: 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).

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZDE1)
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University of Michigan Ann Arbor
Ann Arbor
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Cheng, Jing; Cheng, Nancy F; Guo, Zijian et al. (2018) Mediation analysis for count and zero-inflated count data. Stat Methods Med Res 27:2756-2774
Lim, Sungwoo; Tellez, Marisol; Ismail, Amid I (2015) Dental caries development among African American children: results from a 4-year longitudinal study. Community Dent Oral Epidemiol 43:200-7
Heima, Masahiro; Milgrom, Peter (2015) Soda Consumption May Increase Risk of Dental Caries in Primary Teeth of Low-income African Americans. J Evid Based Dent Pract 15:200-1
Ismail, Amid I; Lim, Sungwoo; Tellez, Marisol (2015) Tooth Surface Level Caries Progression in the Primary Dentition among Preschool Children. Caries Res 49:442-8
Ismail, Amid I; Ondersma, Steven; Jedele, Jenefer M Willem et al. (2011) Evaluation of a brief tailored motivational intervention to prevent early childhood caries. Community Dent Oral Epidemiol 39:433-48
Lim, Sungwoo; Zoellner, Jamie M; Ajrouch, Kristine J et al. (2011) Overweight in childhood: the role of resilient parenting in African-American households. Am J Prev Med 40:329-33
Ismail, Amid I; Lim, Sungwoo; Sohn, Woosung (2011) A transition scoring system of caries increment with adjustment of reversals in longitudinal study: evaluation using primary tooth surface data. Community Dent Oral Epidemiol 39:61-8
Lee, Joyce M; Lim, Sungwoo; Zoellner, Jamie et al. (2010) Don't children grow out of their obesity? Weight transitions in early childhood. Clin Pediatr (Phila) 49:466-9
Ajrouch, Kristine J; Reisine, Susan; Lim, Sungwoo et al. (2010) Situational stressors among African-American women living in low-income urban areas: the role of social support. Women Health 50:159-75
Ajrouch, Kristine J; Reisine, Susan; Lim, Sungwoo et al. (2010) Perceived everyday discrimination and psychological distress: does social support matter? Ethn Health 15:417-34

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