Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in American Indian Head Start Programs
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Purpose
An intensive intervention of specially trained paraprofessionals, called community oral health specialists (COHS), administering on a quarterly basis for 2 years fluoride varnish and oral health promotion education, compared to usual care, will reduce decayed, missing, and filled tooth surface measures at 2 years for children in American Indian Head Start Programs.
| Condition | Intervention | Phase |
|---|---|---|
|
Early Childhood Dental Caries |
Device: Fluoride varnish Behavioral: Oral health education Other: Dental services delivered by the Indian Health Service. |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in American Indian Head Start Programs |
- Decayed, missing, and filled tooth surfaces (dmfs) [ Time Frame: Over 3 years ] [ Designated as safety issue: No ]The number of decayed, missing, and filled tooth surfaces (dmfs) for each child. The dental examiners will be trained and calibrated, and standardized criteria and instruments will be used for the detection of the dental caries.
- Dental knowledge, attitudes, and behaviors of the caregivers of the children [ Time Frame: Over 3 years ] [ Designated as safety issue: No ]An automated computer assisted survey interview (ACASI)will be done of the caregivers of the children. The questions have been standardized across 6 studies from the Collaborating Research Centers to Reduce Oral Health Disparities.
- Caries patterns [ Time Frame: Over 3 years ] [ Designated as safety issue: No ]Caries patterns will be studied in terms of the specific teeth and tooth surfaces that are affected.
- Utilization and costs of dental care [ Time Frame: Up to 3 years after randomization ] [ Designated as safety issue: No ]Utilization and costs of dental care received by the children in the study will be compared, as well as the costs of the intervention program.
| Estimated Enrollment: | 1040 |
| Study Start Date: | April 2011 |
| Estimated Study Completion Date: | August 2015 |
| Estimated Primary Completion Date: | August 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: COHS administered fluoride varnish and oral health education
Paraprofessionals, called community oral health specialists (COHS), will be trained to administer fluoride varnish and oral health education to head start children quarterly for 2 years.
|
Device: Fluoride varnish
Fluoride varnish will be administered by the COHS quarterly for 2 years.
Behavioral: Oral health education
Oral health education will be provided quarterly for 2 years. It will include information about how to mitigate the known risk factors for early childhood dental caries.
|
|
Active Comparator: Usual care
Usual care will include regular dental services provided by the Indian Health Service.
|
Other: Dental services delivered by the Indian Health Service. |
Detailed Description:
The study design will be a clustered randomized design. Fifty-two head start classes in a Southwest American Indian Reservation will be randomized, 26 to the intervention program and 26 to usual care. The intervention will be comprised of specially trained paraprofessionals, called community oral health specialists (COHS), administering fluoride varnish and oral health promotion education quarterly for 2 years. Baseline and annual measures of decayed, missing, and filled tooth surfaces (dmfs)of the children, and surveys of their caregivers' dental knowledge, attitudes, and behaviors will be completed. The study will be a 5-year study, with 2 years for intake/accrual, and 3 years of follow-up.
Eligibility| Ages Eligible for Study: | 3 Years to 5 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Children ages 3-5 enrolled in Head Start Centers on a Southwest Indian Reservation and having a primary caregiver (preferably mother, or the child's legal guardian as documented by the HSC)
- American Indian, as defined by the tribe, or children of other racial/ethnic groups who are in the Head Start classes on the Reservation
- Parent/caregiver able to read, understand, and sign the study consent form and willing and able to follow the study procedures and instructions
Exclusion Criteria:
- Allergy to any of the components of the fluoride varnish
- Ulcerative gingivitis, stomatitis, or other conditions resulting in disrupted or irritated oral mucosa
- Any other conditions or findings that, in the opinion of the investigators, would interfere with or preclude participation in the study.
Contacts and Locations| Contact: David O Quissell, Ph.D. | 303-724-4560 | David.Quissell@ucdenver.edu |
| Contact: William Henderson, MPH, PhD | 303-724-1165 | William.Henderson@ucdenver.edu |
| United States, Colorado | |
| University of Colorado | Recruiting |
| Aurora, Colorado, United States, 80045 | |
| Contact: David Quissell, PhD 303-724-4560 David.Quissell@ucdenver.edu | |
| Contact: William G Henderson, MPH, PhD 303-724-1165 William.Henderson@ucdenver.edu | |
More Information
No publications provided
| Responsible Party: | University of Colorado, Denver |
| ClinicalTrials.gov Identifier: | NCT01116739 History of Changes |
| Other Study ID Numbers: | 08-0892, 1U54DE019259 |
| Study First Received: | May 3, 2010 |
| Last Updated: | November 21, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Dental Caries Tooth Demineralization Tooth Diseases Stomatognathic Diseases Fluorides, Topical |
Fluorides Cariostatic Agents Protective Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013