Great Beginnings for Healthy Native Smiles

健康原生微笑的良好开端

基本信息

批准号：
9924504
负责人：
Julie Ann Baldwin
金额：
$ 65.48万
依托单位：
NORTHERN ARIZONA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-06-01 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9924504
关键词：
Absenteeism Address Adult Affect Age American Indians Arizona Attitude Behavioral Belief Biological Caregivers Child Child Health Child health care Chronic Disease Collaborations Communities Community Health Crow Tribe of Montana Crows Dental Care Dental Clinics Dental Hygiene Dental caries Dentists Diet Early treatment Educational Status Emotional Ethnic group Family member Fluoride Varnishes Growth Guidelines Head Start Program Health Health Knowledge, Attitudes, Practice Health Personnel Health Services Health Services Accessibility Health behavior Health education Healthcare Impairment Incidence Individual Infant Intervention Interview Knowledge Lead Left Low income Measures Methods Modeling Montana Mothers Oral health Outcome Patients Perception Population Predisposition Pregnancy Pregnant Women Prevention Recommendation Research Research Methodology Resources Risk Risk Factors Sampling Self Efficacy Self Perception Severities Site Smiling Social Work Special Supplemental Nutrition Program for Women, Infants, and Children Surveys Techniques Testing Time Tooth Loss Tooth structure Training Transportation Tribes United States United States Indian Health Service Woman base care coordination care providers caregiving chronic pain cost deciduous tooth demographics design early childhood ethnic diversity experience family support feeding formative assessment health belief health disparity healthy lifestyle holistic approach improved innovation lifestyle intervention low socioeconomic status motivational enhancement therapy nutrition peer postnatal postnatal period prenatal prenatal experience prenatal health prevent randomized controlled study rural area social tooth surface tribal community tribal health

项目摘要

PROJECT SUMMARY Early Childhood Caries (ECC) is the most common chronic disease among children. American Indian (AI) children are 4 times more likely to have untreated dental decay than white children. If left untreated, ECC can lead to chronic pain, loss of teeth, poor nutrition, and impaired growth. The proposed study aims to reduce the burden of ECC in two AI communities through an innovative, community based participatory approach. The project will: 1) partner with 2 tribes, the Hopi Tribe (Arizona) and the Crow Tribe (Montana), to conduct a formative assessment on oral health (OH); 2) adapt a “bundled” best practices OH intervention to be locally and contextually relevant for each of our tribal communities; and 3) conduct a randomized, controlled study to evaluate the impact of the “bundled” best practices OH intervention (compared to a standard prenatal/postnatal healthy lifestyle intervention) on the reduction of ECC. Community health representatives (CHRs) will be trained to deliver the interventions with pregnant women and follow them until the child’s last exam (24-36 months). The OH intervention will consist of 4 intervention components known to be effective (best practices) in the prevention of ECC: 1) dietary and OH education provided during pregnancy and the postnatal period; 2) OH care of children including the application of fluoride varnish; 3) motivational interviewing with children’s mothers; and 4) patient navigation of existing OH and other social services in each study community, facilitated by CHRs. Caries experience (dmfs) and severity will be compared across both conditions at the 1, 2, and 3- year exams. Mother knowledge, attitudes, and behaviors related to ECC will be also measured for both conditions at pre-test and post-test. Surveys will assess each level of the social ecological model. Individual level domains will include: 1) demographics of mother and baby (pre-test only); 2) dental health of the child to date; 3) mother’s and child’s OH (postnatal); 4) mother’s knowledge, beliefs, and attitudes about best practices in OH; 5) mother’s perception of self-efficacy and susceptibility; and 6) mother’s prenatal health and experiences. Interpersonal level domains will include: 1) current living situation and family support; 2) availability of emotional, informational, and instrumental support; and 3) perceptions of peers’ and family members’ attitudes toward caregiving and OH. Community level domains will include: 1) tribal identity and related experiences; 2) care coordination, transportation, and access to social and OH services; and 3) perceptions of cultural congruence of CHR interactions and intervention materials. If successful, this community-based approach may prove to be a feasible method for improving OH of AI children and reducing the burden of ECC in many Native communities with limited access to regular dental care.

项目概要儿童早期龋齿 (ECC) 是美洲印第安人儿童中最常见的慢性疾病。 (AI) 如果不及时治疗，儿童患蛀牙的可能性是白人儿童的 4 倍。 ECC 可能导致慢性疼痛、牙齿脱落、营养不良和生长受损。旨在通过创新的、基于社区的方式减轻两个人工智能社区的 ECC 负担该项目将：1）与 2 个部落合作，即霍皮部落（亚利桑那州）和克罗部落。 Tribe（蒙大拿州），对口腔健康进行形成性评估（OH）2）采用“捆绑”最佳方案；实施与我们每个部落社区当地和具体情况相关的 OH 干预措施；以及 3) 进行随机对照研究，评估“捆绑”最佳实践的影响 OH 干预措施（与标准的产前/产后健康生活方式干预相比） ECC 的社区卫生代表 (CHR) 将接受培训以提供干预措施。孕妇并跟踪他们直到孩子最后一次检查（24-36 个月）。包括 4 个已知对预防 ECC 有效的干预措施（最佳实践）：1) 孕期和产后的饮食和健康教育；2）儿童的健康教育；包括使用氟化物清漆；3) 对儿童母亲进行动机访谈；4) 每个研究社区中现有 OH 和其他社会服务的患者导航，由 CHR 的龋齿经历 (dmfs) 和严重程度将在 1、2 和 3 时进行比较。与 ECC 相关的母亲知识、态度和行为也将被衡量。调查将评估社会生态模型的每个级别。个人级别领域将包括：1) 母亲和婴儿的人口统计数据（仅限预测试）；2) 牙科；孩子迄今为止的健康状况； 3) 母亲和孩子的健康状况（产后）； 4) 母亲的知识、信仰和对 OH 最佳实践的态度；5) 母亲对自我效能和敏感性的看法；6) 母亲的产前健康和经历包括： 1) 目前的生活。情况和家庭支持；2) 情感、信息和工具支持的可用性；以及同伴和家庭成员对护理和 OH 的态度的看法。领域将包括：1) 部落身份和相关经验；2) 护理协调、交通和获得社会和职业健康服务的机会；以及 3) 对 CHR 互动和文化一致性的看法如果成功，这种基于社区的方法可能被证明是可行的。改善 AI 儿童 OH 并减轻许多原住民社区 ECC 负担的方法获得常规牙科护理的机会有限。