Family intervention with caregivers of children with urgent dental needs

对有紧急牙科需求的儿童的照顾者进行家庭干预

基本信息

批准号：
8210484
负责人：
Suchitra S. Nelson
金额：
$ 29.01万
依托单位：
CASE WESTERN RESERVE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8210484
关键词：
11 year old Acute Address Behavior Behavior Therapy Behavioral Caregivers Caries prevention Caring Child Chronic Disease Clinic Clinical Clinical Protocols Communities Community Dentistry Data Data Analyses Data Collection Dental Dental Care Dental Schools Dental Staff Dental caries Dentists Development Disadvantaged Educational Materials Effectiveness Enrollment Ensure Evaluation Faculty Family Family Caregiver Fluoride Varnishes Focus Groups Future Goals Guidelines Health Health Planning Health Services Health Services Accessibility Health education Healthy People 2010 Individual Informal Social Control Institutional Review Boards International Intervention Intervention Studies Intervention Trial Interview Laws Letters Low income Manuals Mediator of activation protein Medicaid Medicine Methods Minority Modeling Monitor National Institute of Dental and Craniofacial Research Neighborhoods Ohio Oral health Parents Perception Phase Phase II Clinical Trials Pit and Fissure Sealants Planning Theory Population Prevalence Prevention program Primary Dentition Procedures Process Protocols documentation Provider Public Health Questionnaires Randomized Clinical Trials Randomized Controlled Trials Recruitment Activity Reporting Research Research Design Resources Safety Sample Size Sampling Schedule Schools Screening procedure Secure Structure Telephone Testing Thinking Tooth structure United States Health Resources and Services Administration Universities Visit Washington Writing base care seeking care systems community organizations cost effective design elementary school follow-up health disparity high risk illness perceptions improved informant inner city innovation instrument kindergarten meetings operation permanent tooth programs response second grade social soft drink statistics success theories tool trend usability

项目摘要

DESCRIPTION (provided by applicant): Tooth decay in 2 to 11 year olds is increasing nationally especially among poor and minority populations, and it is unlikely that Healthy People 2020 goals will be met. Dental screening of children in public elementary schools has been mandated in 12 states and endorsed by U.S. and international organizations. Nevertheless, in spite of enthusiasm for the concept, screening and referral has been ineffective as a tool to get parents and caregivers to take children to the dentist. This application is to support planning of a Phase II randomized clinical trial to assess the effectiveness of a referral approach to increase dental attendance (for receipt of care) among inner-city urban elementary school children with urgent/restorative needs. The intervention to be tested relies on two theoretical frameworks -Common Sense Model of Self-Regulation (CSM), and the theory of Planned Behavior (TPB) that could be used in conjunction with child-level interventions in a school-based program. The objectives of the R34 study will occur in two phases: (1) pilot phase to validate the modified illness perception questionnaire -Revised (IPQ-RD) for dental caries, acceptability and delivery of the intervention, mediators and moderators for accessing care; focus groups of community organizations and providers to identify enabling resources to be included in the experimental intervention; and testing the experimental intervention regarding appropriateness/accuracy of educational materials; (2) planning phase primarily devoted to the major planning activities required for a U01 submission including development of the study protocol, manual of operations, and Institutional Review Board application and its associated materials. The sample size for the R34 includes 120 caregivers of KG, first, and second grade school children recruited from among 5 elementary schools in an urban inner-city school district in Cleveland, OH, and 10 to 20 key informants from several community agencies or providers. Data collection involves semi-structured one-to-one interviews and questionnaire responses for caregivers and focus groups for community/provider informants. Data analysis will utilize a mixed method design (grounded theory and theory driven) for qualitative data, and descriptive/analytical statistics for quantitative data. This behavioral approach has the potential to change the public health standard of practice for screening programs by utilizing a cost-effective, easily transportable, and sustainable referral approach. The transdiscipilinary research team includes faculty from Department of Community Dentistry at Case Western Reserve and the Northwest Center to Reduce Oral Health Disparities at the University of Washington. PUBLIC HEALTH RELEVANCE: The proposed study addresses an innovative behavioral approach to the referral process never attempted before to address three caregiver issues - (1) importance of caries-free baby teeth for protection of permanent teeth (2) viewing dental caries as a chronic disease rather than acute or episodic; and (3) navigation of resources for dental care access. This behavioral approach also has the potential to change the public health standard of practice for school screening programs required by law in many states.

描述（由申请人提供）：2至11岁的年龄在全国范围内，尤其是在贫困人口和少数族裔中，有2至11岁的年轻人的蛀牙正在增加，并且不太可能实现健康的2020年目标。在12个州授权公立小学的儿童牙科筛查，并得到美国和国际组织的认可。尽管如此，尽管对这一概念充满热情，但筛查和推荐是一种使父母和照顾者带孩子去牙医的工具。该应用是为了支持一项II期随机临床试验的计划，以评估在有紧急/恢复需求的城市城市小学儿童中提高牙科出勤率（以接受护理）的有效性。要测试的干预措施依赖于两个理论框架 - 自我调节的典型感知模型（CSM），以及可以与学校计划中的儿童级干预措施一起使用的计划行为理论（TPB）。 R34研究的目标将分为两个阶段：（1）验证修改后的疾病感知问卷调查（IPQ -RD）用于牙齿龋齿，可接受性和提供干预者，调解人和调节剂的牙科服务；社区组织和提供者的焦点小组，以确定能够将资源包括在实验干预措施中；并测试有关教育材料的适当性/准确性的实验干预；（2）计划阶段主要致力于U01提交所需的主要计划活动，包括制定研究协议，操作手册以及机构审查委员会的申请及其相关材料。 R34的样本量包括从俄亥俄州克利夫兰市区城市内城市学区的5所小学中招募的120名公斤和二年级儿童的护理人员，以及来自几个社区机构或提供者的10至20位关键信息。数据收集涉及半结构化的一对一访谈，以及针对社区/提供者线人的护理人员和焦点小组的问卷回答。数据分析将用于定性数据的混合方法设计（扎根理论和理论驱动），以及用于定量数据的描述性/分析统计。这种行为方法有可能通过利用具有成本效益，易于运输和可持续的推荐方法来改变筛查计划的公共卫生实践标准。跨学科研究团队包括凯斯西部储备金和西北中心社区牙科系的教职员工，以减少华盛顿大学的口腔健康差异。公共卫生相关性：拟议的研究涉及对转诊过程的创新行为方法，从未尝试过解决三个护理人员问题 - （1）无龋齿的乳牙以保护永久性牙齿的重要性（2）将龋齿视为慢性疾病，而不是急性或情节性；（3）牙科护理通道的资源导航。这种行为方法还有可能改变许多州法律要求的学校筛查计划的公共卫生实践标准。