Cooper Anna Mary, Coffey Margaret, Dugdill Lindsey
School of Health Sciences, University of Salford, Salford, UK.
Pragmat Obs Res. 2014 Dec 2;5:43-51. doi: 10.2147/POR.S52287. eCollection 2014.
Often within oral health, clinical outcome measures dominate trial design rather than behavioral outcome measures, and often there is a reliance on proxy self-reporting of children's behavior with no corroboration through triangulation of measures. The complexity of the interventions involved in oral health intervention is often overlooked in trial design, and more flexible pragmatic designs that take account of the research context may be more appropriate. Some of the limitations in oral health behavioral intervention studies (trials) in primary school age children were reported in a recently published Cochrane review. This paper aims to critically discuss the findings of a recent Cochrane review in terms of the methodological implications that arise for future design, development, measurement, and reporting of oral health trials in primary school age children. Key components of the UK Medical Research Council's framework for the design and evaluation of complex interventions are discussed in relation to using taxonomies of behavior change. This paper is not designed to be a definitive guide but aims to bring learning from other areas of public health and health promotion into dental public health. Ultimately, the aim is to aid the design of more successful interventions that produce long-term behavioral changes in children in relation to toothbrushing and nighttime sugar snacking.
在口腔健康领域，临床结局指标往往主导试验设计，而非行为结局指标，并且常常依赖对儿童行为的代理自我报告，而没有通过多种测量方法相互印证。口腔健康干预所涉及的干预措施的复杂性在试验设计中常常被忽视，考虑研究背景的更灵活的实用设计可能更为合适。最近发表的一篇Cochrane综述报告了小学年龄段儿童口腔健康行为干预研究（试验）中的一些局限性。本文旨在批判性地讨论最近一篇Cochrane综述的结果，涉及对小学年龄段儿童口腔健康试验未来设计、开发、测量和报告所产生的方法学影响。结合行为改变分类法，讨论了英国医学研究理事会复杂干预设计与评估框架的关键组成部分。本文并非旨在成为权威性指南，而是旨在将公共卫生和健康促进其他领域的经验引入牙科公共卫生。最终目标是帮助设计更成功的干预措施，使儿童在刷牙和夜间吃含糖零食方面产生长期行为改变。
