The aim of the proposed Community Oral Health Interventions Program (COHIP) is to develop and implement an integrated model for reducing oral health disparities. COHIP's vision, mission, and design framework were developed with direct input from community partners and the findings for the Detroit Dental Health Project (DDHP), a disparity research center funded by NIH. The DDHP has had a successful model for understanding the determinants of oral health disparities and has built a strong community and organizational foundations. The DDHP has produced so far over 19 refereed publications, 3 PhD dissertations, and 2 MSc theses. Moreover, the DDHP core leadership has managed during the last 6 years a complex research project focusing on families of low-income African-American children. The findings from the DDHP underscore the need for multi-level interventions. Following the Ottawa and Jakarta Declarations for health promotion, COHIP was designed to intervene on key social, behavioral, and clinical factors of oral health disparities. The COHIP will focus on building healthy communities around four dental clinics owned by 2 Federally Qualified Health Centers. Around each clinic the lowest income census tracts will be selected to target a population of 16,023 children aged 0-11 years and their caregivers. The selected areas will be stratified into small clusters of households and randomized into intervention and comparison groups. COHIP includes three clustered randomized demonstration trials targeting the same families. One project will aim to intervene on the social, behavioral, and biological determinants of dental caries; another will focus on resolving a major problem identified in the DDHP analyses where children who get care have a significant proportion of their cavitated tooth surfaces left untreated within 2 years of follow-up; and the third will focus on reducing the significant disparities in periodontal diseases on adults by intervening on the social, behavioral, and biological risk factors of periodontal diseases. COHIP has assembled a multi-disciplinary team of social, behavioral, biological, dental, medical and organizational researchers. COHIP plans to intervene at the community and clinical levels. Sustainability of the COHIP model is a requirement demanded by the community partners. COHIP is collaborating with FQHC operational experts and has the support of HRSA regional office, University of Michigan ($1 Million grant), and the NNHOA. ?
