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Hippalgaonkar N, Nguyen RHT, Cohn EB, Horowitz J, Waite AW, Mersha T, Sandoval C, Khan S, Salum K, Thomas P, Murphy AM, Brent B, Coleman L, Khosla P, Hoskins KF, Henderson V, Carnahan LR. Are We the Problem? A Call to Action for Addressing Institutional Challenges to Engaging Community Partners in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:236. [PMID: 38397725 PMCID: PMC10888328 DOI: 10.3390/ijerph21020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Community-engaged research (CEnR) is a potent tool for addressing health inequities and fostering equitable relationships among communities, researchers, and institutions. CEnR involves collaboration throughout the research process, demonstrating improvements in study recruitment and retention, intervention efficacy, program sustainability, capacity building among partners, and enhanced cultural relevance. Despite the increasing demand for CEnR, institutional policies, particularly human participation protection training (HPP), lag behind, creating institutional barriers to community partnerships. Here, we highlight challenges encountered in our ongoing study, Fostering Opportunities in Research through Messaging and Education (FOR ME), focused on promoting shared decision-making around clinical trial participation among Black women diagnosed with breast cancer. Grounded in CEnR methods, FOR ME has a partnership with a community-based organization (CBO) that addresses the needs of Black women with breast cancer. Our CBO partner attempted to obtain HPP training, which was administratively burdensome and time-consuming. As CEnR becomes more prevalent, academic and research institutions, along with researchers, are faced with a call to action to become more responsive to community partner needs. Accordingly, we present a guide to HPP training for community partners, addressing institutional barriers to community partner participation in research. This guide outlines multiple HPP training pathways for community partners, aiming to minimize institutional barriers and enhance their engagement in research with academic partners.
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Affiliation(s)
- Neha Hippalgaonkar
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
| | - Ryan Huu-Tuan Nguyen
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Eliza Brumer Cohn
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | - Joseph Horowitz
- Department of Medicine and Pediatrics, University of Illinois College of Medicine, Chicago, IL 60612, USA;
| | - Ana Williams Waite
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Tigist Mersha
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Christen Sandoval
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Sarah Khan
- Sinai Chicago, Chicago, IL 60612, USA; (S.K.); (P.K.)
| | - Kauthar Salum
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | | | - Anne Marie Murphy
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Beulah Brent
- Sisters Working It Out, Chicago, IL 60612, USA; (B.B.); (L.C.)
| | - Lolita Coleman
- Sisters Working It Out, Chicago, IL 60612, USA; (B.B.); (L.C.)
| | | | - Kent F. Hoskins
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Vida Henderson
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | - Leslie R. Carnahan
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
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Martin MA, Sundararajan V, Ochoa N, Dziak J, Berbaum M, Lee HH, Avenetti DM, Zhang T, Sandoval A, Torres J, Wu A. Oral Health Behaviors for Young Low-Income Urban Children during the COVID-19 Pandemic: A Mixed Methods Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1329. [PMID: 37628328 PMCID: PMC10453313 DOI: 10.3390/children10081329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
This research assessed oral health behaviors changes in urban families with young children during the stay-at-home period of the COVID-19 pandemic (Nov 2020-August 2021). Survey data on oral health behaviors were collected in homes at three points before COVID-19, and via phone during COVID-19. A subset of parents and key informants from clinics and social service agencies completed in-depth interviews via video/phone. Of the 387 parents invited, 254 completed surveys in English or Spanish (65.6%) during COVID-19. Fifteen key informant interviews (25 participants) and 21 family interviews were conducted. The mean child age was 4.3 years. Children identified as mainly Hispanic (57%) and Black race (38%). Parents reported increased child tooth brushing frequency during the pandemic. Family interviews highlighted changes in family routines that impacted oral health behaviors and eating patterns, suggesting less optimal brushing and nutrition. This was linked to changed home routines and social presentability. Key informants described major disruptions in oral health services, family fear, and stress. In conclusion, the stay-at-home period of the COVID-19 pandemic was a time of extreme routine change and stress for families. Oral health interventions that target family routines and social presentability are important for families during times of extreme crisis.
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Affiliation(s)
- Molly A. Martin
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Vyshiali Sundararajan
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Nadia Ochoa
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - John Dziak
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Michael Berbaum
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Helen H. Lee
- College of Medicine Department of Anesthesiology, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA;
| | - David M. Avenetti
- College of Dentistry Department of Pediatrics, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA;
| | - Tong Zhang
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Anna Sandoval
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Javier Torres
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
| | - Andy Wu
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W. Roosevelt Road, WROB, MC 275, Chicago, IL 60608, USA; (V.S.); (N.O.); (J.D.); (M.B.); (T.Z.); (A.S.); (J.T.); (A.W.)
