Coordinated Oral Health Promotion (CO-OP) Chicago

The Coordinated Oral Health Promotion (CO-OP) Chicago studies [UH2DE02583/UH3DE025483] werefunded by the National Institute of Dental and Craniofacial Research (NIDCR) as part of a consortium to developand test interventions to reduce oral health disparities in children. The resulting CO-OP Chicago Trial is a healthdisparities cohort of 420 very young children and their families. At entry into the trial, the mean child agewas 21.5 months old. Forty-two percent of participants describe themselves as Black race, and 54% as Hispanicethnicity. Most children (89%) had Medicaid health insurance. Many caregivers were struggling to brushchildren's teeth twice a day, provide a healthy diet, and take children for preventive oral healthcare. Multi-levelinterventions, such as community health workers (CHWs), are needed to target these factors that operate onindividual, family, community, and public health levels. COVID-19 has brought new changes to household dynamics and unforeseen stressors to thesefamilies. The medical clinics and social service agencies that service these families have also beenmajorly affected. As we begin the process of resuming health, dental, and social services, we need to considerwhat changes are needed. Challenges fall into several domains. (1) Dental care: Access to dental services waschallenging for low-income families before this crisis; this will worsen as providers and facilities attempt to resumeregular services while also catching up on those that had been cancelled and maintaining new safety protocols.Many questions regarding understanding of COVID-19, trust, safety, and logistics surround this process. (2) Oralhealth behaviors: With the disruption of schools, child care, and employment, how have oral health behaviorschanged? (3) Nutrition: How have dietary habits changed with food insecurity challenges and more time at home?(4) Mental health: How has the stress, household chaos, and alternation to social support systems associatedwith this pandemic affected families? We propose to answer these questions in the Community InterventionModifications for Low-Income Urban Families after COVID-19 study. The results will inform the interventionsdental, health, and social service agencies will need to provide in order to support high-risk families to establishhealthy oral health behaviors after a major societal stressor like COVID-19.SPECIFIC AIM: To determine specific intervention needs regarding dental care access, oral healthbehaviors, nutrition, and mental health for low-income urban families with young children followingCOVID-19. We will achieve this aim using quantitative and qualitative data collected from the CO-OP Chicagocohort and our 20 partner sites. Our hypothesis is that families will have poor mental health, food insecurity,disrupted home oral health routines, distrust of dental services, and challenges accessing dental care. We expecttargeted CHW outreach and care coordination will be the best interventions to address these issues. When it comes to long-term recovery from COVID-19, let us not `go back to normal.'