Tooth decay in 2 to 11 year olds is increasing and dental utilization is lower nationally especially among poor and minority populations, while untreated primary tooth decay has remained steady. With these statistics, it is unlikely that Healthy People 2020 goals will be met. The Common Sense Model of Self-Regulation (CSM) was developed to understand individual's perception of chronic illness and for effective self-management of disease (Leventhal et al. 1997). The CSM concept has been applied to medical conditions. Except for the applicant's sponsor, the CSM framework and the questionnaire assessing CSM concepts (Illness Perception Questionnaire revised for dental: IPQ-RD) have not yet been investigated for children's or parent's perceptions of their dental problems. Building on the work of my sponsor, the overall goal of my proposed F32 research is to utilize the CSM and the behavioral model of health services use (Andersen 1968) to determine how predisposing and enabling factors, and need influence parents'illness perception of their child's dental caries (tooth decay). The objectives of this research training fellowship are: (1) A matched case control study design will compare if parent/caregivers of young children (<6 years) who have severe early childhood caries (cases: S-ECC) versus those of parent/caregivers of children without early childhood caries (controls) are different in IPQ-RD scores;(2) A path model will investigate the effect of parent/caregiver predisposing (socio- demographic, oral health behavior, knowledge, attitude, beliefs, psychosocial factors, dental fear), enabling (dental insurance, access, personal dentist, perception of dental system), need (routine/preventive vs. problematic care) related factors on IPQ-RD, which in turn affects the likelihood of being in the case or control group. The sample size of 120 (60 case caregivers and 60 control caregivers) will be recruited from a hospital based dental clinic setting. Data collectin will involve abstraction of decayed, missing, filled primary teeth from clinic charts to determine case and control status, and two self-administered questionnaires (IPQ-RD and caregiver questionnaire). The parent/caregiver will provide consent and complete questionnaires at the time of child's routine care dental visit (controls) and at the time of restorative treatment under general anesthesia in OR (case). Data analysis will include descriptive statistics, conditional logistic regression, and structural equations [PATH] modeling approach. This research responds to NIDCR's 2009-2013 Strategic Plan I-2 "Increase the Institute's commitment to basic and applied research in the behavioral and social sciences";II-2 "Emphasize the training and career development investment of individuals";II-3 "Welcome new disciplines poised to expand oral, dental, and craniofacial research";IV-1 "Identify the full range of factors that contribute to ora health inequalities". .
The proposed fellowship research study will assess the illness perception of parent/caregivers of children with severe tooth decay compared to children without tooth decay. This research will build on limited work in this area of understanding the perception of parent/caregivers towards their child's tooth decay. The findings will be useful to identify factors that contribute to poor perception regarding childhood tooth decay.