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Lee HH, Dziak JJ, Avenetti DM, Berbaum ML, Edomwande Y, Kliebhan M, Zhang T, Licona-Martinez K, Martin MA. Association between neighborhood disadvantage and children's oral health outcomes in urban families in the Chicago area. Front Public Health 2023; 11:1203523. [PMID: 37457261 PMCID: PMC10345837 DOI: 10.3389/fpubh.2023.1203523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose The prevalence of childhood caries in urban Chicago, compared with national and state data, indicates that neighborhood context influences oral health. Our objective was to delineate the influence of a child's neighborhood on oral health outcomes that are predictive of caries (toothbrushing frequency and plaque levels). Methods Our study population represents urban, Medicaid-enrolled families in the metropolitan Chicago area. Data were obtained from a cohort of participants (child-parent dyads) who participated in the Coordinated Oral Health Promotion (CO-OP) trial at 12 months of study participation (N = 362). Oral health outcomes included toothbrushing frequency and plaque levels. Participants' neighborhood resource levels were measured by the Area Deprivation Index (ADI). Linear and logistic regression models were used to measure the influence of ADI on plaque scores and toothbrushing frequency, respectively. Results Data from 362 child-parent dyads were analyzed. The mean child age was 33.6 months (SD 6.8). The majority of children were reported to brush at least twice daily (n = 228, 63%), but the mean plaque score was 1.9 (SD 0.7), classified as "poor." In covariate-adjusted analyses, ADI was not associated with brushing frequency (0.94, 95% CI 0.84-1.06). ADI was associated with plaque scores (0.05, 95% CI 0.01-0.09, p value = 0.007). Conclusions Findings support the hypothesis that neighborhood-level factors influence children's plaque levels. Because excessive plaque places a child at high risk for cavities, we recommend the inclusion of neighborhood context in interventions and policies to reduce children's oral health disparities. Existing programs and clinics that serve disadvantaged communities are well-positioned to support caregivers of young children in maintaining recommended oral health behaviors.
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Affiliation(s)
- Helen H. Lee
- Department of Anesthesiology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - John J. Dziak
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - David M. Avenetti
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, IL, United States
| | - Michael L. Berbaum
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Yuwa Edomwande
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Margaret Kliebhan
- Department of Pediatrics, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Tong Zhang
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Karla Licona-Martinez
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Molly A. Martin
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
- Department of Pediatrics, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
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Martin MA, Avenetti D, Lee HH, Nordgren R, Berbaum ML, Edomwande Y, Cui L, Sandoval A. Community health worker intervention to improve tooth brushing in young children: Results from a cluster randomized controlled trial. Community Dent Oral Epidemiol 2023; 51:503-511. [PMID: 35766288 PMCID: PMC9797618 DOI: 10.1111/cdoe.12768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Coordinated Oral health Promotion (CO-OP) Chicago is a cluster randomized controlled trial testing the efficacy of a community health worker (CHW) intervention to improve tooth brushing in low-income children. METHODS Four hundred twenty children under 3 years old (mean 21.5 months) were recruited from 20 sites in or near Chicago, IL. Children were identified mainly as Black race (41.9%) or Hispanic ethnicity (53.8%) and most (85.2%) had Medicaid. Intervention families were offered four CHW home visits over 1 year. Brushing frequency was self-reported. Plaque score was determined from images collected in homes using disclosing solution. Analyses used GEE logistic models with variable selection at p < .05. RESULTS At enrolment, 45.0% of families reported twice a day or more child brushing frequency, and child plaque scores were poor (mean of 1.9, SD: 0.6). Data were obtained from 87.1% of children at 6 months and 86.2% at 12 months. In the CHW intervention arm (10 sites, N = 211), 23.7% received 4 visits, 12.8% 3 visits, 21.3% 2 visits, 23.2% 1 visit and 19% no visits from CHWs. No intervention effect was seen for brushing frequency or plaque score. Child brushing frequency improvement over time was associated with a range of child and caregiver factors. The only factor associated with a change in plaque score over time was parent involvement in brushing. CONCLUSIONS Oral-health-specific CHW services were not associated with improved brushing behaviours in these young children. However, caregiver involvement with brushing supported more quality brushing. More robust interventions are needed to support families during this critical developmental period.
