The goal Of RC3 is to demonstrate the effectiveness of specially trained American Indian (Al) Community Oral Health Specialists (COHS) for delivering a caries prevention program to children enrolled in Head Start programs on a large Al reservation in the Southwest.
The specific aims of the project are: 1) to develop a manualized intervention protocol for a caries prevention program delivered by COHS;2) to implement and evaluate the feasibility and acceptability of a COHS-delivered program of oral health promotion and fluoride varnish (FV), as well as a more traditional FV program delivered by dental assistants;and 3) to compare the two programs in terms of secondary outcomes (caries patterns, cost-effectiveness, dispersion effects), as well as any differences identified by potential moderators and mediators that appear to affect outcomes. Head Start Centers (N=32) in communities across the reservation will be randomly assigned to one of the program conditions. The COHS condition will differ from the VAR condition primarily in that activities will include a proactive approach to working with children and their parents to initiate effective home oral health behaviors, as well as community educational activities. Fluoride varnishes will be provided quarterly in both programs. Children will be followed for two years, with caries assessments by calibrated dental hygienists at baseline, 1 year, and 2 years. The content of the COHS training protocol, which originally was developed in a pilot study that was implemented on a Northern Plains reservation, will be reviewed and revised with community input. This study provides a conservative evaluation of the COHS approach, which is designed to overcome resistance to cultural barriers to accessing established dental care services, and to make preventive services more widely available. Rather than comparing the COHS model with standard, higher cost, professional services, we are making a comparison with low-cost providers who will be deployed in a community setting to provide an intervention that consists primarily of a pharmacotherapeutic service (FV) that has proven efficacy for caries prevention. COHS providers, also low cost personnel, will deliver FV as well, so the central research question is whether a focus on personalized and community oral health promotion provided by someone clearly identified with the community provides a significantly greater effect on caries incidence than a low-cost pharmacotherapeutic prevention program. As questions continue to be raised about new delivery models for populations in rural and other underserved settings, this study will provide important information about the model of a prevention specialist trained in a 4-week program to work for improvement in the oral health of preschool children. It is anticipated that this study will be informed and further shaped by early results from RC1.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54DE019259-05
Application #
8376974
Study Section
Special Emphasis Panel (ZDE1-MS)
Project Start
Project End
Budget Start
2012-06-01
Budget End
2013-05-31
Support Year
5
Fiscal Year
2012
Total Cost
$1,024,730
Indirect Cost
$349,663
Name
University of Colorado Denver
Department
Type
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Garcia, Raul I; Tiwari, Tamanna; Ramos-Gomez, Francisco et al. (2017) Retention strategies for health disparities preventive trials: findings from the Early Childhood Caries Collaborating Centers. J Public Health Dent 77:63-77
Tiwari, Tamanna; Albino, Judith (2017) Acculturation and Pediatric Minority Oral Health Interventions. Dent Clin North Am 61:549-563
Heaton, Brenda; Crawford, Andrew; Garcia, Raul I et al. (2017) Oral health beliefs, knowledge, and behaviors in Northern California American Indian and Alaska Native mothers regarding early childhood caries. J Public Health Dent 77:350-359
Albino, Judith; Tiwari, Tamanna; Gansky, Stuart A et al. (2017) The basic research factors questionnaire for studying early childhood caries. BMC Oral Health 17:83
Wilson, Anne R; Mulvahill, Matthew J; Tiwari, Tamanna (2017) The Impact of Maternal Self-Efficacy and Oral Health Beliefs on Early Childhood Caries in Latino Children. Front Public Health 5:228
Albino, J; Batliner, T S; Tiwari, T (2017) Preventing Caries in American Indian Children: Lost Battle or New Hope? JDR Clin Trans Res 2:406-409
Albino, Judith; Shapiro, Allison L B; Henderson, William G et al. (2016) Validation of the Sense of Coherence Scale in an American Indian population. Psychol Assess 28:386-93
Wilson, Anne R; Brega, Angela G; Campagna, Elizabeth J et al. (2016) Validation and Impact of Caregivers' Oral Health Knowledge and Behavior on Children's Oral Health Status. Pediatr Dent 38:47-54
Brega, A G; Thomas, J F; Henderson, W G et al. (2016) Association of parental health literacy with oral health of Navajo Nation preschoolers. Health Educ Res 31:70-81
Albino, J; Tiwari, T (2016) Preventing Childhood Caries: A Review of Recent Behavioral Research. J Dent Res 95:35-42

Showing the most recent 10 out of 25 publications