Tooth decay (caries) is the most common childhood disease in the United States, affecting 28% of children 2-5 years old, and costing the United States over $35 billion dollars every year. Latino children are more likely to be affected and are more likely to have severe, extensive and untreated decay. A linguistically and culturally appropriate intervention, called Contra Caries, was developed based on prior qualitative research with Latino families and Bandura's Social Cognitive Theory (SCT). SCT is a health behavior theory that outlines constructs, such as behavioral capability, outcome expectations, self-efficacy, and environment that have been associated with many behaviors. However, the SCT constructs have not fully been explored for oral hygiene behaviors. The Contra Caries intervention (NIH grant # R21DE019210, Barker PI) was piloted with rural, low-income Spanish-speaking parent/caregivers of children 1-5 years old and found to be well- accepted and feasible to implement. But Contra Caries has never been evaluated for effects on behavior, nor was the Contra Caries evaluation part of the original grant application. The overall objectives of this proposal are to create new knowledge and translate that into evidence- based interventions for improved early childhood oral health. The goals of this proposal are to better understand the cognitive factors influencing parental oral health protective behaviors, such as toothbrushing, and to evaluate whether Contra Caries improved the quantity and quality of such behaviors. Using data from the Contra Caries study population, the aims of the current proposal are:
Aim 1 : To determine if survey questions measuring behavioral capability, outcome expectations, self-efficacy, and environment are positively associated with protective behaviors especially, but not limited to, regular tooth brushing of children's teeth.
Aim 2 : To determine if the Contra Caries education intervention improves quantity and quality of protective behaviors, such as toothbrushing of children's teeth. The knowledge gained from Aims 1 and 2 will provide the necessary preliminary data to inform future intervention research, such as design of a randomized controlled trial to evaluate the efficacy of the Contra Caries education intervention. Skills gained from this proposal will create a methodological skill base to carry out Aims 1 and 2 as well as prepare the applicant for her long term career goals. The training objective is to complete doctoral training in order to become an independent investigator seeking to understand and reduce disparities in oral health, especially focusing on Latino populations and on early childhood. The proposed training plan will be performed as a part of UCSF's doctoral program in Epidemiology &Translational Science including epidemiology research design and methods coursework and independent studies in oral health disparities and translational science with leading researchers in these fields.

Public Health Relevance

Tooth decay is the most common childhood disease in the United States, affecting 28% of all children 2-5 years old;it costs the United States over $35 billion dollars every year. Because low-income, Mexican- American, migrant, and rural children are disproportionately affected, they particularly stand to benefit from interventions that protect and improve their oral health. This research uses existing data from an education intervention to explore psychological influences on protective parental behaviors, such as toothbrushing, and assesses the effectiveness of this new intervention at improving such behaviors.

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
Predoctoral Individual National Research Service Award (F31)
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NIDCR Special Grants Review Committee (DSR)
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Frieden, Leslie A
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University of California San Francisco
Public Health & Prev Medicine
Schools of Medicine
San Francisco
United States
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