Development and Evaluation of School-based Digital Adolescent Oral Health Promotion Program for the Reduction of Oral Health Disparities

旨在减少口腔健康差异的校本数字青少年口腔健康促进计划的开发和评估

• 批准号: 10745029
• 负责人: EDWARD GUSTAV FEIL
• 金额: $ 30.84万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745029
• 关键词: Address; Adolescence; Adolescent; Adolescent Behavior; Adult; Advisory Committees; African American; African American population; Attitude; Behavior; Behavior Therapy; Behavioral; Black Populations; Black race; COVID-19 pandemic; Caries prevention; Child; Chronic Disease; Clinical; Cognition; Collaborations; Communities; Consultations; Consumption; Control Groups; Dental; Dental Care; Dental Hygienists; Dental caries; Development; Devices; Diet; E-learning; Ensure; Evaluation; Fluorides; Focus Groups; Goals; Habits; Health; Health Promotion; Health behavior; Hispanic; Internet; Intervention; Latinx; Longevity; Low income; Minority; Modeling; Mouth Diseases; Not Hispanic or Latino; Online Systems; Oral; Oral health; Orthodontic Appliances; Outcome; Persons; Phase; Planning Theory; Population; Prevalence; Prevention; Prevention Research; Prevention strategy; Primary Prevention; Process; Program Acceptability; Public Health; Quality of life; Randomized; Randomized Controlled Clinical Trials; Randomized, Controlled Trials; Recommendation; Research; Risk; Sampling; School-Age Population; Schools; Self Care; Speed; Students; Subgroup; Target Populations; Technology; Teenagers; Testing; Time; Tobacco use; Toothbrushing; Toothpaste; U-Series Cooperative Agreements; United States National Institutes of Health; Waiting Lists; Work; Youth; access disparities; behavior change; cost; design; digital; digital intervention; digital platform; disparity reduction; eighth grade; ethnic disparity; ethnic diversity; health disparity; health knowledge; health management; improved; income disparities; intervention program; online delivery; permanent tooth; prevent; programs; prototype; racial disparity; racial diversity; randomized, clinical trials; satisfaction; secondary outcome; seventh grade; student participation; substance use; sugar; sweetened beverage; teacher; therapy design; usability; vaping; web-based intervention; willingness

PROJECT SUMMARY Dental caries, or tooth decay, is a highly prevalent chronic disease afflicting a significant proportion of the U.S. population, including a majority of youth and adults. Health disparities in oral health have persisted for decades, with lower-income youth, Black/African Americans and Latinx minorities being especially at risk for dental caries. Although adolescence is an ideal time to implement healthy behavioral habits that will be sustained into adulthood, there is a dearth of effective dental health programs for at-risk adolescents. Research has shown that primary oral health promotion strategies during adolescence include improving dental health behaviors, abstaining from tobacco use and vaping, and reducing sugar consumption. Following these recommendations and informed by our formative research findings, our proposed digital dental program for adolescents will target three oral health behavior domains: twice-daily tooth brushing with fluoride toothpaste, abstaining from tobacco use, including vaping, and reducing consumption of sugar-sweetened beverages. Grounded in the Theory of Planned Behavior, augmented by the Prototype/Willingness Model for adolescents, the proposed cross-platform digital program will target theoretically based mechanisms to promote these three targeted oral health behaviors. It will include engaging video and interactive game components. Thus, in this UG3/UH3 application, we will develop and evaluate a theoretically based digital dental health promotion program designed to engage lower income Black/African Americans, Latinx/Hispanic, and white non-Hispanic 7th and 8th grade students. In the UG3 phase, we propose to conduct formative work to iteratively develop a school-based, web-based oral health promotion program. In the UH3 phase, we will conduct a clinical randomized control trial (RCT) in schools, to evaluate “real world” program efficacy. In the RCT, we will assess program acceptability, feasibility, usability, satisfaction, and engagement, as well as the three primary behavioral and clinical health outcomes. Secondary outcomes are the theoretically based mechanisms the program targets for behavior change. Seventh and 8th grade students (N = 2,000) from 40 lower-income schools across multiple states will be randomized to receive the program intervention or to be on the waitlist (control condition). Participating students will complete assessments at three time points (baseline, six weeks post-baseline, and six months post-baseline) to evaluate both short- and long-term program outcomes. If effective, this comprehensive digital behavioral dental health program would greatly impact public health by decreasing persistent oral health disparities. Delivering the program via schools will address disparities in access to such programs, as students will access the program via school internet and school-owned digital devices. A web-based intervention is also easily scalable and can be widely disseminated at little cost, reaching adolescent populations most at risk for dental caries. The long- term goal is to facilitate healthy dental habits and related oral health behaviors for adolescents to attain a lifetime free from preventable oral disease.

项目概要 龋齿或蛀牙是一种非常普遍的慢性疾病，困扰着美国很大一部分人。 人口，包括大多数青少年和成年人，口腔健康方面的健康差距持续了数十年， 低收入青年、黑人/非裔美国人和拉丁裔少数民族尤其面临牙科职业的风险。 尽管青春期是养成健康行为习惯的理想时期，这些习惯将持续到 研究表明，成年后，缺乏针对高危青少年的有效牙齿健康计划。 青春期的主要口腔健康促进策略包括改善牙齿健康行为， 戒烟和电子烟，并遵循这些建议。 并根据我们的形成性研究结果，我们提出的青少年数字牙科计划将针对 三个口腔健康行为领域：每天两次用含氟牙膏刷牙、戒烟 的使用，包括电子烟​​和减少含糖饮料的消费。 计划行为，由青少年原型/意愿模型增强，拟议的跨平台 数字计划将针对基于理论的机制来促进这三种有针对性的口腔健康行为。 它将包括引人入胜的视频和交互式游戏组件，因此，在这个 UG3/UH3 应用程序中，我们将。 开发和评估基于理论的数字牙科健康促进计划，旨在吸引较低的人群 收入 UG3 中的黑人/非裔美国人、拉丁裔/西班牙裔以及非西班牙裔白人学生。 阶段，我们建议开展形成性工作，迭代开发基于学校、基于网络的口腔健康 在UH3阶段，我们将在学校进行临床随机对照试验（RCT）。 评估“现实世界”项目的功效 在 RCT 中，我们将评估项目的可接受性、可行性、可用性、 满意度和参与度，以及三个主要的行为和临床健康结果。 结果是第七和第八项计划目标的基于理论的机制。 来自多个州 40 所低收入学校的年级学生 (N = 2,000) 将被随机分配接受 计划干预或列入候补名单（控制条件）的学生将完成。 在三个时间点（基线、基线后六周和基线后六个月）进行评估 如果有效的话，这种全面的数字行为牙科健康计划将取得短期和长期的成果。 该计划将通过减少持续存在的口腔健康差异来极大地影响公众健康。 通过学校开展的计划将解决获得此类计划的差异，因为学生将访问该计划 通过学校互联网和学校拥有的数字设备，基于网络的干预也很容易扩展并且可以。 以低廉的成本广泛传播，覆盖最易患龋齿的青少年群体。 长期目标是促进健康的牙齿习惯和相关的口腔健康行为，使青少年终生受益 没有可预防的口腔疾病。