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）：全国范围内，2 至 11 岁儿童的蛀牙现象正在增加，特别是在贫困人口和少数民族人口中，“健康人民 2020”目标不太可能实现。 12 个州已强制要求公立小学的儿童进行牙科筛查，并得到美国和国际组织的认可。然而，尽管人们对这一概念充满热情，但筛查和转诊作为让父母和看护者带孩子去看牙医的工具并没有发挥作用。该申请旨在支持一项 II 期随机临床试验的规划，以评估转诊方法对提高有紧急/恢复需求的内城区小学生牙科就诊率（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——自我调节常识模型（CSM）和计划行为理论（TPB），可以与学校项目中的儿童干预措施结合使用。 R34 研究的目标将分两个阶段进行：(1) 试点阶段，验证修改后的疾病认知调查问卷 - 修订版 (IPQ-RD)，以了解龋齿、干预措施的可接受性和实施情况、获得护理的中介者和调节者；社区组织和提供者的焦点小组，以确定可纳入实验干预的有利资源；并测试有关教育材料的适当性/准确性的实验干预； (2) 规划阶段主要致力于 U01 提交所需的主要规划活动，包括制定研究方案、操作手册、机构审查委员会申请及其相关材料。 R34 的样本量包括从俄亥俄州克利夫兰市内城区学区的 5 所小学招募的 120 名幼儿园、一年级和二年级儿童的照顾者，以及来自多个社区机构或提供商的 10 至 20 名关键信息提供者。数据收集包括针对护理人员的半结构化一对一访谈和问卷调查以及针对社区/提供者信息提供者的焦点小组。数据分析将利用混合方法设计（基础理论和理论驱动）来处理定性数据，并利用描述性/分析统计来处理定量数据。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转诊方法来改变筛查项目的公共卫生实践标准。这个跨学科研究团队包括来自凯斯西储社区牙科系和华盛顿大学西北减少口腔健康差异中心的教师。公共健康相关性：拟议的研究提出了一种以前从未尝试过的转诊过程的创新行为方法，以解决三个护理人员问题 - (1) 无龋乳牙对于保护恒牙的重要性 (2) 将龋齿视为一种慢性疾病而不是急性或偶发性的； (3) 牙科护理资源导航。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。