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Affiliation(s)
| | | | - Helen H Lee
- University of Illinois Chicago, Chicago, Illinois, USA
| | | | | | | | - Liyong Cui
- University of Illinois Chicago, Chicago, Illinois, USA
| | - Anna Sandoval
- University of Illinois Chicago, Chicago, Illinois, USA
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Martin MA, Sundararajan V, Ochoa N, Dziak J, Berbaum M, Lee HH, Avenetti DM, Zhang T, Sandoval A, Torres J, Wu A. Oral health behaviors for young low-income urban children during the COVID-19 pandemic: a mixed methods analysis. RESEARCH SQUARE 2023:rs.3.rs-2956733. [PMID: 37292971 PMCID: PMC10246233 DOI: 10.21203/rs.3.rs-2956733/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This research assessed oral health behaviors changes in urban families with young children during the stay-at-home period of the COVID-19 pandemic. Survey data on oral health behaviors were collected in homes at three points over one year before COVID-19, and then via phone during COVID-19. Multivariate logistic regression was used to model tooth brushing frequency. A subset of parents completed in-depth interviews via video/phone that expanded on oral health and COVID-19. Key informant interviews via video/phone were also conducted with leadership from 20 clinics and social service agencies. Interview data were transcribed and coded, and themes were extracted. COVID-19 data collection went from Nov 2020 - August 2021. Of the 387 parents invited, 254 completed surveys in English or Spanish (65.6%) during COVID-19. Fifteen key informant (25 participants) and 21 parent interviews were conducted. The mean child age was approximately 4.3 years. Children identified as mainly Hispanic (57%) and Black race (38%). Parents reported increased child tooth brushing frequency during the pandemic. Parent interviews highlighted significant changes in family routines that impacted oral health behaviors and eating patterns, suggesting less optimal brushing and nutrition. This was linked to changed home routines and social presentability. Key informants described major disruptions in their oral health services and significant family fear and stress. In conclusion, the stay-at-home period of the COVID-19 pandemic was a time of extreme routine change and stress for families. Oral health interventions that target family routines and social presentability are important for families during times of extreme crisis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Andy Wu
- University of Illinois Chicago
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Avenetti DM, Martin MA, Gansky SA, Ramos-Gomez FJ, Hyde S, Van Horn R, Jue B, Rosales GF, Cheng NF, Shiboski CH. Calibration and reliability testing of a novel asynchronous photographic plaque scoring system in young children. J Public Health Dent 2023; 83:108-115. [PMID: 36781405 PMCID: PMC10329468 DOI: 10.1111/jphd.12557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 11/17/2022] [Accepted: 12/02/2022] [Indexed: 02/15/2023]
Abstract
OBJECTIVES The Simplified Oral Hygiene Index for Maxillary Incisors (OHI-MIS) is a novel plaque scoring system adapted for young children. This study describes calibration training and testing used to establish the inter- and intra-rater reliability for OHI-MIS measured from clinical photographs. METHODS Two raters from the Coordinated Oral Health Promotion Chicago (CO-OP) and one from the Behavioral EConomics for Oral health iNnovation (BEECON) randomized controlled trials (RCTs) underwent calibration with gold standard raters, followed by annual re-calibration. Raters from CO-OP also completed inter-rater reliability testing; all three raters completed intra-rater reliability testing rounds. Photographs were obtained from children aged 9-39 months. RESULTS All three raters achieved greater than 0.77 Lin's Concordance Correlation (LCC) versus gold standard consensus during calibration. All three raters had LCC ≥0.83 at recalibration 1 year later. CO-OP trial raters scored 604 photos (151 sets of 4 photographs); mostly both raters were somewhat/very confident in their scoring (≥89%), describing the most photos as "clear" (90% and 81%). The CO-OP inter-rater LCC for total OHI-MIS score was 0.86, changing little when low quality or confidence photos were removed. All three raters demonstrated high intra-rater reliability (≥0.83). CONCLUSIONS The OHI-MIS plaque scoring system on photos had good reliability within and between trials following protocol training and calibration. OHI-MIS provides a novel asynchronous plaque scoring system for use in young children. Non-clinicians in field or clinical settings can obtain photographs, offering new opportunities for research and clinical care.
