Integrating Social and Systems Science Approaches to Promote Oral Health Equity

整合社会科学和系统科学方法促进口腔健康公平

• 批准号: 9118946
• 负责人: CAROL KUNZEL
• 金额: $ 71.85万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9118946
• 关键词: Adopted; Adult; Age; Aging; Behavior; Biological Models; Buffers; Caring; Chronic Disease; Clinic; Communities; Comprehensive Health Care; Computer software; Coupled; Dental; Dental Care; Dentistry; Development; Diabetes Mellitus; Dimensions; Elderly; Environment; Exercise; Funding Opportunities; Geographic Information Systems; Health; Health Policy; Health Promotion and Care; Health Services Accessibility; Health behavior; Health behavior outcomes; Healthcare; Human; Hypertension; Improve Access; Individual; Investigation; Knowledge; Learning; Medical; Methodology; Methods; Minority; Modeling; Monitor; Neighborhoods; Oral health; Outcome; Pathway interactions; Patients; Periodontal Diseases; Policies; Population; Population Group; Population Heterogeneity; Research; Sampling; Science; Services; Shapes; Social Environment; Social Sciences; System; Thinking; Tooth Loss; Tooth structure; Underserved Population; United States National Institutes of Health; Work; base; built environment; care seeking; community setting; ethnic diversity; ethnic minority population; expectation; health care availability; health care delivery; health equity; healthy aging; improved; improved outcome; oral care; oral condition; peer; peer support; programs; racial diversity; racial minority; screening; social; social model; stressor; Adopted; Adult; Age; Aging; Behavior; Biological Models; Buffers; Caring; Chronic Disease; Clinic; Communities; Comprehensive Health Care; Computer software; Coupled; Dental; Dental Care; Dentistry; Development; Diabetes Mellitus; Dimensions; Elderly; Environment; Exercise; Funding Opportunities; Geographic Information Systems; Health; Health Policy; Health Promotion and Care; Health Services Accessibility; Health behavior; Health behavior outcomes; Healthcare; Human; Hypertension; Improve Access; Individual; Investigation; Knowledge; Learning; Medical; Methodology; Methods; Minority; Modeling; Monitor; Neighborhoods; Oral health; Outcome; Pathway interactions; Patients; Periodontal Diseases; Policies; Population; Population Group; Population Heterogeneity; Research; Sampling; Science; Services; Shapes; Social Environment; Social Sciences; System; Thinking; Tooth Loss; Tooth structure; Underserved Population; United States National Institutes of Health; Work; base; built environment; care seeking; community setting; ethnic diversity; ethnic minority population; expectation; health care availability; health care delivery; health equity; healthy aging; improved; improved outcome; oral care; oral condition; peer; peer support; programs; racial diversity; racial minority; screening; social; social model; stressor

DESCRIPTION (provided by applicant): Demographic shifts that include an aging and more racially and ethnically diverse population coupled with ongoing changes in the healthcare policy environment are demanding that the dental profession both redirect and expand its focus. Challenges include providing more comprehensive care for patients with complicated medical and social needs, while improving access to care for underserved population groups. In the coming years, the practice of dentistry is expected to include screening for, and monitoring of, chronic diseases such as hypertension and diabetes related to cumulative oral conditions such as tooth loss and periodontal disease. Meanwhile, expectations for dentistry by the public will require the field to develop strategies to manage the oral health of groups not now receiving adequate care, including older adults. Recent methodological developments enabled by computational advances, such as agent-based modeling, system dynamics, and geographic information systems, have spurred a body of research on the effects of multiple scales (e.g., community, interpersonal, and individual) and dimensions (e.g., built environment and social context at the community scale) on health behaviors and outcomes. Yet, because software platforms capable of combining these approaches have only recently become available, the methods have generally been applied only in isolation. In particular, little empirical work has examined how factors at multiple scales contribute to oral health and care-seeking behaviors for racial and ethnic minority older adults. Previous research conducted with racial and ethnic minority older adults who attend senior centers in underserved urban neighborhoods (hereafter referred to as urban minority senior center attendees) found lower levels of tooth loss than in US national samples. In order to learn from what is working well in this older adult population, the specific aims and hypotheses are to: (1) understand how urban minority senior center attendees utilize services such as health and dental care at the community scale to enhance their oral health; (2) identify how factors at the interpersonal scale enhance care-seeking behaviors and improve the oral health outcomes of urban minority senior center attendees; (3) examine the cultural acceptability of screening for hypertension and diabetes in the dental setting at the individual scale for urban minority senior center attendees; and (4) model the knowledge gained about factors at the community, interpersonal, and individual scales for urban minority senior center attendees in Aims 1, 2, and 3 to enhance community- and clinic-based oral health service delivery and improve oral health outcomes. These aims are consistent with the research objectives of the National Institutes of Health through Funding Opportunity Announcement PAR-11-314 to develop applied projects utilizing systems science methodologies relevant to human behaviors, social sciences, and health. Successful completion of these aims will aid in understanding how community assets shape familial and peer interactions and contribute to oral health promotion and care seeking behaviors as adult's age.

描述（由申请人提供）：人口转变，包括衰老，种族和种族多样化的人群以及医疗保健政策环境的持续变化，要求牙科专业重定向并扩大其重点。挑战包括为具有复杂的医疗和社会需求的患者提供更全面的护理，同时改善了服务不足的人群的护理机会。在接下来的几年中，牙科的实践预计包括对慢性疾病的筛查和监测，例如高血压和与累积口服疾病有关的糖尿病，例如牙齿脱落和牙周疾病。同时，公众对牙科的期望将要求该领域制定策略，以管理现在不接受适当护理的团体的口腔健康，包括老年人。由计算进步（例如基于代理的建模，系统动力学和地理信息系统）实现的最新方法论发展，促使对多个量表（例如社区，人际关系和个人）以及维度（例如，在社区规模上建立环境和社会背景）对健康行为和成果的影响（例如，社区，人际关系和个人）以及维度（例如，社区，人际关系和个人）的影响。但是，由于能够组合这些方法的软件平台直到最近才可用，因此通常仅隔离地应用了这些方法。特别是，很少的经验工作已经研究了多个尺度的因素如何促进种族和少数民族老年人的口头健康和寻求护理行为。以前的研究是由种族和少数民族老年人进行的，他们参加了服务不足的城市社区（以下称为城市少数民族中心参与者）的研究，发现牙齿丧失水平低于美国国家样本。为了学习在这个老年人群体中运作良好的事情，具体的目标和假设是：（1）了解城市少数族裔高级中心与会者如何利用社区规模的健康和牙科护理等服务来增强口腔健康； （2）确定人际关系的因素如何改善寻求护理的行为并改善城市少数民族高级中心参与者的口腔健康成果； （3）检查在城市少数民族高级中心参与者的个人规模上，在牙科环境中筛查高血压和糖尿病的文化可接受性； （4）模拟有关在AIMS 1、2和3的城市少数民族中心参与者的社区，人际关系和个人量表的知识，以增强社区和临床的口腔健康服务提供并改善口腔健康状况。这些目标与美国国立卫生研究院的研究目标是一致的，通过资助机会公告Par-11-314，以使用与人类行为，社会科学和健康相关的系统科学方法来开发应用项目。这些目标的成功完成将有助于理解社区资产如何塑造家庭和同伴的互动，并为口腔健康促进和寻求护理作为成年人年龄的行为做出贡献。