Demographic shifts that include an aging and more racially and ethnically diverse population coupled with ongoing changes in the healthcare policy environment are demanding that the dental profession both redirect and expand its focus. Challenges include providing more comprehensive care for patients with complicated medical and social needs, while improving access to care for underserved population groups. In the coming years, the practice of dentistry is expected to include screening for, and monitoring of, chronic diseases such as hypertension and diabetes related to cumulative oral conditions such as tooth loss and periodontal disease. Meanwhile, expectations for dentistry by the public will require the field to develop strategies to manage the oral health of groups not now receiving adequate care, including older adults. Recent methodological developments enabled by computational advances, such as agent-based modeling, system dynamics, and geographic information systems, have spurred a body of research on the effects of multiple scales (e.g., community, interpersonal, and individual) and dimensions (e.g., built environment and social context at the community scale) on health behaviors and outcomes. Yet, because software platforms capable of combining these approaches have only recently become available, the methods have generally been applied only in isolation. In particular, little empirical work has examined how factors at multiple scales contribute to oral health and care-seeking behaviors for racial and ethnic minority older adults. Previous research conducted with racial and ethnic minority older adults who attend senior centers in underserved urban neighborhoods (hereafter referred to as urban minority senior center attendees) found lower levels of tooth loss than in US national samples. In order to learn from what is working well in this older adult population, the specific aims and hypotheses are to: (1) understand how urban minority senior center attendees utilize services such as health and dental care at the community scale to enhance their oral health;(2) identify how factors at the interpersonal scale enhance care-seeking behaviors and improve the oral health outcomes of urban minority senior center attendees;(3) examine the cultural acceptability of screening for hypertension and diabetes in the dental setting at the individual scale for urban minority senior center attendees;and (4) model the knowledge gained about factors at the community, interpersonal, and individual scales for urban minority senior center attendees in Aims 1, 2, and 3 to enhance community- and clinic-based oral health service delivery and improve oral health outcomes.
These aims are consistent with the research objectives of the National Institutes of Health through Funding Opportunity Announcement PAR-11-314 to develop applied projects utilizing systems science methodologies relevant to human behaviors, social sciences, and health. Successful completion of these aims will aid in understanding how community assets shape familial and peer interactions and contribute to oral health promotion and care seeking behaviors as adult's age. !

Public Health Relevance

Demographic shifts that include an aging and more racially and ethnically diverse population coupled with ongoing changes in the healthcare policy environment are demanding that the dental profession both redirect and expand its focus. This study is original in utilizing social and systems science to explore integrated models of primary and oral health screening for older adults in community settings.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
1R01DE023072-01
Application #
8420978
Study Section
Special Emphasis Panel (ZRG1-HDM-Q (50))
Program Officer
Clark, David
Project Start
2012-09-01
Project End
2017-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
1
Fiscal Year
2012
Total Cost
$804,774
Indirect Cost
$116,333
Name
New York University
Department
Public Health & Prev Medicine
Type
Schools of Dentistry
DUNS #
041968306
City
New York
State
NY
Country
United States
Zip Code
10012
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Jung, Molly; Kwon, Simona C; Edens, Neile et al. (2017) Oral Health Care Receipt and Self-Rated Oral Health for Diverse Asian American Subgroups in New York City. Am J Public Health 107:S94-S96
Northridge, Mary E; Kavathe, Rucha; Zanowiak, Jennifer et al. (2017) Implementation and dissemination of the Sikh American Families Oral Health Promotion Program. Transl Behav Med 7:435-443
Chakraborty, Bibhas; Widener, Michael J; Mirzaei Salehabadi, Sedigheh et al. (2017) Estimating peer density effects on oral health for community-based older adults. BMC Oral Health 17:166
Northridge, Mary E; Estrada, Ivette; Schrimshaw, Eric W et al. (2017) Racial/Ethnic Minority Older Adults' Perspectives on Proposed Medicaid Reforms' Effects on Dental Care Access. Am J Public Health 107:S65-S70
Greenblatt, A P; Estrada, I; Schrimshaw, E W et al. (2017) Acceptability of Chairside Screening for Racial/Ethnic Minority Older Adults: A Qualitative Study. JDR Clin Trans Res 2:343-352
Northridge, Mary E; Schenkel, Andrew B; Birenz, Shirley et al. (2017) ""You Get Beautiful Teeth Down There"": Racial/Ethnic Minority Older Adults' Perspectives on Care at Dental School Clinics. J Dent Educ 81:1273-1282
Northridge, Mary E; Shedlin, Michele; Schrimshaw, Eric W et al. (2017) Recruitment of racial/ethnic minority older adults through community sites for focus group discussions. BMC Public Health 17:563
Northridge, Mary E; Metcalf, Sara S (2016) Enhancing implementation science by applying best principles of systems science. Health Res Policy Syst 14:74
Northridge, Mary E; Kum, Susan S; Chakraborty, Bibhas et al. (2016) Third Places for Health Promotion with Older Adults: Using the Consolidated Framework for Implementation Research to Enhance Program Implementation and Evaluation. J Urban Health 93:851-870

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