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Affiliation(s)
- David M. Avenetti
- Department of Pediatric Dentistry, UIC College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Molly A. Martin
- Department of Pediatrics, UIC College of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Stuart A. Gansky
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Francisco J. Ramos-Gomez
- Division of Preventative and Restorative Sciences, Section of Pediatric Dentistry, UCLA School of Dentistry, University of California, Los Angeles, California, USA
| | - Susan Hyde
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Rebecca Van Horn
- Department of Pediatric Dentistry, UIC College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Bonnie Jue
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Genesis F. Rosales
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nancy F. Cheng
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Caroline H. Shiboski
- Department of Orofacial Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
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Patel S, Fantauzzi AJ, Patel R, Buscemi J, Lee HH. Childhood caries and dental surgery under general anesthesia: an overview of a global disease and its impact on anesthesiology. Int Anesthesiol Clin 2023; 61:21-25. [PMID: 36480646 PMCID: PMC9752176 DOI: 10.1097/aia.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Children’s oral health is influenced, negatively and positively, but modifiable social determinants. For high-risk populations, severe disease burden leads to dental treatment under general anesthesia (DGA), which represents a costly and futile use of scarce resources. These clinical events, at the intersection of medicine and dentistry, often involve anesthesiologists to facilitate care. However, clinical interventions do not address the etiology of disease, which are largely rooted in health behaviors. In this review, we will summarize the scope of severe disease on a global scale and its impact on individual and population health and health systems. We will also provide insight into factors that influence DGA utilization from perspectives of families, providers, health systems, policy, and community-level environment. A child’s need for DGA may represent missed prevention opportunities at several levels. However, the surgical period may serve as a prime window to change a family’s oral health behaviors and reduce chance of recurrent disease amongst the highest risk families.
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Affiliation(s)
- Shiragi Patel
- Department of Anesthesiology, Ann & Robert H. Lurie Children's Hospital, McGaw Medical Center of Northwestern University, Chicago, Illinois
| | - Andrés J Fantauzzi
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois
| | - Raj Patel
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, Illinois
| | - Helen H Lee
- Department of Anesthesiology, Institute for Health Policy and Research, University of Illinois at Chicago, Chicago, Illinois
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Lee HH, Avenetti D, Edomwande Y, Sundararajan V, Cui L, Berbaum M, Nordgren R, Sandoval A, Martin MA. Oral community health worker-led interventions in households with average levels of psychosocial factors. FRONTIERS IN ORAL HEALTH 2022; 3:962849. [PMID: 36035381 PMCID: PMC9403266 DOI: 10.3389/froh.2022.962849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionHousehold-level psychosocial stress levels have been linked to child tooth brushing behaviors. Community health worker (CHW) interventions that target psychosocial factors in high-risk communities have been associated with changes in health behaviors.AimObserve changes in psychosocial factors over time and an association between psychosocial factors and CHW intervention dose amongst urban Chicago families.Patients and methodsParticipants (N = 420 families) were recruited from 10 community clinics and 10 Women, Infants, or Children (WIC) centers in Cook County, Illinois to participate in a clinical trial. Research staff collected participant-reported psychosocial factors (family functioning and caregiver reports of depression, anxiety, support, and social functioning) and characteristics of CHW-led oral health intervention visits (number, content, child engagement) at 0, 6, and 12 months. CHWs recorded field observations after home visits on household environment, social circumstances, stressors, and supports.ResultsParticipants across the cohort reported levels of psychosocial factors consistent with average levels for the general population for nearly all measures. Psychosocial factors did not vary over time. Social functioning was the only measure reported at low levels [32.0 (6.9); 32.1 (6.7); 32.7 (6.9); mean = 50 (standard deviation)] at 0, 6, and 12 months. We did not observe a meaningful difference in social functioning scores over time by exposure to CHW-led intervention visits (control arm, 0, 1, 2, 3, and 4 visits). Field observations made by CHWs described a range of psychosocial stress related to poverty, language barriers, and immigration status.ConclusionThe unexpectedly average and unchanging psychosocial factors over time, in the context of field observations of stress related to poverty, lack of support, immigration status, and language barriers, suggests that our study did not adequately capture the social determinants of health related to oral health behaviors or that measurement biases precluded accurate assessment. Future studies will assess psychosocial factors using a variety of instruments in an attempt to better measure psychosocial factors including social support, depression, anxiety, functioning, trauma and resilience within our urban population. We will also look at neighborhood-level factors of community distress and resilience to better apply the social ecologic model to child oral health behaviors.
