Social Network Dynamics and Oral Health Disparities in Mexican American Immigrants

墨西哥裔美国移民的社交网络动态和口腔健康差异

• 批准号: 9081086
• 负责人: Gerardo Maupome
• 金额: $ 70.76万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-22 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9081086
• 关键词: Acculturation; Address; Adult; Affect; Area; Assimilations; Attention; Attitude; Attitude to Health; Behavior; Belief; Biology; Characteristics; Child; Clinical; Communication; Communities; Community Networks; Complex; Country; Data; Dental Care; Dental Insurance; Dental caries; Diffusion; Diffusion of Innovation; Dimensions; Elements; Environment; Ethnic group; Etiology; Evolution; Exposure to; Face; Failure; Food; Foundations; Future; Genomics; Gingivitis; Goals; Guidelines; Health; Health Policy; Health Resources; Health Services; Health behavior; Healthcare; Healthcare Systems; Hispanics; Immigrant; Immigration; Individual; Intervention; Investigation; Knowledge; Latino; Life; Link; Methods; Mexican; Mexican Americans; Modeling; National Institute of Dental and Craniofacial Research; Oral health; Outcome; Pathway Analysis; Pattern; Perception; Periodontitis; Population; Preventive care; Preventive dental care; Process; Public Health; Public Policy; Race; Research; Research Methodology; Resources; Respondent; Role; Science; Self Care; Shapes; Social Environment; Social Interaction; Social Network; Solid; Specific qualifier value; Structure; System; Targeted Research; Time; Vision; base; behavior change; behavioral outcome; causal model; clinical care; design; effective intervention; experience; health disparity; improved; longitudinal design; practical application; precision medicine; programs; public health relevance; service utilization; social; social norm; socioeconomics; tool

 DESCRIPTION (provided by applicant): Latinos in the US experience substantial oral health disparities (OHD). They face barriers to accessing oral health services (e.g., among the lowest rates of dental insurance among any racial or ethnic group), and are disproportionately less likely to seek regular and preventive dental care. Latino children and adults also experience higher rates of dental caries, gingivitis, and/or chronic periodontitis. Studies of oral health among Latinos have been limited to identifying individual-level socioeconomic and sociocultural mechanisms, with little attention to broader personal and community network contexts. Viewed from a network science perspective, the health behaviors, beliefs, and attitudes of individuals are shaped through contact and communication with others; there is a strong relationship between social networks and health outcomes. The current oral health research toolbox does not adequately capture the multiple nested levels of influence embodied in OHD. We propose to apply Social Network Analysis (SNA) methods to address the critical need to understand how social norms, attitudes, resources, and information around dental care and oral health propagate through personal and community networks, and affect individual behavior and outcomes. In the proposed research we will build on our completed formative project (NIDCR DE022096), a pioneer study using SNA methods in OHD research targeting people of Mexican descent (or Mexican-Americans [MAs]) in the US. In that prior cross-sectional design we characterized experiences about food, oral health behaviors, and dental care in the context of the networks they live in. Describing OHD factors and mechanisms affecting MAs has great public health significance because the MA sub-group makes up about 60% of Latinos in the US. In the present longitudinal design, we will develop a strong causal model of OHD by focusing on the dynamic processes underlying the coevolution of networks, oral health culture, and dental care attitudes and behaviors over time among MAs who have recently immigrated. Our specific aims are to: 1) characterize the norms, attitudes, behaviors, and perceptions of barriers around dental care and oral health among MA immigrants, with specific attention to associations between these factors and personal social network features; and 2) determine the relationships between acculturation, personal and community network dynamics, diffusion of norms and resources, and evolving oral health behaviors, attitudes, and outcomes over time among MA immigrants. Having additional, and more accurate knowledge about the complex and dynamic mechanisms underlying OHD will provide a foundation to develop four aspects: effective public policy, efficient clinical guidelines, culturally-sensitive clinical and preventive care, and futur research directions with practical applications. Moreover, drawing on the rich body of existing research on network interventions and diffusion of innovation from other health areas, our findings can be applied to tailoring programs that leverage the strengths and resources of MA communities to improve population oral health.

 描述（由申请人提供）：美国的拉丁裔人口在获得口腔健康服务方面面临着巨大的障碍（例如，在所有种族或族裔群体中牙科保险率最低），而且比例要低得多。拉丁裔儿童和成人的龋齿、牙龈炎和/或慢性牙周炎的发病率也较高。对拉丁裔口腔健康的研究仅限于确定个人水平。失业和社会文化机制，很少关注更广泛的个人和社区网络环境。从网络科学的角度来看，个人的健康行为、信仰和态度是通过与他人的接触和交流而形成的；当前的口腔健康研究工具箱未能充分捕捉 OHD 所体现的多重嵌套影响水平。以及有关牙科护理和口腔健康的信息传播在拟议的研究中，我们将建立在我们已完成的形成性项目（NIDCR DE022096）的基础上，这是一项针对墨西哥裔（或墨西哥裔美国人）的 OHD 研究中使用 SNA 方法的先驱研究。在之前的横断面设计中，我们在美国的 MA 中描述了有关食物、口腔健康行为和牙科护理的经历。描述影响 MA 的 OHD 因素和机制具有重大的公共卫生意义，因为文学硕士该亚群体约占美国拉丁裔人口的 60% 在目前的纵向设计中，我们将通过关注网络、口腔健康文化和牙科护理态度的共同进化的动态过程来开发一个强大的 OHD 因果模型。我们的具体目标是：1) 描述 MA 移民对牙科护理和口腔健康障碍的规范、态度、行为和看法，特别关注这些因素与个人之间的关联。社交网络功能；以及 2)确定 MA 移民的文化适应、个人和社区网络动态、规范和资源的传播以及口腔健康行为、态度和结果之间的关系。对 OHD 背后的复杂和动态机制有更多、更准确的了解。为制定四个方面提供了基础：有效的公共政策、高效的临床指南、文化敏感的临床和预防性护理以及具有实际应用的未来研究方向。此外，还借鉴了有关网络干预和创新扩散的丰富现有研究。其他健康领域，我们的研究结果可以应用于量身定制计划，利用马萨诸塞州社区的优势和资源来改善人口口腔健康。