The Environment in Pediatric Tooth Brushing Frequency: A System Dynamics Model

描述(申请人提供)：目前，导致许多健康行为出现和维持的环境和行为过程没有在系统动力学模型中表示。缺乏这样的模型是一个问题，因为在它们被开发出来之前，没有办法确定那些改变的杠杆，这些杠杆可以最大化健康的行为，同时最大限度地减少政策阻力。目前应用的目标是开发和测试刷牙频率环境的初步系统动力学模型。刷牙是一种理想的健康行为模式，因为刷牙往往与其他健康行为同时发生，如安全带和戴头盔。因此，我们对刷牙的了解可能会推广到其他健康行为。其次，它显示出政策阻力的倾向。该应用程序的中心假设是，家庭和社区中的过程会影响儿童的刷牙行为。这一假说源于健康行为理论。审查这些过程的理由是，家庭可能是最易变和最容易获得的预防性干预目标。核心假设将在三个具体目标上得到检验。目标1是建立个人、家庭和社区层面刷牙频率的动态关系的初步模型。假设刷牙频率是由社区和家庭中表现出来的文化过程决定的。目标2是确定在最大限度地减少政策阻力的同时最大限度地刷牙的杠杆。假设干预措施应针对家庭和同龄人群体。目标3是确定模型中重要的、未指明的部分。假设模型的某些部分将被低估，并将需要来自尚不存在的研究的数据。本申请中提出的研究具有创新性，因为它利用了系统动力学建模。预计这项研究的贡献将是确定假定的监管机构，这些监管机构应该随着时间的推移进行更深入的研究。这一贡献意义重大，因为这是一项研究计划的第一步，预计该计划将导致对龋齿进行更准确的风险评估，并采取干预措施增加刷牙频率。 公共卫生相关性：该应用程序将确定导致儿童龋齿这一最常见的儿童疾病公共卫生负担的环境和行为过程。一旦针对这些过程的干预措施可用，就有望防止儿童龋齿的发展，这是2010年健康人的目标。

DESCRIPTION (provided by applicant): Currently, the environmental and behavioral processes that contribute to the emergence and maintenance of many health behaviors are not represented in system dynamics models. The lack of such models is a problem because until they are developed, there is no way to identify those levers of change that maximize healthful behavior while minimizing policy resistance. The objective of the current application is to develop and test a preliminary system dynamics model of the environment in tooth brushing frequency. Tooth brushing is an ideal health behavior to model because tooth brushing tends to co-occur with other health behaviors, such as seatbelt and helmet wearing. Thus, what we learn about tooth brushing is likely to generalize to those other health behaviors. Second, it displays policy-resistant tendencies. The central hypothesis of the application is that processes in the family and community affect tooth brushing behaviors in the child. This hypothesis is derived from health behavior theories. The rationale for examining these processes is that the family may be the most mutable and accessible target for preventive interventions. The central hypothesis will be tested in three specific aims. Aim 1 is to create a preliminary model of the dynamic relationships among individual-, family-, and community-level processes in tooth brushing frequency. It is hypothesized that tooth brushing frequency is determined by cultural processes manifested in the community and family. Aim 2 is to identify the levers that maximize tooth brushing while minimizing policy resistance. It is hypothesized that interventions should target the family and peer group. Aim 3 is to identify important, underspecified portions of the model. It is hypothesized that some portions of the model will be underspecified and will require data from studies that do not yet exist. The research proposed in this application is innovative because it utilizes system dynamics modeling. The contribution of the study is expected to be the identification of putative regulators that should be studied more intensively over time. This contribution is significant because it is the first step in a program of research that is expected to lead to the development of more accurate risk assessments for dental caries and interventions that increase tooth brushing frequency. PUBLIC HEALTH RELEVANCE: This application will identify environmental and behavioral processes contributing to the public health burden of dental caries in children, the most prevalent childhood disease. Once interventions targeting these processes become available, there is the promise that they will prevent the development of dental caries in children, a Healthy People 2010 objective.