: Young children of low-income African American mothers are at risk of developing severe dental caries in primary teeth. This can negatively influence not only their subsequent health but also, by inducing pain an discomfort, may impair their academic performance and well-being. Previous research documents the associations of diet, oral health behaviors and weaning practices with severe dental caries. Yet mothers with low income, low education, and low work status often do not follow health-promoting practices. Current research is inadequate to explain the process by which such social stratification, starting early in childhood, translates into poor oral health later on in life. Without understanding of the social context of low-income and disadvantaged parents, preventive interventions are doomed to failure. Accordingly, the aim of the proposed research is to examine the influence of personal and social context, in a low-income African American community, at the individual (e.g., family income, supports and stresses) and neighborhood (census track, police precinct, and City of Detroit data) level on children?s oral health status. It will consider the mediating and moderating effects of caregivers? parenting behaviors, beliefs, and racial and self identities. Special attention will be given to the interface between racial identity and health promotion as part of parenting. To understand how context influences parenting and parenting influences outcomes over time, the project uses a longitudinal design and takes advantage of newly developed techniques in growth curve and hierarchical modeling. Families, including at minimum a main caregiver and a child aged 0-5 will be enrolled for 4 years, such that the sample children will be aged 4-9 at the conclusion of the study. To minimize costs and maximize the chance of studying high-risk African American families, families with household incomes < 250 percent of poverty will be drawn from the 39 poorest Census tracts in Detroit. Data will be collected in years 2 (2002), 2 and 6, and include face-to-face interviews with the main caregivers, dental examinations, and use of the most up-to-date behavioral self report techniques. The data from this project will provide information on the interactions among social, parenting, and oral hygiene, dietary and health care seeking behaviors, and how these factors cause severe dental caries (examined in Project 2).
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