Early Childhood Caries and Storytelling in American Indian Communities

美洲印第安人社区的儿童早期龋齿和讲故事

• 批准号: 8243398
• 负责人: Kristal Lea Chichlowska
• 金额: $ 15.67万
• 依托单位: CALIFORNIA RURAL INDIAN HEALTH BOARD
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-17 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8243398
• 关键词: 11 year old; 4 year old; Academy; Address; Affect; Age; Age-Months; American; American Indian and Alaska Native; American Indians; Area; Behavior; Belief; Birth; California; Caries prevention; Child; Chronic; Clinical; Communities; Dental; Dental caries; Eating; Education; Epidemiology; Ethnic group; Family; Funding; Future; Goals; Health; Health Promotion; Health behavior; Housing; Indigenous; Infection; Intervention; Intervention Studies; Knowledge; Language Development; Lead; Lesion; Life; Longevity; Maintenance; Methods; Minority Groups; Mothers; National Institute of Dental and Craniofacial Research; Nature; Oral; Oral health; Outcome; Pain; Pediatric Dentistry; Pit and Fissure Sealants; Population; Pregnant Women; Prevalence; Prevention program; Preventive Intervention; Public Health; Quality of life; Race; Recruitment Activity; Reporting; Research; Risk Factors; Rural; San Francisco; Socialization; Speech Development; Streptococcus mutans; Structure; Surgeon; Surveys; Target Populations; Testing; Time; Tooth Diseases; Tooth structure; Toothpaste; Universities; Water fluoridation; Woman; aged; base; cariogenic bacteria; community based participatory research; deciduous tooth; design; disorder prevention; early childhood; early onset; improved; innovation; novel; population based; post intervention; prevent; racial and ethnic; tooth surface; transmission process; treatment program; tribal community; tribal organization

DESCRIPTION (provided by applicant): Despite advances in population-based interventions to prevent dental caries, the prevalence of ECC in children is increasing and disproportionately affects children from racial and ethnic minority groups. ECC is a significant public health problem in American Indian/Alaska Native (AI/AN) children: it's highly prevalent, more severe and occurs earlier in the lifespan compared to other race/ethnic groups in the US. This underscores an urgent need for effective, culturally- appropriate oral health promotion, disease prevention and treatment programs for AI/AN children. This project, uses community-based participatory research principles and takes advantage of the strengths of the partnership among the California Tribal Epidemiology Center and the California Dental Support Center, both housed at the California Rural Indian Health Board, and the Center to Address Disparities in Children's Oral Health at the University of California, San Francisco. We will implement an innovative storytelling intervention to prevent ECC by partnering with tribal organizations in three areas in northern California and by specifically targeting mothers because they influence ECC risk factors earliest in the lifespan. The purpose of this research is to develop and evaluate a culturally-tailored intervention that incorporates key oral health messages in the indigenous practice of storytelling intended to provide education on ECC risk factors and promote positive oral health behaviors. The proposed intervention includes a story told by a traditional storyteller indigenous to California in a talking circle format. The primary research question to be answered is whether this culturally- tailored, novel intervention is a feasible and acceptable one for improving knowledge, beliefs and behaviors regarding ECC among self-identified age 18 and older AI/AN pregnant women or mothers of children aged 0-71 months. The secondary research question is whether positive effects can be detected from the intervention and the specific aim is to document the effects of the structured intervention for increasing knowledge, beliefs, and positive oral health behaviors through pre-test and two post-test surveys. Outcomes will be assessed immediately after the intervention (post-test 1) and 6 months later (post-test 2) to examine maintenance. This project is important because it will help inform future intervention studies that may include both oral health promotion and clinical interventions for families and their communities to reduce ECC in AI/AN populations. PUBLIC HEALTH RELEVANCE: Among American Indians/Alaska Natives, Early Childhood Caries (ECC) begins at younger ages, is more frequent (68% in 2-4 year olds compared to 11% in the general US population; DHHS, 2000) and presents itself more severely than other US populations. The proposal implements a storytelling intervention to prevent ECC by partnering with tribal organizations and by specifically targeting mothers because they influence ECC risk factors earliest in the lifespan. If storytelling in a talking circle format is feasible and acceptable by this target population, then this culturally-appropriate strategy can be further extended to families and the community to promote oral health.

描述（由申请人提供）：尽管预防龋齿的基于人群的干预措施取得了进展，但儿童 ECC 的患病率仍在增加，并且对少数种族和族裔群体的儿童产生了不成比例的影响。 ECC 是美洲印第安人/阿拉斯加原住民 (AI/AN) 儿童中的一个重大公共卫生问题：与美国其他种族/族裔群体相比，ECC 非常普遍、更严重且发生在生命周期中更早。这凸显了针对 AI/AN 儿童的有效且适合文化的口腔健康促进、疾病预防和治疗计划的迫切需要。该项目采用基于社区的参与性研究原则，并利用加州部落流行病学中心和加州牙科支持中心（均设在加州农村印第安人健康委员会）和解决儿童残疾问题中心之间的合作优势。加州大学旧金山分校的口腔健康。我们将通过与北加州三个地区的部落组织合作，并专门针对母亲，实施创新的讲故事干预措施，以预防 ECC，因为她们在生命周期中最早影响 ECC 风险因素。本研究的目的是开发和评估一种根据文化定制的干预措施，将关键的口腔健康信息纳入本土讲故事的实践中，旨在提供有关 ECC 风险因素的教育并促进积极的口腔健康行为。拟议的干预措施包括由加州土著传统讲故事者以谈话圈的形式讲述的故事。要回答的主要研究问题是，这种根据文化量身定制的新颖干预措施对于提高自我认定年龄为 18 岁及以上的 AI/AN 孕妇或 0 岁儿童母亲有关 ECC 的知识、信念和行为是否可行且可接受。 -71个月。第二个研究问题是是否可以从干预中检测到积极效果，具体目的是通过预测试和两次测试后调查来记录结构化干预对于增加知识、信念和积极口腔健康行为的效果。干预后（测试后 1）和 6 个月后（测试后 2）将立即评估结果，以检查维护情况。该项目很重要，因为它将有助于为未来的干预研究提供信息，这些研究可能包括口腔健康促进和家庭及其社区的临床干预，以减少 AI/AN 人群中的 ECC。 公共健康相关性：在美洲印第安人/阿拉斯加原住民中，儿童早期龋齿 (ECC) 开始的年龄较小，更为常见（2-4 岁儿童中 68%，而美国普通人群中这一比例为 11%；DHHS，2000 年）并且呈现出其自身比其他美国人口更严重。该提案实施讲故事干预措施，通过与部落组织合作并专门针对母亲来预防 ECC，因为她们在生命周期中最早影响 ECC 风险因素。如果以谈话圈的形式讲故事是可行的并且被目标人群所接受，那么这种适合文化的策略可以进一步扩展到家庭和社区，以促进口腔健康。