Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial

Severe early childhood caries (S-ECC) is a common disease within marginalized pediatric populations. S-ECC is often treated under general anesthesia to facilitate extensive treatment in young children, but treatment does not address etiology of an infectious disease that is rooted in health behavior...

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Main Authors: Joanna Buscemi, Teresa G. Borowski, David Avenetti, Lisa Tussing-Humphreys, Molly Martin, Marc S. Atkins, Teresa Marshall, Michael Berbaum, Helen H. Lee
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1488910/full
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author Joanna Buscemi
Teresa G. Borowski
David Avenetti
Lisa Tussing-Humphreys
Lisa Tussing-Humphreys
Lisa Tussing-Humphreys
Molly Martin
Molly Martin
Marc S. Atkins
Teresa Marshall
Michael Berbaum
Helen H. Lee
Helen H. Lee
author_facet Joanna Buscemi
Teresa G. Borowski
David Avenetti
Lisa Tussing-Humphreys
Lisa Tussing-Humphreys
Lisa Tussing-Humphreys
Molly Martin
Molly Martin
Marc S. Atkins
Teresa Marshall
Michael Berbaum
Helen H. Lee
Helen H. Lee
author_sort Joanna Buscemi
collection DOAJ
description Severe early childhood caries (S-ECC) is a common disease within marginalized pediatric populations. S-ECC is often treated under general anesthesia to facilitate extensive treatment in young children, but treatment does not address etiology of an infectious disease that is rooted in health behaviors. Without behavior changes related to toothbrushing and sugar consumption, many children experience recurrent disease, and some require subsequent surgeries. To improve post-surgery oral health, we developed PROTECT (Preventing Recurrent Operations Targeting Early Childhood Caries Treatment), a community health worker (CHW)-delivered behavioral intervention for caregivers that focuses on children’s oral health behaviors. This study aims to test the efficacy of the PROTECT intervention compared to Usual Care (UC), to improve behavioral oral health outcomes. We will conduct a randomized clinical trial to test the efficacy of PROTECT (n = 210) compared to UC (n = 210) in the pediatric DGA (dental surgery under general anesthesia) population. We developed PROTECT through an iterative process, incorporating feedback from caregivers, dentists, and community health workers and through a small pilot trial. Caregivers will be recruited at their dental clinic and then will engage in a 10-session intervention with a community health worker. Topics covered will include education about toothbrushing and sugar consumption, behavioral strategies (e.g., goal setting, problem solving, self-monitoring), positive parenting and stress management and maintenance. Our two primary outcomes are parental assisted toothbrushing (twice/day, 2 min each time) and reduced added sugar consumption (less than 10% of overall daily caloric intake). Proposed mechanisms of change are self-efficacy and positive parenting. The ultimate goal of PROTECT is to prevent subsequent surgical events for children presenting with S-ECC to prevent further chronic disease and reduce costs and stress for families who already experience high levels of systemic barriers to their health.
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spelling doaj-art-69b3d9c94b3948e18bb1f81d27ac1d722025-01-27T18:25:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011310.3389/fpubh.2025.14889101488910Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trialJoanna Buscemi0Teresa G. Borowski1David Avenetti2Lisa Tussing-Humphreys3Lisa Tussing-Humphreys4Lisa Tussing-Humphreys5Molly Martin6Molly Martin7Marc S. Atkins8Teresa Marshall9Michael Berbaum10Helen H. Lee11Helen H. Lee12Department of Psychology, DePaul University, Chicago, IL, United StatesInstitute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United StatesDepartment of Pediatric Dentistry, University of Illinois Chicago, Chicago, IL, United StatesInstitute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United StatesDepartment of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United StatesUniversity of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, United StatesInstitute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United StatesDepartment of Pediatrics, University of Illinois Chicago, Chicago, IL, United StatesInstitute for Juvenile Research, University of Illinois Chicago, Chicago, IL, United StatesDepartment of Preventive and Community Dentistry, University of Iowa, Iowa City, IA, United StatesInstitute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United StatesInstitute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United StatesDepartment of Anesthesiology, University of Illinois Chicago, Chicago, IL, United StatesSevere early childhood caries (S-ECC) is a common disease within marginalized pediatric populations. S-ECC is often treated under general anesthesia to facilitate extensive treatment in young children, but treatment does not address etiology of an infectious disease that is rooted in health behaviors. Without behavior changes related to toothbrushing and sugar consumption, many children experience recurrent disease, and some require subsequent surgeries. To improve post-surgery oral health, we developed PROTECT (Preventing Recurrent Operations Targeting Early Childhood Caries Treatment), a community health worker (CHW)-delivered behavioral intervention for caregivers that focuses on children’s oral health behaviors. This study aims to test the efficacy of the PROTECT intervention compared to Usual Care (UC), to improve behavioral oral health outcomes. We will conduct a randomized clinical trial to test the efficacy of PROTECT (n = 210) compared to UC (n = 210) in the pediatric DGA (dental surgery under general anesthesia) population. We developed PROTECT through an iterative process, incorporating feedback from caregivers, dentists, and community health workers and through a small pilot trial. Caregivers will be recruited at their dental clinic and then will engage in a 10-session intervention with a community health worker. Topics covered will include education about toothbrushing and sugar consumption, behavioral strategies (e.g., goal setting, problem solving, self-monitoring), positive parenting and stress management and maintenance. Our two primary outcomes are parental assisted toothbrushing (twice/day, 2 min each time) and reduced added sugar consumption (less than 10% of overall daily caloric intake). Proposed mechanisms of change are self-efficacy and positive parenting. The ultimate goal of PROTECT is to prevent subsequent surgical events for children presenting with S-ECC to prevent further chronic disease and reduce costs and stress for families who already experience high levels of systemic barriers to their health.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1488910/fullsevere early childhood cariescommunity health workerbehavioral interventionparenting interventionoral health
spellingShingle Joanna Buscemi
Teresa G. Borowski
David Avenetti
Lisa Tussing-Humphreys
Lisa Tussing-Humphreys
Lisa Tussing-Humphreys
Molly Martin
Molly Martin
Marc S. Atkins
Teresa Marshall
Michael Berbaum
Helen H. Lee
Helen H. Lee
Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial
Frontiers in Public Health
severe early childhood caries
community health worker
behavioral intervention
parenting intervention
oral health
title Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial
title_full Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial
title_fullStr Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial
title_full_unstemmed Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial
title_short Testing a multi-behavioral intervention to improve oral health behaviors in the pediatric dental surgery population: protocol for the PROTECT trial
title_sort testing a multi behavioral intervention to improve oral health behaviors in the pediatric dental surgery population protocol for the protect trial
topic severe early childhood caries
community health worker
behavioral intervention
parenting intervention
oral health
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1488910/full
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