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Affiliation(s)
- Helen H. Lee
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, United States
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Helen H. Lee
| | - David Avenetti
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
- Department of Pediatric Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Yuwa Edomwande
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Vyshiali Sundararajan
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Liyong Cui
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Michael Berbaum
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Rachel Nordgren
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Anna Sandoval
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Molly A. Martin
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, United States
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Ramos-Gomez FJ, Martin MA, Nelson SS, Borrelli B, Henshaw MM, Curtan S, Lindau HE, Rueras N, Sandoval AS, Gansky SA. COVID-19 Impact on Community-Based Participatory Randomized Controlled Trials—Lessons From the Oral Health Disparities in Children Consortium. FRONTIERS IN DENTAL MEDICINE 2021; 2. [PMID: 35669970 PMCID: PMC9164288 DOI: 10.3389/fdmed.2021.671911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The COVID-19 pandemic has had a major impact on nearly every sector of science and industry worldwide, including a significant disruption to clinical trials and dentistry. From the beginning of the pandemic, dental care was considered high risk for viral transmission due to frequent aerosol-generating procedures. This resulted in special challenges for dental providers, oral health care workers, patients, and oral health researchers. By describing the effect that the COVID-19 pandemic had on four community-based randomized clinical trials in the Oral Health Disparities in Children (OHDC) Consortium, we highlight major challenges so researchers can anticipate impacts from any future disruptions.
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Affiliation(s)
- Francisco J. Ramos-Gomez
- Department of Pediatric Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
- Center to Address Disparities in Children’s Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA, United States
| | - Molly A. Martin
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Suchitra S. Nelson
- Department of Community Dentistry, Case Western Reserve University, Cleveland, OH, United States
| | - Belinda Borrelli
- Center for Behavioral Sciences Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, United States
| | - Michelle M. Henshaw
- Global and Population Health, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, United States
| | - Shelley Curtan
- Department of Community Dentistry, Case Western Reserve University, Cleveland, OH, United States
| | - Helen E. Lindau
- Department of Pediatric Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicolle Rueras
- Center for Behavioral Sciences Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, United States
| | - Anna S. Sandoval
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Stuart A. Gansky
- Center to Address Disparities in Children’s Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA, United States
- School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
- Correspondence: Stuart A. Gansky,
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Martin M, Pugach O, Avenetti D, Lee H, Salazar S, Rosales G, Songthangtham N. Oral Health Behaviors in Very Young Children in Low-Income Urban Areas in Chicago, Illinois, 2018-2019. Prev Chronic Dis 2020; 17:E152. [PMID: 33274700 PMCID: PMC7735487 DOI: 10.5888/pcd17.200213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Because most data on oral health do not include infants and toddlers, we aimed to describe the oral health behaviors of low-income children younger than 3 years and determine factors associated with child tooth brushing. Methods We obtained data from the Coordinated Oral Health Promotion Chicago study, which included 420 families with children aged 6 to 36 months and their caregivers in Cook County, Illinois. We assessed child frequency of brushing from caregiver reports and objectively determined child dental plaque scores. Significant factors associated with tooth brushing frequency and dental plaque score were identified using the Least Absolute Shrinkage and Selection Operator variable selection. Results Mean child age was 21.5 (SD, 6.9) months, and only 45% of caregivers brushed their children’s teeth twice per day or more. The mean plaque score was 1.9 (SD, 0.6), indicating high levels of plaque. Child brushing frequency was higher when children were older; used the correct toothpaste amount; brushed for a longer duration; and when caregivers brushed their own teeth more frequently, had more help with the overall care of the child’s teeth, and had family to help. Child brushing frequency was lower for caregivers with more interference from activities of daily life. Children whose caregivers had more adult help with child brushing had better plaque scores; worse plaque scores were seen in children with higher sugary beverage and food consumption and lower household incomes. Conclusion The tooth brushing behaviors of young children are strongly associated with those of their parents and with the level of family support for brushing. Interventions to improve brushing in young children should focus on the entire family.
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Affiliation(s)
- Molly Martin
- College of Medicine, Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois.,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.,University of Illinois at Chicago, 840 South Wood St, M/C 856, Chicago, IL 60612.
| | - Oksana Pugach
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - David Avenetti
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.,College of Dentistry, Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| | - Helen Lee
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.,College of Medicine, Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois
| | - Shojanny Salazar
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Genesis Rosales
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Nattanit Songthangtham
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
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