This Developmental/Exploratory study will use theoretical models that have been used in medicine to promote access and improve outcomes as the point of departure for examining why low-income and socially disadvantaged Hispanic, African American, and Caucasian parents do not obtain dental care for their children. The short goal of this proposal is to determine the psychosocial, structural and cultural factors that impact parental help seeking and to refine and evaluate an intervention to enhance parental dental care seeking behavior. The long-term goal of this pilot research is to test a community, family, and practice approach to improve access to care in an R01 multi-site efficacy trial. The pilot research will be accomplished in two phases. In Phase I we will use focus groups to develop a family and community based intervention and measures that will be used in Phase II. In Phase II the intervention will be pilot tested using a randomized controlled repeated measures design in which families will be assigned to an intervention group and a control group. Data will be collected from all participating parents by telephone interview at three assessment periods prior to and immediately after the family intervention implementation. Data will be collected for a third time from a subsample of parents in the intervention group who visit the dental office and all parents in the control group. Analysis of Covariates and logic regression procedures will be used to analyze the direct effects of the intervention. Evaluation of the intervention processes will also be conducted. The results of this pilot project are needed to directly support implementation of an R01 multi-site intervention efficacy trial that will (1) empirically cross validate the measures used in the pilot study and refine the intervention model, and (2) test the direct and indirect effects of the interventions. The proposed research addresses the NIDCR's Health Disparities Plan that recognizes the need for patient-oriented research to understand the bases of health disparities: specifically, the sociological, anthropological and political underpinnings of health-care seeking behavior.
| Binkley, Catherine J; Garrett, Brent; Johnson, Knowlton W (2010) Increasing dental care utilization by Medicaid-eligible children: a dental care coordinator intervention. J Public Health Dent 70:76-84 |
| Kelly, Susan E; Binkley, Catherine J; Neace, William P et al. (2005) Barriers to care-seeking for children's oral health among low-income caregivers. Am J Public Health 95:1345-51 |
