Oral Health Disparities: Actions Taken About Pain

口腔健康差异：针对疼痛采取的行动

• 批准号: 7111395
• 负责人: JOSEPH L RILEY
• 金额: $ 5.91万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7111395
• 关键词: African American; Hispanic Americans; analgesia; behavioral /social science research tag; caucasian American; clinical research; dental disorder; dental health services; health behavior; health care policy; health care service utilization; health disparity; health services research tag; interview; longitudinal human study; pain; racial /ethnic difference; self medication

DESCRIPTION (provided by applicant): One of the primary goals of Healthy People 2010 is to eliminate health disparities among different segments of the population, with substantial emphasis given to disparities associated with race and ethnicity. The recent, first-ever Surgeon General's Report on Oral Health addresses the inequities and disparities among those least able to achieve optimal oral health, and relates the consequences as leading to needless pain and suffering. Studies show that pain is the most commonly reported impact of oral disease and is more strongly associated with perceived need for care, actual dental care, and diminished quality of life than other subjective signs or symptoms. We have conducted community-based studies that provide evidence that US minority adults are at increased risk for orofacial pain and are less likely to use oral health services in response to pain. However, there is little known about the interplay between race and ethnicity with individual, social, and economic characteristics as determinants of taking therapeutic action for orofacial pain. This project proposes to examine common and unique mechanisms underlying decisions to seek care or self-manage orofacial pain with a sampling strategy that will allow for comparisons among race and ethnic subgroups. Along with African- Americans, we have targeted Hispanic adults, a group that is particularly understudied regarding painful oral symptoms, given that they represent the fastest growing ethnic group in America. The aims of this study are to test hypothesis regarding: 1) Differences in the action taken to manage orofacial pain between minority Americans and non-Hispanic Whites; 2) That race and ethnicity interact with the sensory, emotional, and temporal characteristics of pain, behavioral and emotional impacts, and attitudes and beliefs about care as predictors of visiting a health care professional, engaging in pain self-management, or talking to others about pain. The study design will be a cross-sectional baseline study with a prospective longitudinal panel. We will conduct telephone interviews with a representative probability sample of community-dwelling adults, which will include oversampling of Hispanics and African-Americans within Miami-Dade, Broward, and Palm Beach counties in the state of Florida. Florida's population is rapidly increasing in both size and ethnic diversity and offers a unique opportunity to examine the interethnic differences in the actions taken to manage oral pain. This study proposes to use the Andersen Behavioral Model of Health to account for predisposing, enabling, and need characteristics as predictors of the targeted health enhancing behaviors. Unique contributions of this project will be the use of a validated model of health care use, the inclusion of a broad range of health behaviors (health care visits across multiple disciplines, self-care behaviors, and communicating with others), and the inclusion of Hispanic Americans. As culture can have a significant impact on the subjective experience of illness, differences in response to painful symptoms may help explain differences in behavioral options considered (or not considered) in response to oral disease. This information has important health policy implications for reducing the race and ethnic disparities in oral health through interventions that facilitate access to care and utilization of appropriate services.

描述（由申请人提供）：2010年健康人的主要目标之一是消除不同人口各个部门之间的健康差异，重点是与种族和种族相关的差异。最近的第一个外科医生关于口腔健康的报告解决了最不能力实现最佳口腔健康的人之间的不平等和差异，并将后果联系起来是导致不必要的痛苦和痛苦。研究表明，与其他主观体征或症状相比，疼痛是口腔疾病的最常见影响，与对护理，实际牙科护理的需求，实际牙科护理和生活质量下降更密切相关。我们进行了基于社区的研究，提供了证据表明，美国少数族裔成年人患口腔疼痛的风险增加，并且不太可能响应口腔健康服务来应对疼痛。但是，关于种族与种族与个人，社会和经济特征之间的相互作用鲜为人知，这是采取治疗性痛苦的决定因素。该项目提议通过采样策略来研究寻求护理或自我管理的口语疼痛的共同和独特的机制，这将允许在种族和族裔亚组之间进行比较。我们与非洲裔美国人一起瞄准了西班牙裔成年人，鉴于他们代表着美国增长最快的族裔，该群体对痛苦的口腔症状进行了尤为研究。这项研究的目的是检验有关：1）在管理少数族裔美国人和非西班牙裔白人之间采取的行动的差异； 2）种族和种族与痛苦，行为和情感影响的感官，情感和时间特征相互作用，以及对护理的态度和信念，作为参观医疗保健专业人员，从事痛苦自我管理或与他人交谈的预测指标关于疼痛。研究设计将是一项具有前瞻性纵向面板的横断面基线研究。我们将对佛罗里达州的迈阿密戴德，布劳沃德和棕榈滩县内的社区成年人的代表性概率样本进行电话采访，其中包括对西班牙裔和非洲裔美国人的过度采访。佛罗里达州的人口的规模和种族多样性都在迅速增加，并提供了一个独特的机会来检查管理口腔疼痛所采取的行动的种族间差异。这项研究建议使用安德森的健康行为模型来解释易感性，启用和需要特征，作为目标健康增强行为的预测因素。该项目的独特贡献将是使用经过验证的医疗保健模型，包括广泛的健康行为（跨多个学科，自我保健行为以及与他人沟通的医疗保健访问）以及包括西班牙裔美国人。由于培养物可以对疾病的主观经历产生重大影响，因此对疼痛症状的反应差异可能有助于解释响应口腔疾病的行为方案（或未考虑）的行为方案的差异。该信息通过促进获得护理和利用适当服务的干预措施来减少口腔健康的种族和种族差异具有重要的健康政策影响。