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降低南亚裔移民儿童龋齿和肥胖风险:常见健康/风险因素方法的随机对照试验。

Reducing pediatric caries and obesity risk in South Asian immigrants: randomized controlled trial of common health/risk factor approach.

机构信息

Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, 10461, USA.

出版信息

BMC Public Health. 2018 May 31;18(1):680. doi: 10.1186/s12889-018-5317-9.

Abstract

BACKGROUND

This paper describes the design and methods of a multi-phase study to reduce early childhood caries and obesity in vulnerable South Asian (SA) immigrants in the United States. Early childhood caries and obesity are the most common diseases of early childhood. Risk factors for both diseases are rooted in early childhood feeding practices such as bottle feeding and intake of sweets and sweetened beverages. The Common Health/Risk Factor Approach to addressing oral health is widely promoted by the WHO and other policy makers. This approach recognizes links between oral health and other diseases of modernity. Our CHALO! ("Child Health Action to Lower Obesity and Oral health risk"--from a Hindi word meaning "Let's go!") study targets SA families at high risk for early childhood caries and obesity. CHALO! addresses common risk factors associated with these two common diseases of childhood.

METHODS

This two part project includes a randomized controlled trial, and a Knowledge Translation campaign. A randomized controlled trial will enroll n =  360 families from pediatric practices serving South Asians in the New York metro area. The intervention group will receive home visits by SA community health workers at 6, 8, 10, 12, 14, and 16 months of age. Controls will receive culturally tailored educational material. Primary outcomes-- cariogenic and obesogenic feeding practices at 6, 12, and 18 months-- will be assessed with the MySmileBuddy iPad based tool. Secondary outcomes include: oral hygiene practices, anthropometrics, and caries incidence at 18 months. A public education campaign will focus on both families and health care providers.

DISCUSSION

There are few Common Health/Risk Factor Approach published studies on obesity and oral health risk in children, despite health morbidity and costs associated with both conditions. CHALO! comprises a multi-level interventions designed to promote culturally competent, sustainable change.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03077425 .

摘要

背景

本文描述了一项多阶段研究的设计和方法,旨在减少美国脆弱的南亚(SA)移民中的幼儿龋齿和肥胖问题。幼儿龋齿和肥胖是幼儿最常见的疾病。这两种疾病的风险因素都植根于幼儿的喂养习惯,如奶瓶喂养以及摄入甜食和含糖饮料。世界卫生组织和其他政策制定者广泛推广了以共同健康/风险因素方法来解决口腔健康问题。这种方法认识到口腔健康与现代其他疾病之间的联系。我们的 CHALO!(“降低肥胖和口腔健康风险的儿童健康行动”——来自一个印地语单词,意思是“Let's go!(我们走!)”)研究针对幼儿龋齿和肥胖风险较高的 SA 家庭。CHALO!针对与这两种儿童常见疾病相关的共同风险因素。

方法

这个两部分项目包括一项随机对照试验和一项知识转化运动。一项随机对照试验将招募来自纽约都会区服务南亚裔儿童的儿科诊所的 n=360 个家庭。干预组将在 6、8、10、12、14 和 16 个月大时接受 SA 社区卫生工作者的家访。对照组将接受文化适应的教育材料。主要结局——6、12 和 18 个月时致龋和致肥胖的喂养习惯——将使用基于 MySmileBuddy iPad 的工具进行评估。次要结局包括:18 个月时的口腔卫生习惯、人体测量学和龋齿发生率。一个公共教育运动将同时针对家庭和医疗保健提供者。

讨论

尽管与这两种情况相关的健康发病率和成本很高,但针对儿童肥胖和口腔健康风险的共同健康/风险因素方法发表的研究很少。CHALO!由旨在促进文化上胜任、可持续变化的多层次干预措施组成。

试验注册

ClinicalTrials.gov NCT03077425。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a376/5984363/f6e5c58b9b4d/12889_2018_5317_Fig1_HTML.jpg

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