The goal of RC1 is to demonstrate that the incidence of early childhood caries (ECC) in an American Indian (Al) reservation community can be reduced through the use of Motivational Interviewing (Ml) to change maternal oral health behaviors.
The specific aims are: 1) to develop culturally relevant health education and promotional materials for use in ECC prevention with an Al community;2) to manualize an oral health Ml intervention for pregnant women/mothers of newborns;and 3) to test this intervention in a randomized trial. All of the women, ages 15 or older, who are receiving prenatal care in the clinics of a large Northern Plains Al reservation, will be asked to participate in this trial, and all will be provided with the oral health promotion materials and aids, which will be developed using community participation strategies. For the demonstration trial, approximately 600 women will be randomly assigned to the Ml group, or the control condition. For those in the Ml group, oral health visits will be made to their homes prenatally and immediately after birth, then at 6, 12, 24, and 36 months of age. Children will be followed for 3 years, and caries assessments will be conducted by calibrated dental hygienists within 3 months of each child's 1st, 2nd, and 3rd birthday. The primary outcome will be annual increase in caries incidence. Secondary outcome measures will focus on caries patterns and cost-effectiveness of the program. A variety of mediators/moderators also will be examined, including such issues as mother's oral health knowledge and beliefs, stress, self-efficacy, and locus of control. AI/AN children have 3 times more untreated decay than children in the general population, and access to both preventive services and professional dental treatment are inadequate. The decision was made not to pair clinical/pharmacologic approaches with Ml in order to provide a definitive test of the most universally available strategy for prevention-that is, home oral disease prevention behaviors. If the effectiveness of Ml for preventing ECC can be demonstrated, future studies might look at adaptations for community implementation. It is anticipated that lessons from this study can be used to adapt the final protocol for RC3, which is focused on the provision of oral health prevention services (including fluoride varnish) by specially trained Al community oral health specialists working in Head Start Centers. There are implications for use with other clinical approaches to prevention as well. A major strength of this study is the extent to which involvement by representatives of the participant community, as well as Al health service providers, is shaping the development of materials and the design of the research protocol. This participation is expected to be a major asset for dissemination activities as well.

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZDE1-MS)
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University of Colorado Denver
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Albino, J; Tiwari, T (2016) Preventing Childhood Caries: A Review of Recent Behavioral Research. J Dent Res 95:35-42
Hoeft, K S; Barker, J C; Shiboski, S et al. (2016) Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children. Community Dent Oral Epidemiol 44:564-576
Garcia, Raul I; Tiwari, Tamanna; Ramos-Gomez, Francisco et al. (2016) Retention strategies for health disparities preventive trials: findings from the Early Childhood Caries Collaborating Centers. J Public Health Dent :
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, 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
Bryant, Lucinda L; Quissell, David O; Braun, Patricia A et al. (2016) A Community-Based Oral Health Intervention in Navajo Nation Head Start: Participation Factors and Contextual Challenges. J Community Health 41:340-53
Braun, P A; Quissell, D O; Henderson, W G et al. (2016) A Cluster-Randomized, Community-Based, Tribally Delivered Oral Health Promotion Trial in Navajo Head Start Children. J Dent Res 95:1237-44
Tiwari, T; Sharma, T; Harper, M et al. (2015) Community Based Participatory Research to Reduce Oral Health Disparities in American Indian Children. J Fam Med 2:
Braun, Patricia A; Lind, Kimberly E; Henderson, William G et al. (2015) Validation of a pediatric oral health-related quality of life scale in Navajo children. Qual Life Res 24:231-9

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