual-level subsequent caries incidence and increment through both quantitative (secondary data analysis) and community-based qualitative methods (focus groups). Our research would be the first to assess the impact of SRD on oral health using to-be-validated ZIP code-level measures associated with racial/ethnic residential segregation. This project aims to examine differences in oral health treatments provided (e.g., prevention, restoration, restraint, sedation, extraction) to be used as an SRD measure, and impacts on oral health outcomes among Hispanic children compared to White Children using multistate longitudinal oral health datasets. Researchers will also assess ZIP code-level SRD variables (e.g., child opportunity index, racial/ethnic opportunity gap, citizenship status, and limited English proficiency percentage) as potential effect modifiers of the relationship between oral health treatments provided as an SRD measure and impacts on oral health outcomes (caries incidence) among Hispanic children. Focus groups will be conducted with Hispanic families (including immigrants, people with limited English proficiency, and non-citizens) to gain a deeper understanding of how multi-level SRD factors are experienced among adults for themselves and their children, especially relating to access to dental care, treatment options, and oral health outcomes; and which family, organizational, neighborhood, and community protective factors help people overcome SRD barriers to help optimize their oral health. This research has significant implications, as it will provide a deeper understanding of how SRD affects Hispanic oral health and identify potential protective factors that could inform intervention development to address issues related to inequities in oral care.