Pathways to Oral Health Among Low-income Pregnant Urban Women

城市低收入孕妇口腔健康的途径

• 批准号: 10308267
• 负责人: Stefanie L Russell
• 金额: $ 51.31万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10308267
• 关键词: Address; Advocate; Affect; Biological Process; Birds; Clinical; Collaborations; Data; Dental; Dental Care; Dental caries; Dentistry; Dentists; Discipline of Nursing; Discipline of obstetrics; Disease; Doctor of Philosophy; Environment; Equation; Female; First Pregnancy Trimester; Gender; Gingivitis; Goals; Guidelines; Gynecologic; Gynecology; Health; Hospitals; Income; Investigation; Link; Low income; Measures; Medicaid; Medical; Modeling; Mouth Diseases; New York; Oral; Oral Examination; Oral health; Outcome; Participant; Pathway interactions; Patients; Periodontitis; Postpartum Period; Predictive Factor; Pregnancy; Pregnant Women; Prenatal care; Preventive; Preventive treatment; Process; Prospective Studies; Psychologist; Psychosocial Factor; Reporting; Research; Risk; Scientist; Services; Social Behavior; Specific qualifier value; Structure; Surveys; Testing; Therapeutic; Third Pregnancy Trimester; Time; Tooth Loss; Universities; Woman; Yang; college; design; ethnic minority population; evidence based guidelines; experience; health related quality of life; healthy lifestyle; improved; innovation; pregnant; prenatal; programs; prospective; psychosocial; racial and ethnic; recruit; reproductive; sex; social; sociologist; success; theories; therapy design

Project Summary/Abstract Racial/ethnic minority and low-income women are most vulnerable to poor oral health during pregnancy. These vulnerable women are less likely than White and higher-income women to utilize dental care during pregnancy. However, pregnancy is often the only time when these women can access dental care through the Medicaid program. National evidence-based guidelines advocate for dental care during pregnancy to improve oral health. However, prenatal oral health programs designed to increase dental utilization among vulnerable pregnant women have had disappointing results. The major obstacle to identifying upstream barriers to downstream dental care utilization during pregnancy is the lack of longitudinal data on factors that predict dental care utilization and oral health in vulnerable women. This study is informed by the Theory of Constrained Choice (Bird & Rieker, 1999), which posits that women’s opportunities to create a healthy lifestyle are constrained due to social and gender-related processes that interact with biological processes (e.g., pregnancy). This study will leverage an ongoing interprofessional collaboration between the New York University College of Dentistry and the Bellevue Hospital Obstetrics and Gynecology Service. We will collect survey data on socio-behavioral and psychosocial factors common in these vulnerable women during the first trimester of pregnancy. We will conduct clinical oral examinations to evaluate tooth loss, dental caries, gingivitis and periodontitis and will refer all women for dental care. We will re-survey and re-examine these women during the third trimester of pregnancy and will use Medicaid claims to evaluate dental care utilization. We will use cross-sectional and longitudinal structural equation modeling to identify socio-behavioral and psychosocial predictors of dental care utilization and oral health during pregnancy. This project explicitly addresses RFA-OD-19-029’s call to examine sex and gender influences on oral health and oral disease and expand research on female-specific conditions and diseases, including reproductive stages and maternal and gynecologic health. This research will elucidate which factors must be addressed when designing interventions to improve dental care utilization and oral health outcomes among pregnant women at elevated risk for oral disease. This study is the first step in addressing our long-term goal to improve the oral health of vulnerable women by intervening during pregnancy.

项目概要/摘要 少数种族/族裔和低收入妇女在怀孕期间最容易出现口腔健康状况不佳的情况。 与白人和高收入女性相比，这些弱势女性在生育期间利用牙科护理的可能性较小。 然而，怀孕往往是这些妇女可以通过牙科护理获得牙科护理的唯一时间。 医疗补助计划。国家循证指南提倡改善怀孕期间的牙科护理。 然而，产前口腔健康计划旨在提高弱势群体的牙齿利用率。 孕妇的结果令人失望，这是识别上游障碍的主要障碍。 怀孕期间下游牙科护理的利用是缺乏预测因素的纵向数据 弱势女性的牙科护理利用和口腔健康这项研究是基于以下理论。 约束选择（Bird & Rieker，1999），它定位了女性创造健康生活方式的机会 由于与生物过程相互作用的社会和性别相关过程而受到限制（例如， 这项研究将利用纽约之间正在进行的跨专业合作。 我们将收集大学牙科学院和贝尔维尤医院妇产科服务。 关于这些弱势妇女在第一阶段中常见的社会心理行为和社会因素的调查数据 我们将在怀孕三个月进行临床口腔检查，以评估牙齿脱落、龋齿、 牙龈炎和牙周炎，并将转介所有女性进行牙科护理，我们将重新调查和检查这些问题。 妊娠晚期的女性，将使用医疗补助索赔来评估牙科护理的利用率。 我们将使用横截面和纵向结构方程模型来识别社会行为和 该项目明确指出了怀孕期间牙科护理利用和口腔健康的心理社会预测因素。 回应 RFA-OD-19-029 呼吁检查性别和性别对口腔健康和口腔疾病的影响，以及 扩大对女性特有状况和疾病的研究，包括生殖阶段和产妇和疾病 这项研究将阐明在设计干预措施时必须考虑哪些因素。 改善口腔风险较高的孕妇的牙科护理利用率和口腔健康结果 这项研究是实现我们改善弱势群体口腔健康这一长期目标的第一步。 女性在怀孕期间进行干预。