One session treatment for dental phobia in an underserved population

服务欠缺人群的牙科恐惧症的一次疗程治疗

基本信息

批准号：
10698001
负责人：
THOMAS H. OLLENDICK
金额：
$ 31.58万
依托单位：
UNIVERSITY OF TEXAS RIO GRANDE VALLEY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-06 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10698001
关键词：
Address Adherence Adolescence Adolescent Adult Affect Age Anxiety Anxiety Disorders Appearance Area Automobile Driving Award Basic Science Child Childhood Clinic Clinical Clinical Research Clinical Trials Communities Controlled Study Country Data Data Collection Dental Dental Anxiety Dental Care Dental Clinics Dental Hygienists Dental Offices Dentists Development Diet Disease Dissemination and Implementation Documentation Eating Ensure Etiology Evidence based treatment Family Feasibility Studies Fright Future Goals Good Clinical Practice Grant Health Professional Healthcare Hispanic Hispanic Populations Individual Interdisciplinary Study Interruption Intervention Intervention Studies Knowledge Label Laboratories Latino Learning Literature Low income Measures Mediating Mediator Medical National Institute of Dental and Craniofacial Research Odontogenesis Oral Oral health Pain Participant Patient Recruitments Phase Phobias Prediction of Response to Therapy Prevalence Procedures Quality of life Randomized Relaxation Therapy Sampling Shame Specific Phobia Testing Tooth structure Treatment outcome Underserved Population United States Work Youth acceptability and feasibility active control anxious behavioral clinical trial childhood anxiety clinical research site community setting comparative efficacy effective therapy efficacious treatment efficacy evaluation experience high risk implementation efforts participant retention patient response psychoeducation psychoeducational recruit retention rate social standard of care success theories treatment arm treatment effect trial comparing

项目摘要

PROJECT SUMMARY/ABSTRACT Dental phobia is associated with avoidance of proper dental care, poor dental health, and decrements in social and oral quality of life. Although dental phobia may persist for many years, the disorder usually first manifests during childhood or adolescence. Hispanic youth may be at particularly high risk of developing dental phobia because Hispanic/Latino families are less likely to take a preventative stance toward dental health. This means that Hispanic youths’ first encounters with a dentist are more likely to be for treatment that is associated with pain, discomfort, or shame – the types of learning experiences related to the development of dental phobia. Although our knowledge about the etiology of dental phobia is well developed, we know considerably less about how to treat dental phobia in youth. Recently, a one-session exposure therapy treatment (OST) for specific phobias has proven successful in addressing a variety of phobias in children and adolescents. However, youth with dental/medical phobias have not been included in the trials assessing OST because of the need to include dental health professionals in the treatment. Therefore, the primary goal of this application is to prepare for and conduct a Stage III trial comparing OST for dental phobia in children and adolescents to an active control treatment in a predominantly Hispanic population and to examine inhibitory learning as the mechanism responsible for changes in anxiety and fear. The aims of the UG3 phase are to do the preparatory work needed for the trial, including the development of all study documentation and finalizing the clinical sites. Additional plans during the UG3 phase include the assessment of the acceptability and feasibility of the study procedures and a trial examining whether youth treated with OST show evidence of changes in inhibitory learning. The primary aim of the UH3 stage is to examine the efficacy of OST in a Stage III social/behavioral clinical trial in which OST is delivered by dental hygienists. This trial would randomize dental clinics to one of the two treatment arms (OST vs. Control) so that patient response and the hypothesized mechanism of treatment can be assessed. Factors related to future dissemination and implementation efforts will also be examined. It is hypothesized that OST can provide an efficacious treatment option that can be delivered by hygienists in the dental office. That is, that the treatment can decrease both anxiety and phobic avoidance in youth. Moreover, although exposure therapy has a high level of empirical support in youth and a good deal of laboratory work has been conducted to develop the theory to explains its effects, the main hypothesized mechanism of action – inhibitory learning – has not been studied as a mediator within the context of a clinical trial; therefore, this work could advance our understanding of the mechanism driving one of the most promising treatments for individuals with anxiety disorders.

项目概要/摘要牙科恐惧症与避免适当的牙科护理、牙齿健康状况不佳以及社交能力下降有关。尽管牙科恐惧症可能持续多年，但这种疾病通常首先表现出来。在童年或青春期，西班牙裔青少年患牙科恐惧症的风险特别高。因为西班牙裔/拉丁裔家庭不太可能对牙齿健康采取预防措施。西班牙裔年轻人第一次见到牙医更有可能是为了接受与以下方面相关的治疗疼痛、不适或羞耻——与牙科恐惧症的发展相关的学习经历类型。尽管我们对牙科恐惧症的病因学了解很丰富，但我们对牙科恐惧症的了解却相当少。如何治疗青少年的牙科恐惧症最近，针对特定情况的单次暴露疗法（OST）。事实证明，恐惧症可以成功地解决儿童和青少年的各种恐惧症。患有牙科/医疗恐惧症的人尚未被纳入评估 OST 的试验中，因为需要包括因此，此应用程序的首要目标是为牙齿健康专业人员的治疗做好准备。并进行一项 III 期试验，将 OST 治疗儿童和青少年牙科恐惧症与主动对照进行比较在以西班牙裔为主的人群中进行治疗并检查抑制学习作为机制 UG3阶段的目的是做好必要的准备工作。试验，包括制定所有研究文件并最终确定临床地点。 UG3阶段的计划包括评估研究程序的可接受性和可行性一项试验检查接受 OST 治疗的青少年是否显示出抑制性学习发生变化的证据。 UH3 阶段的主要目的是检查 OST 在 III 期社会/行为临床试验中的功效该 OST 由牙科保健员提供，该试验将随机将牙科诊所分配给两家诊所之一。治疗组（OST 与对照），以便患者的反应和已开发的治疗机制可以还将审查与未来传播和实施工作相关的因素。 OST 可以提供有效的治疗选择，可由卫生员在也就是说，治疗可以减少年轻人的焦虑和恐惧回避。尽管暴露疗法在青少年中拥有高水平的经验支持和大量的实验室工作已经进行了发展理论来解释其效果，主要开发的作用机制 - 抑制学习——尚未在临床试验中作为中介进行研究；因此，这项工作可以增进我们对驱动最有希望的治疗方法之一的机制的理解患有焦虑症的人。