Transcript ppt

CENTER FOR NATIVE ORAL
HEALTH RESEARCH
Judith E. Albino, PhD, PI
Spero Manson, PhD, Co-I
Funded by: NIH-NIDCR-U54-DE019259
CENTER FOR NATIVE ORAL HEALTH RESEARCH
(CNOHR)
VISION
To become the premier national center working with
AI/AN communities to generate and sustain research,
training, information dissemination, and technical
assistance needed to address AI/AN oral health
disparities.
The Mission of CNOHR is to work with AI/AN communities
to conduct, facilitate, and disseminate the next generation of
AI/AN oral health intervention research, with an initial focus
on oral infections and their complications.
CENTER FOR NATIVE ORAL HEALTH RESEARCH
Community Advisory
Committee
Judith E. Albino, PI
Spero Manson, Co-I
CNOHR Asst.
Administrator
Judy Sandoval
RPAC
Judith Albino, PI
Training and Career
Development
Terry Batliner, DDS
Developmental
Research Programs
Judith Albino, PhD
RC1: Promoting Behavioral
Change for OH in MI
Mothers & Children
Terry Batliner, PI
CNOHR Executive
Committee
Ruth NowjackRaymer,
J. Albino, S. Manson,
W. Henderson
S&DCC
William Henderson, PI
Community Liaison
and Dissemination
Core
Spero Manson, PhD
RC2: Preventing Caries in
Preschoolers: Delivery
Model in AI Head Start
Centers
David Quissell, PI
Statistics & Sampling
Luohua Jiang
CNOHR
Multi-methods Team
Clinical, Community,
Economic,
Epidemiologic
Ethnographic, etc.
University of Colorado
Denver/Boulder/Colorado Springs
UCD Anschutz Medical Campus
Colorado School
of Public Health
School
of Dental Medicine
Centers for American Indian/Alaska Native Health
School
of Medicine
Urban Indian
Heart Health
School
of Pharmacy
AI/AN Head
Start Research
Native Elder
Research
Special Diabetes
Program for
Indians
Center for Native
Oral Health
Research
(CNOHR)
Export/Minority
Health &
Disparities
Center for Native
AmericanTelehealth
&
Tele-Education
AI/AN Mental
Health
Research
Circles of Care
Colorado Clinical and Translational Science Institute
Faculty in
Other CU
Schools &
Colleges
Public Health
Faculty at CSU
and UNC
Professions and Disciplines of Individuals Who
Have Contributed to CNOHR
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Anthropology
Biostatistics
Business Administration
Communications
Clinical Psychology
Community Psychology
Demography
Dental Hygiene
Developmental Psychology
Diabetology
Economics
Epidemiology
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General Dentistry
Health Psychology
Medicine
Microbiology
Pediatric Dentistry
Pediatric Medicine
Periodontics
Psychology
Psychiatry
Public Health
Social Psychology
Sociology
Why Study AI/AN Oral Health Issues?
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The population is small, but
…the disparities are great.
Demographics
• Census 2000 – 4.1 million individuals identified as
AI/AN (1.5% of the US population).
• AI/AN live predominantly in the West (43%) and
South (31%).
• Approximately 35% of AI/ANs live on reservations
or in AN villages.
• 560 AI/AN tribes and communities recognized by US
Government. Tribes are legally sovereign nations.
.
• AI/AN groups reflect great cultural diversity, with
differences in language, culture and customs.
More Demographics
• Median age is 29 compared to 35 for the US as a whole
• Approximately 33% are under 18 (26% of overall US population)
• Only 6% are 65 or older (12% for US)
• Only 71% of AI/ANs have at least a high school education and
11% at least a baccalaureate degree, compared to 80% and
24%, respectively
• 2006, the overall poverty rate for AI/ANs was 26%, compared to
12% of the US generally.
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AI/AN Health Disparities
• Life expectancy is 6 years less than for the US population
• Infant mortality rate is 21% higher
• Injuries 3.4 times higher ; tuberculosis 4.4 times higher;
alcoholism 7.5 times higher; diabetes almost 4 times higher; CHD
2 times higher
• CVD rates are rising, and CVD appears to be more fatal
• Higher mortality from all cancers than other groups
• Higher risks: Obesity in AI/AN WIC children is 2 times higher
(20% vs 13%); smoking is more prevalent (36% vs 23%); adults
more likely not to exercise (50% vs 37%)
• In 2005, per-capita spending for Medicare was almost $6800; for
Medicaid, $4300+; and for IHS, just $2130.
Oral Health Disparities in the AI/AN Population
• The greatest group disparities in oral health are found among
American Indians/ Alaska Natives.
• Results from IHS Oral Health Surveys show ECC in AI/ANs
continues to increase.
• Compared to other children ages 2-5, AI/ANs are 3+ times more
likely to have untreated decay (68% vs 19%).
• AI/AN adults have significantly more periodontal disease.
• Nearly 25% of AI/ANs over 65 are completely edentulous.
Major Research Components
Two studies focused on prevention of ECC
RC1: Promoting Behavioral Change for Oral Health in
American Indian Mothers and Children
adapt, demonstrate, and test a preventive intervention
strategy (MI) for ECC targeted to newborns (600 mothers
and 600 controls)
RC2: Preventing Caries in Preschoolers: Testing a
Unique Service Delivery Model in AI Head Start
Programs
- develop and test a prevention program, including FV, and
provided by AI community workers in 26 HS Centers (26
control Centers)
Affiliated and Developmental Projects
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“Denver Children’s Oral Health Project,” J. O’Connell, PI, & J. Albino,
Denver AI Focus Schools. Funded by the Colorado Trust, 2006“A Motivational Approach to Improve Prevention of ECC in AI
Children,” T. Batliner, PI, & J. Albino, Southern Ute, Ignacio, CO,
for Project Export (S. Manson, PI). Funded by NCMHD 63085479,
2008-
“Training Community Members for Prevention of ECC in AI
Children,” J. Albino, PI, & D. Quissell, for Native American Research
Centers for Health, G. Belcourt, Montana-Wyoming Tribal Leaders
Council, PI. Funded by DHHS-IHS, NOT GM-08-115, 2009“Periodontal Disease Prevention and Control in AI Adolescents and
Young Adults,” E. Morrato, PI, Denver Indian Health and Family
Services Center, developmental project concept to be presented
Tuesday.
CNOHR’s Student Investigators
• NOT-OD-09-060 Administrative Supplement: Providing
Summer Research Experiences for Students and Science
Educators
• Amanda Campbell is AI/AN, from the Cherokee and Yup’ik tribes,
Amanda is a first year student at the SoDM. She graduated Cum Laude
with a BS in Biology from California Lutheran University and then
completed the Post-Baccalaureate program at UC Denver’s SoDM.
• Kendra Velasquez is Hispanic and grew up in Los Lunas, NM. Kendra
graduated with honors, earning a BS in Biology from the New Mexico
Institute of Mining and Technology on an academic scholarship. She is
the first in her family to earn a degree and pursue graduate/professional
studies.
• Copies of their final presentation to faculty can be found at the front
table.