: The long-term objective of this project is to develop an effective tailored behavior change expert system (ES) education program to promote and maintain good oral health and prevent oral diseases among low-income children and their caregivers. To achieve this, the proposed multimedia-based, self-help intervention is designed to be easy to use and easy to diffuse for large-scale use through personal computers. Due to the current lack of tailored self-help behavior change dental interventions, substantial time and resources are needed to develop the content and to test the instruments and feasibility of the proposed interventions. This project has five specific aims: 1) To design and produced two interventions to promote oral health and prevent oral disease among caregivers and their children: (i) an interactive, tailored, theory-driven, behavior change ES education program, and (ii) an untailored health information HI comparison program. 2) To assess the feasibility and usability of these unique interventions with a small-scale feasibility study prior to their final implementation. 3) To revise the interventions based on the findings of the feasibility study and implement the efficacy trial. 4) To evaluate the efficacy of the interventions with two clinical outcomes: gingivitis among caregivers and untreated tooth decay among caregivers and their children. 5) To examine the extent to which the clinical outcomes are mediated by the affective, evaluative, and situational individual factors influenced by the tailored intervention, or by broader psychosocial factors addressed in other center projects. The efficacy of the tailored ES intervention, whether it results in better oral health than the untailored HI intervention, will be tested by the randomized controlled trial. In year 4 of the course of the longitudinal center research, the participating caregivers, low income African Americans recruited from the poorest 39 census tracks in the city of Detroit, will be randomly assigned to one of the two education programs at the beginning of the multimedia intervention session. The oral follow-up examination at year four will be the baseline measurement of this trial, and changes in the outcomes will be assessed in the follow-up examination in year 6. Both the participants and examiners will be blinded from the intervention regimens. Production and evaluation of a state of the science, interactive, tailored multimedia self-help ES program for oral health will provide an opportunity to obtain currently nonexistent information about the ability to influence behaviors that determine oral health status among low SES African Americans caregivers and their children.
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