Testing a Multi-behavioral Intervention to Improve Oral Health Behaviors in the Pediatric Dental Surgery Population

测试多种行为干预措施以改善儿童牙科手术人群的口腔健康行为

基本信息

批准号：
10504758
负责人：
JOANNA BUSCEMI
金额：
$ 33.19万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-20 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10504758
关键词：
Address Adherence Adult Affect Anesthesiology Bacteria Behavior Behavior Therapy Behavioral Calories Caregivers Child Child Behavior Child Health Child Psychology Child Rearing Childhood Chronic Disease Clinical Community Health Aides Conflict (Psychology)Consumption Data Dental Dental caries Dentistry Development Diet Dietary Intervention Disease Dissemination and Implementation Dose Effectiveness of Interventions Enrollment Etiology Event Family Frequencies Future General Anesthesia Goals Health Status Health behavior Health behavior change Household Iatrogenesis Intake Intervention Knowledge Life Link Low income Measurement Measures Mediation Mediator of activation protein Medicaid Mental Health Modeling Monitor Motivation Nursery Schools Nutritional Science Operative Surgical Procedures Oral health Outcome Parents Participant Pathway interactions Pediatric Surgical Procedures Perioperative Persons Phase Pilot Projects Population Population Intervention Preschool Child Prevalence Preventive dental care Protocols documentation Provider Qualitative Research Quality of life Randomized Randomized Clinical Trials Randomized Controlled Trials Recurrence Recurrent disease Reporting Research Research Personnel Ribosomal RNA Risk Role Safety Schedule Self Efficacy Target Populations Telephone Testing Text Messaging Time Toothbrushing Training Work acceptability and feasibility aged behavior change behavior influence burden of illness catalyst clinical development dental surgery disorder risk early childhood efficacy testing evidence base experience feasibility testing follow-up health knowledge high risk improved intervention delivery longitudinal analysis lower income families nutrition obesity in children operation oral microbiome prevent primary outcome psychosocial psychosocial wellbeing racial and ethnic racial minority population recruit remote assessment rural area rural dwellers saliva sample secondary outcome social social cognitive theory stressor sugar treatment as usual treatment comparison treatment group

项目摘要

Project Summary. Vulnerable (Medicaid enrolled, low-income, minoritized, urban/rural resident) children are at high risk for severe early childhood caries (S-ECC). Treating young children for S-ECC often requires dental surgery under general anesthesia (DGA). Unfortunately, surgery is not an effective cure. A DGA event does not address underlying oral health behaviors such as tooth brushing and diet, so caries commonly recurs. Changing oral health behaviors is challenging, as parents struggle with concurrent life stressors. However, parents want to change their child’s oral health behaviors and identify that they need help to enact change at the time of a DGA event. We propose a behavioral parenting intervention to support oral health behavior change within families whose children experience the most severe disease burden at a critical point in their child’s oral health. We will develop and test the efficacy of PROTECT (Preventing Recurrent Operations Targeting Early Childhood Caries Treatment), a community health worker (CHW)-delivered, behavioral parenting intervention for preschool-aged children scheduled for DGA. The primary outcomes are frequency of tooth brushing and percent of total calorie intake from added sugar. The first session will occur in person at the time of surgery (60 minutes) and the remaining 10 sessions (30 minutes) will be delivered by phone to address barriers to engagement. The intervention will take place over a 6-month period, starting with the surgical event, with assessments measuring primary and secondary outcomes at baseline, 2 weeks, 6 months and 12-month follow up. Our investigators are experts in clinical (anesthesiology, dentistry, pediatrics, psychology, nutrition) and scientific realms (randomized controlled trials, management and analysis of longitudinal behavioral, psychosocial, and clinical outcomes, nutrition science, development of clinical interventions, dissemination and implementation). During the UG3 phase, we aim to develop PROTECT and test for feasibility and acceptability. The development of PROTECT will be informed by behavior change mechanisms of Social Cognitive Theory (SCT; e.g., positive parenting, self-efficacy, knowledge) and evidence-based behavioral parenting and dietary interventions, along with stakeholder (caregivers, providers, CHWs) input. We will identify barriers to recruitment, retention, intervention delivery, and outcome measurements. During the UH3 phase, we will test the efficacy of PROTECT compared to Usual Care (UC) to improve oral health behaviors. Participants will be randomized to receive PROTECT (n = 210) or UC (n = 210). We hypothesize that participants in the PROTECT group will increase tooth brushing and decrease added sugar intake to a greater degree than those in the UC group. Secondary outcomes and hypothesized SCT mechanisms of intervention effectiveness will also be tested. As an exploratory aim, saliva samples will be collected to assess changes to the oral microbiome from baseline to 6 months. This work fits within our broad research goal to improve children’s oral health, starting with the surgical population and potentially extending to children and adults within households.

项目摘要。严重的幼儿龋齿的高风险（S-ECC）通常需要牙科不幸的是，在全身麻醉下进行手术。解决牙齿刷牙和饮食之类的口服健康行为，因此龋齿通常会发生变化。随着父母并发挣扎，口腔健康行为具有挑战性。改变孩子的口服行为并确定他们需要帮助 DGA事件。孩子在孩子口腔健康的关键时刻承受着最严重的疾病负担。我们将开发和测试保护的功效儿童龋齿治疗），一名社会卫生工作者（CHW），交付，行为育儿干预对于预定为DGA的学龄前儿童。添加糖的卡路里摄入量的百分比将在手术时亲自发生（60个分钟），其余10次会议（30分钟）将通过电话交付，以解决障碍订婚。在基线，2周，6个月和12个月后的评估测量主要和次要结果 UP。我们的调查人员是临床专家（麻醉，牙科，儿科，心理学，营养）科学领域（纵向行为的随机对照试验，管理和分析，社会心理和临床结果，营养科学，临床干预和传播的发展以及暗示UG3阶段，我们旨在开发保护和测试可行性和接受性。保护的发展将通过社会认知理论的行为变化机制来告知（SCT；例如，积极的育儿，自我效能感，知识）和基于证据的行为陈旧和饮食干预措施以及利益相关者（护理人员，提供者，CHW）的意见。保留，国际交付和结果测量。保护与通常的护理（UC）相比，可以随机地改善参与者。接收保护（n = 210）或UC（n = 210）。比UC组的牙齿刷牙增加并减少添加的糖摄入程度。次要结果和假设的SCT @干预有效有效性也将被测试一个探索目的，将收集唾液样本，以评估从巴塞琳到口服微生物组 6个月以来，我们的整个研究目标是改善儿童的口腔健康人口，有可能延伸到家庭中的儿童和成人。