Investigating the relationship between dental cavities and protective factors among children aged 0-5 years.

The purpose of this study was to determine the protective factors that contribute to the prevention of children aged 0-5 years from developing dental cavities. The oral hygiene practices of 266 children aged 0-5 years were assessed through surveys administered from 2019 to 2022 to identify clinical, dietary, social and parental factors. The Partial Least Squares (PLS) Regression and Artificial Neuron Networks (ANN) Models were used to determine protective factors associated with the prevention of dental cavities in children. The race distribution of the children as identified by caregivers is as follows: (1) Black or African-American (53.4%); (2) Asian (25.9%); (3) White (18.4%); and (4) Native American (2.3%). We found behavioral protective factors to significantly affect the oral health outcome (cavities) among children aged 0-5 years (p < 0.05). We also found that children whose parents/caregivers flossed their teeth were less likely to develop cavities. In addition, children were least likely to have cavities if their parents/caregivers used toothpaste and mouthwash, avoided sharing chewed food, and refrained from drinking 100% juice. In contrast, children were more likely to obtain cavities if their parents/caregivers had a lower education level, rarely cleaned their teeth, and often consumed marijuana, cow or goat milk, juice drinks and sugary beverages. The education level of parents, and on the contrary, oral hygiene practices of the family, play a significant role in influencing the prevalence of cavities in children aged 0-5 years.

A Multilevel Approach to Stakeholder Engagement in the Formulation of a Clinical Data Research Network.

OBJECTIVES: To ensure meaningful engagement of stakeholders (patients, clinicians, and communities) in developing the Mid-South Clinical Data Research Network (MS-CDRN), we implemented a comprehensive, multilevel approach: (1) identify barriers to involving stakeholders in governance, network design, and implementation; (2) engage stakeholders in priority setting and research topic generation; (3) develop strategies to fully integrate stakeholders in CDRN governance and oversight; and (4) solicit guidance on patient-centered tools and strategies for recruiting research participants. METHODS: We engaged stakeholders: (1) as integral research team members; (2) on oversight and advisory committees; (3) as consultants (using Community Engagement Studios); and (4) through interviews and surveys. We recruited stakeholders from community health centers, churches, barbershops, health fairs, a volunteer registry, and a patient portal. We prioritized recruitment from populations often underrepresented in research. RESULTS: During the first 18 months, we engaged 5670 stakeholders in developing the MS-CDRN. These were research team members and on governance committees (N=10), consultants (N=58), survey respondents (N=5543), and interviewees (N=59). Stakeholders identified important barriers and facilitators to engagement, developed stakeholder-informed policies, provided feedback on priority topics and research questions, and developed an intake process for data requests and interventional studies that included reviewing for appropriate patient-centeredness, patient engagement, and dissemination. DISCUSSION: Multilevel stakeholder engagement is a novel systematic approach to developing a meaningful patient-centered and patient-engaged research program. This approach allows ongoing input from highly engaged stakeholders while leveraging focused input from larger, more diverse groups to enhance the patient-centeredness of research and increase relevance to broader audiences.

Development and Initial Testing of the FLOW Instrument: Novel Assessment of Lower Urinary Tract Symptoms in Men.

PURPOSE: We sought to develop a method to assess lower urinary tract symptoms regardless of literacy and numeracy. MATERIALS AND METHODS: We convened focus groups and developed a questionnaire based on 4 identified domains of urinary function, including frequency, incontinence (leakage), nocturia (overnight voiding) and weak stream. We pilot tested the novel FLOW (frequency, leakage, overnight voiding and weak stream) questionnaire in 64 men and performed quantitative analysis to determine internal consistency. Criterion validity was established via direct comparison to the AUA (American Urological Association) symptom score in a larger cohort of 161 men. RESULTS: Median time to complete the FLOW questionnaire was 18.0 seconds (IQR 15.8-21.0). The mean number of positive responses to the FLOW instrument was 1.7. Test-retest reliability was 0.91 and the Cronbach α was 0.67. In the validation cohort there was a significant correlation between FLOW scores and AUA symptom score (r = 0.63, p <0.001). All men regardless of health literacy completed FLOW. However, fewer men with low health literacy completed the AUA symptom score compared to men with adequate health literacy (81% vs 100%, p <0.001). For FLOW health literacy was unrelated to the median completion time (21.5 seconds), the median number of prompts needed (0) or the median score (2). CONCLUSIONS: A critical analysis of the AUA symptom score using valid health literacy scales revealed that it is frequently not completed, requires prompting and takes longer to complete for men with low health literacy. The FLOW instrument represents a novel method to assess lower urinary tract symptoms in all men. It represents a valid alternative to the AUA symptom score.

Needs, Priorities, and Recommendations for Engaging Underrepresented Populations in Clinical Research: A Community Perspective.

Engaging underrepresented groups in outcomes research is a public health priority for reducing health and health care disparities; yet, engaging these groups is challenging. Failure to involve these underrepresented populations in research further exacerbates these disparities. This article presents the health and research priorities of diverse groups of underrepresented populations in biomedical research, their concerns for participating in research, and strategies to engage them in their healthcare and research studies. Eleven community listening sessions, ranging from 7 to 13 community members each (N = 117), representing racial/ethnic minority, economically disadvantaged (e.g., uninsured), and hearing impaired communities. We used an inductive, qualitative content analysis approach to analyze the data for emerging themes. We identified the following themes: Uncertainties of underrepresented populations regarding research participation; Ineffective communication about research opportunities and research findings; Research on primary care and prevention are priorities for underrepresented populations in research; and Research teams need training in cultural competence and humility. Underrepresented groups provided research priorities, concerns, and strategies to engage them in their healthcare and in research studies. Findings from this study could facilitate improvement of research participation among underrepresented groups, ultimately reducing health disparities and improving quality of life among groups commonly omitted from research recruitment and participation.

Patient navigation and clinical trial participation: A randomized controlled trial design.

BACKGROUND: To our knowledge, no published studies utilizing a randomized controlled design have examined the efficacy of patient navigation for improving clinical trial enrollment. METHODS: This patient navigation and clinical trial participation study is a randomized controlled trial to assess the effect of a patient navigator on enrollment into therapeutic cancer clinical trials. Participants are randomly assigned to high intensity, patient navigator-delivered patient educational materials (PEM) and needs assessment vs. low intensity patient navigation (patient navigator-delivered patient educational materials [PEM] alone). Discussion: Effective enrollment strategies may include utilization of patient navigators as away to meet individual needs, barriers, and concerns of participants enrolled in clinical trials.