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Design and implementation of a dental caries prevention trial in remote Canadian Aboriginal communities.

https://arctichealth.org/en/permalink/ahliterature143573
Source
Trials. 2010;11:54
Publication Type
Article
Date
2010
Author
Rosamund Harrison
Jacques Veronneau
Brian Leroux
Author Affiliation
Division of Pediatric Dentistry, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada. rosha@interchange.ubc.ca
Source
Trials. 2010;11:54
Date
2010
Language
English
Publication Type
Article
Keywords
American Native Continental Ancestry Group - psychology
Cariostatic Agents - therapeutic use
Child, Preschool
Cluster analysis
Dental Caries - ethnology - prevention & control - psychology
Dental Health Services
Directive Counseling
Female
Fluorides, Topical - therapeutic use
Health Behavior
Health Education, Dental
Health Knowledge, Attitudes, Practice
Health Services, Indigenous
Humans
Infant
Interview, Psychological
Male
Motivation
Pamphlets
Pregnancy
Prevalence
Quebec - epidemiology
Questionnaires
Sample Size
Single-Blind Method
Abstract
The goal of this cluster randomized trial is to test the effectiveness of a counseling approach, Motivational Interviewing, to control dental caries in young Aboriginal children. Motivational Interviewing, a client-centred, directive counseling style, has not yet been evaluated as an approach for promotion of behaviour change in indigenous communities in remote settings.
Aboriginal women were hired from the 9 communities to recruit expectant and new mothers to the trial, administer questionnaires and deliver the counseling to mothers in the test communities. The goal is for mothers to receive the intervention during pregnancy and at their child's immunization visits. Data on children's dental health status and family dental health practices will be collected when children are 30-months of age. The communities were randomly allocated to test or control group by a random "draw" over community radio. Sample size and power were determined based on an anticipated 20% reduction in caries prevalence. Randomization checks were conducted between groups.
In the 5 test and 4 control communities, 272 of the original target sample size of 309 mothers have been recruited over a two-and-a-half year period. A power calculation using the actual attained sample size showed power to be 79% to detect a treatment effect. If an attrition fraction of 4% per year is maintained, power will remain at 80%. Power will still be > 90% to detect a 25% reduction in caries prevalence. The distribution of most baseline variables was similar for the two randomized groups of mothers. However, despite the random assignment of communities to treatment conditions, group differences exist for stage of pregnancy and prior tooth extractions in the family. Because of the group imbalances on certain variables, control of baseline variables will be done in the analyses of treatment effects. This paper explains the challenges of conducting randomized trials in remote settings, the importance of thorough community collaboration, and also illustrates the likelihood that some baseline variables that may be clinically important will be unevenly split in group-randomized trials when the number of groups is small.
This trial is registered as ISRCTN41467632.
Notes
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PubMed ID
20465831 View in PubMed
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Oral health and the aboriginal child: a forum for community members, researchers and policy-makers.

https://arctichealth.org/en/permalink/ahliterature152963
Source
J Can Dent Assoc. 2008 Jun;74(5):429-32
Publication Type
Conference/Meeting Material
Date
Jun-2008

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake.

https://arctichealth.org/en/permalink/ahliterature105471
Source
Pages 633-645 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):633-645
Publication Type
Article
Date
2013
  1 document  
Author
Donald L Chi
Author Affiliation
University of Washington, School of Dentistry, Department of Oral Health Sciences, Seattle, Washington, USA.
Source
Pages 633-645 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):633-645
Date
2013
Language
English
Geographic Location
U.S.
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
Adolescent
Alaska - epidemiology
Beverages - adverse effects
Chemoprevention - methods
Child
Child, Preschool
Community-Institutional Relations - standards
Cultural Competency
Databases, Bibliographic
Dental Caries - ethnology - prevention & control
Dental Health Services - manpower - supply & distribution
Dietary Sucrose - adverse effects
Female
Health Status Disparities
Humans
Indians, North American - statistics & numerical data
Infant
Inuits - statistics & numerical data
Medically underserved area
Organizational Case Studies
Pregnancy
Pregnancy Complications, Infectious - drug therapy - ethnology - prevention & control
Primary prevention - methods
Abstract
Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown.
To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children.
Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms "Alaska Native", "children" and "oral health" were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970-2012) for relevant clinical trials and evaluation studies.
Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children.
Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising approaches to improve the oral and systemic health of Alaska Native children. Future investigators should evaluate the feasibility of implementing multilevel interventions and policies within Alaska Native communities as a way to reduce children's health disparities.
Notes
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PubMed ID
24377091 View in PubMed
Documents
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A study to establish parameters for the use of pit and fissure sealants in a group of Indian children with high caries rates.

https://arctichealth.org/en/permalink/ahliterature227718
Source
Pages 675-676 in B.D. Postl et al., eds. Circumpolar Health 90. Proceedings of the International Congress on Circumpolar Health, 8th, Whitehorse, Yukon, May 20-25, 1990. Arctic Medical Research 1991; Suppl.
Publication Type
Article
Date
1991
  1 document  
Author
O. Odlum
C. Lachance
Author Affiliation
Faculty of Dentistry, University of Manitoba, Winnipeg, Canada.
Source
Pages 675-676 in B.D. Postl et al., eds. Circumpolar Health 90. Proceedings of the International Congress on Circumpolar Health, 8th, Whitehorse, Yukon, May 20-25, 1990. Arctic Medical Research 1991; Suppl.
Date
1991
Language
English
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
Alaska Medical Library
Keywords
Child
Child, Preschool
Dental Caries - ethnology - prevention & control
Humans
Indians, North American
Manitoba
Pit and Fissure Sealants - therapeutic use
PubMed ID
1365263 View in PubMed
Documents
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