In the United States, children from diverse ethnic groups and those with low socioeconomic status are at a significantly increased risk for early childhood caries. Despite the efforts focused on decreasing early childhood caries in American Indian (AI) populations, these children have the highest incidence of dental caries of any ethnic group, with four times the cases of untreated dental caries compared to white children. This qualitative formative assessment was conducted in two AI communities. Semi-structured interviews (n = 57) were conducted with caregivers and providers to understand the social and community contexts in which oral health behaviors and practices occur from the perspective of the caregivers, oral health care providers, and social service providers in the communities. The analysis was informed by the social determinants of health framework. The key social determinants of pediatric oral health relevant to our study communities included limited access to: oral health promoting nutritious foods, transportation for oral health appointments, and pediatric specialty care. This formative assessment provided locally and contextually relevant information to shape the development of an oral health clinical trial intervention to address early childhood caries in these two communities.

中文翻译：

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对两个美洲印第安人社区儿童早期龋齿相关健康社会决定因素的形成性评估

在美国，来自不同种族的儿童和社会经济地位低的儿童患幼儿龋齿的风险显着增加。尽管努力减少美洲印第安人 (AI) 人群的儿童早期龋齿，但这些儿童的龋齿发病率是所有种族中最高的，与白人儿童相比，未经治疗的龋齿病例是白人儿童的四倍。这种定性形成性评估是在两个 AI 社区中进行的。半结构化面试（n= 57) 与护理人员和提供者一起进行，以从社区的护理人员、口腔保健提供者和社会服务提供者的角度了解口腔健康行为和实践发生的社会和社区环境。该分析以健康的社会决定因素框架为依据。与我们的研究社区相关的儿科口腔健康的关键社会决定因素包括有限的获取途径：促进口腔健康的营养食品、口腔健康预约的交通以及儿科专科护理。这种形成性评估提供了当地和背景相关的信息，以塑造口腔健康临床试验干预措施的发展，以解决这两个社区的儿童早期龋齿问题。