Mon, Feb 13, 2017, noon:
Daniel Almirall, "Getting SMART about adaptive interventions"
a PSC Research Project
Investigators: Margherita R. Fontana, James M. Lepkowski
Dental caries, the most common chronic disease of childhood, is a largely preventable disease. This proposal focuses on addressing inequities in dental caries experience among preschool aged U.S. children. It has been inspired by the shift and increase in dental caries among subsets of the population (i.e., 2-5 year old children, especially from underserved/minority population groups) that calls for a greater focus on targeted healthcare. In an environment of increasing healthcare costs and resource constraints, this approach is paramount in addressing oral health disparities. It is, therefore, very important to be able to identify children at the highest risk to develop dental caries to help target our limited financial and manpower resources on them. Because children have multiple well child pediatric visits in the early years of life, many lower socioeconomic status (SES) and minority children have much greater access to medical care than to dental care. The great need for tools to triage those at highest risk is highlighted by the establishment of public health insurance expansion programs to increase the safety net available for children?s oral health. Our long-term goal is to reduce disparities in dental caries experience in young children in the U.S. by developing effective risk-based caries preventive and therapeutic strategies to be delivered through new models for oral health care, including primary medical healthcare settings. However, the problem is that the lack of a valid, reliable, and practical caries risk assessment instrument grounded in a well-designed prospective longitudinal study in U.S. infants/toddlers leaves providers (especially primary healthcare providers) with the inability to successfully target caries preventive and referral strategies to those who need it the most. Thus, the objective of this innovative application is to validate, over a longitudinal 3-year period, a caries risk questionnaire for use in infants and toddlers in primary healthcare centers. A strength of this proposal is its multidisciplinary, multisite design to address oral health disparities research through risk assessment. Three well-established medical research networks will provide access to at-risk, diverse populations and low socioeconomic groups. In addition, all study sites offer strong partnerships between experienced medical and dental teams with an interest in improving the oral health of children. The three medical research networks will recruit and follow for 36 months a total of 1,326 infants (initially child?s age 12 + 3 months old) from identified risk-population groups through their pediatric well-child visits to assess/quantify the caries process, as well as changes and stability in the questionnaire items. Each study site also has an NIH Clinical and Translational Science Awards (CTSA), and will benefit from infrastructure and experience in clinical translational research. The significance of this collaborative project is that it will result in a valid, reliable, and practical caries risk assessment instrument for the identification of high caries risk infants/toddlers in primary healthcare settings, allowing for cost-effective preventive and/or referral strategies to be developed and targeted to prevent early childhood caries.
|Funding:||National Institute of Dental and Craniofacial Research (1 U01 DE 021412 01 A1)|
Funding Period: 09/23/2011 to 07/31/2016
Country of Focus: USA