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

基本信息

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
项目类别：
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

项目摘要

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（由适用提供）：美国的拉丁美洲人经历了重大的口腔健康差异（OHD）。他们面临着获得口腔卫生服务的障碍（例如，在任何种族或族裔中，牙科保险的最低率之一），并且寻求常规和预防性牙科护理的可能性较小。拉丁裔儿童和成人还经历了更高的牙齿疗法，牙龈炎和/或慢性牙周炎。在拉丁美洲人中对口腔健康的研究仅限于确定个人级别的社会经济和社会文化机制，而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，健康行为，相信和参加个人的观点是通过与他人的接触和沟通来塑造的。社交网络与健康成果之间存在牢固的关系。当前的口腔健康研究工具箱不能充分捕获OHD体现的多个嵌套影响。我们建议采用社交网络分析（SNA）方法，以解决了解社会规范，参与者，资源和有关牙科护理和口腔健康的信息如何通过个人和社区网络传播，并影响个人行为和成果。在拟议的研究中，我们将建立在我们完成的形成项目（NIDCR DE022096）的基础上，这是一项使用SNA方法的先驱研究，以OHD研究为目标，以墨西哥血统（或US）中的墨西哥裔美国人（或墨西哥裔美国人[MAS]）。在先前的横截面设计中，我们表征了有关食品，口腔健康行为和牙科护理的经验。在其居住的网络的背景下。描述影响MAS的OHD因素和机制具有很大的公共健康意义，因为MA子组在美国占拉丁裔的60％。在目前的纵向设计中，我们将通过关注网络共同进化的动态过程，口腔健康文化和牙科护理的依据，从而开发出强大的OHD因果因果模型，并且随着时间的流逝，MAS随着时间的流逝，他们的行为和行为是最近移民的。我们的具体目的是：1）表征MA移民对牙科护理和口腔健康障碍的规范，出现，行为和看法，并特别注意这些因素与个人社交网络特征之间的关联； 2）确定培养，个人和社区网络动态，规范和资源的扩散以及不断发展的口腔健康行为，随着时间的流逝而发展的口腔健康行为和成果。拥有有关OHD潜在的复杂和动态机制的额外和更准确的知识将为发展四个方面提供基础：有效的公共政策，有效的临床准则，对文化敏感的临床和预防性护理以及实用应用的未来研究指示。此外，借鉴了现有的有关网络干预措施的丰富研究和从其他卫生领域的创新扩散，我们的发现可以应用于裁缝计划，以利用MA社区的优势和资源来改善人口的口腔健康。