The overarching goal of this supplemental investigation is directed at delineating the covariation between individual, family and geosocial factors associated with orodental disease and tooth loss in rural Appalachian youth 9-18 years of age. ? ? Geosocial risk factors include: 1) economic resources; 2) social infrastructure; and, 3) physical/geospacial topology. Family risk factors include: 1) domicile quality; 2) family structure, 3) family harmony; 4) caregiver competence; 5) maternal oral heath orientation; and, 6) adherence to health mitigating facets of Appalachian culture. Individual risk factors include: 1) psychological effectiveness (self-regulation, self-esteem, internal locus of control, social skill); and, 2) level of oral health behaviors. Orodental status is comprehensively evaluated by a research dentist for multiple disorders. The multivariate measurement scheme affords the opportunity to delineate both the direct and mediated pathways linking community, family, and individual factors with orodental disease severity and tooth loss. ? ? A total of 360 families in two mountainous, rural West Virginia counties will participate in this project. These families are currently undergoing enrollment in a genetics project funded by NIDCR (R01-DE14899). Data from the two projects will thus inform about the specific and conjoint influences of genetic, environmental, and psychosocial factors on orodental disease and injury. ? ? The proposed research is theory guided. In addition, a systematic data reduction strategy is used to identify the most salient correlates of orodental disease and injury. The multifactorial theory of etiology, representative sampling strategy, and paradigm enabling multivariate modeling yields the information necessary for devising innovative prevention programs that emphasize the quality of individual-environment interactions. Elucidating the pattern of covariation between the individual, family, and community affords the opportunity to target interventions at the appropriate level (e.g., community, family, individual) that effectively enhances oral health behaviors, and accordingly, reduces the rate and severity of orodental disease in this disadvantaged population. ? ?
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