Among infants and toddlers, infant caries commonly called Baby Bottle Tooth Decay (BBTD) continues to be a constant problem without adequate resolution in Puerto Rico and appears to have consequences for general and dental health. Our recent work has found a 41% prevalence and has identified risk factors in some selected communities of the Eastern region of Puerto Rico. Based on these results, research is needed to address why Puerto Rican children experience the disease specially the compromised patient. This proposal attempts to begin to establish a program whose goals are the demonstration that prevention of BBTD is possible in high risk groups of Puerto Rican children. The objective of this project is to develop a community-based and culturally sensitive intervention to prevent BBTD among low socioeconomic groups and HIV seropositive Puerto Rican mothers/caretakers and children. Such an objective is congruent with the new objective in Healthy People 2000 aimed at preventing BBTD and the recommended campaign that enhances parent and caretaker awareness.
Specific aims are: (1) to develop an understanding of the Puerto Rican parenting process and how it many be best influenced over time to prevent infant caries. This will be achieve gaining insight into the attitudes, beliefs, preferences and behaviors of women of childbearing age and their mothers regarding childcaring practices and BBTD and intent or attempts to take action (2) to obtain a qualitative assessment of oral health problems among infants and pre-school children in this population. To achieve these aims a sample of 24 groups of 10 mothers/caretakers from the Municipality of Loiza, with specific characteristics, will be targeted and screened though the focus-group methodology. The questions will focus on (1) child feeding-practices i.e., bottlefeeding, weaning from the bottle, and snacking (2) child dental care and other hygiene practices (3) awareness of BBTD, its relative importance, and intent and attempts to prevent disease (4) child health and temperament, social support, and life stress, and self-efficacy and (5) dental care experiences of the parent/caretaker. All workshops will be audio-taped and video-taped for data analysis and evaluation purposes. The focus group methodology will allow to identify realistic behavioral risk factors and interventions strategies that otherwise would not be presented by parents in other evaluation methods. An Advisory Board will work with project staff to help select and gain access to study populations.
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