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 #
5R01DE023072-03
Application #
8712453
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Clark, David
Project Start
2012-09-01
Project End
2017-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
New York University
Department
Public Health & Prev Medicine
Type
Schools of Dentistry/Oral Hygn
DUNS #
City
New York
State
NY
Country
United States
Zip Code
10012
Kavathe, Rucha; Islam, Nadia; Zanowiak, Jennifer et al. (2018) Building Capacity in the Sikh Asian Indian Community to Lead Participatory Oral Health Projects. Prog Community Health Partnersh 12:1-2
Demby, Neal; Northridge, Mary E (2018) Delivering Equitable Care to Underserved Communities. Am J Public Health 108:1446-1447
Shedlin, Michele G; Birdsall, Stacia B; Northridge, Mary E (2018) Knowledge and behaviours related to oral health among underserved older adults. Gerodontology 35:339-349
Zhang, Qiuyi; Northridge, Mary E; Jin, Zhu et al. (2018) Modeling Accessibility of Screening and Treatment Facilities for Older Adults using Transportation Networks. Appl Geogr 93:64-75
Northridge, Mary E; Duane, John F (2018) Public Health's Aspirational Identity: Who Do We Want to Be? Am J Public Health 108:65-66
Jin, Zhu; Northridge, Mary E; Metcalf, Sara S (2018) Modeling the Influence of Social Ties and Transportation Choice on Access to Oral Healthcare for Older Adults. Appl Geogr 96:66-76
Northridge, Mary E; Chakraborty, Bibhas; Salehabadi, Sedigheh Mirzaei et al. (2018) Does Medicaid Coverage Modify the Relationship between Glycemic Status and Teeth Present in Older Adults? J Health Care Poor Underserved 29:1509-1528
Estrada, Ivette; Kunzel, Carol; Schrimshaw, Eric W et al. (2018) ""Seniors only want respect"": designing an oral health program for older adults. Spec Care Dentist 38:3-12
Kum, Susan S; Northridge, Mary E; Metcalf, Sara S (2018) Using focus groups to design systems science models that promote oral health equity. BMC Oral Health 18:99
Kavathe, Rucha; Islam, Nadia; Zanowiak, Jennifer et al. (2018) Building Capacity in the Sikh Asian Indian Community to Lead Participatory Oral Health Projects. Prog Community Health Partnersh 12:3-14

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