Community-Based Participatory Research Consortium: Advancing DAta and Practice Transformation (ADAPT) for Caries Equity

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  1. Goal
  2. Background
  3. Gaps and Opportunities
  4. Specific Areas of Interest
  5. References

September 2023

Oral Health Disparities and Inequities Program
Center for Clinical Research
Division of Extramural Research

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Goal

The objective of this initiative is three-fold: 1) solicit research projects using community-based participatory approaches to design, implement, and evaluate population-based intervention strategies for reducing dental caries disparities and inequities in target populations; 2) create two research hubs specializing in community engagement and data coordination and management; and 3) form a research consortium, ADAPT-CariesEQ, that collaborates with Science Collaborative for Health disparities and Artificial intelligence bias REduction, ScHARe, in the data ecosystem. The overarching goal of this research consortium is to accelerate progress toward reducing dental caries disparities and inequities as well as broader system and societal inequities impacting health disparities through collaborative community-based intervention projects and data mining.

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Background

Despite considerable advances in science and the practice of preventing and controlling dental caries over the last 20 years, the progress towards reducing dental caries disparities (experience, burden, and access to evidence-based prevention and management) across the socioeconomic spectrum has been inconsistent and limited. While social determinants of health (SDOH) affect everyone in the community, individuals with limited personal resources and socially disadvantaged groups are impacted the most by inequities in structural determinants such as policies and systems. These upstream inequities ultimately create, sustain, and exacerbate unfair gaps in health and healthcare access between the most and least marginalized groups across the life-course. Therefore, there is a growing recognition about the importance of applying a health equity lens and intersectoral approaches to data collection and intervention strategies in research and practice. These approaches strive to holistically address SDOH and inform policies and systems for reducing health and dental caries disparities and enhancing equity in health outcomes and care access.

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Gaps and Opportunities

Community-based participatory research (CBPR) is an approach in which community partners and stakeholders are equitably involved in critical aspects of the research process. By engaging health disparities key stakeholders and community leaders in the research process from early idea formation to evaluation of research data, CBPR promises research findings that benefit the community and drive environmental and behavioral changes necessary to improve the health of the community and its members. Community engagement (CE) is central to CBPR and its project impact, sustainability, and ability to pursue equity in the community. However, measuring effective CE and mechanisms for how and why it works are poorly specified and documented, thus the quality and quantity of CE efforts and its success varies across CBPR projects.

This initiative will create two research hubs that will reinforce meaningful CE and equity-focused project data collection and sharing in collaboration with ScHARe. The Excellence for Community Engagement (ECE) hub will collaborate with the Data Coordination and Management (DCM) hub in the development, implementation, and evaluation of standardized metrics to assess input, processes, and output of stakeholder engagement to advance the science and practice of CE in CBPR. In addition, the ECE hub will offer centralized technical assistance and training, as needed, for recruitment of hard-to-reach populations and CE obstacle mitigation for participating projects. The DCM hub will be responsible for the coordination of core common data elements (CCDEs) for ScHARe and ADAPT-Caries EQ across consortium projects and the management of project data to be hosted in the ScHARe data repository. In collaboration with the ECE hub and consortium project teams, the DCM hub will also ensure the measurement and monitoring of data that matter to participating communities and mobilization of a real-time data pipeline for ongoing and sustainable use of data that contribute to the goal of dental caries equity. Once the consortium and its collaborative framework with ScHARe are established, additional investigator-initiated funded projects that are consistent with the ADAPT-CariesEQ theme may be invited to join.

This initiative will also support research projects to develop and implement community-level interventions to reduce disparities and inequities of dental caries. Research proposals submitted to this initiative should demonstrate:

  • Existing or planned full partnership with appropriate community stakeholders
  • Defined target populations affected by dental caries disparities and inequities and the proposed hypothesized pathways between the community-level interventions, upstream determinants, and caries disparities guided by a conceptual model and/or appropriate theoretical framework
  • Interventions that promote cross-sector integration/collaboration, the uptake of evidence-based caries prevention and management strategies, address SDOH (e.g., access to nutritious foods, high quality education, etc.) in syndemic approaches, and have the potential to be sustainable in the community after project funding is over
  • Evaluation of implementation context and process data
  • Application of measures and analytic methods appropriate for examining community-level mechanisms of action and reduction of dental caries disparities and inequities
  • Facilitation of ScHARe Think-a-Thon training for members of the target community to be a part of research team
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Specific Areas of Interest

Examples of relevant research areas include but are not limited to:

  • Adapt and test culturally appropriate, multi-pronged evidence-based strategies to address multi-level common risk factors affecting dental caries and comorbidities in NIH-defined health disparities populations.
  • Implement interventions that address structural discrimination and/or biases towards sociodemographic groups and/or minority populations with certain health conditions (e.g., mental health, HIV) across clinical and community settings and measure the impact on dental caries disparities and inequities in the target population.
  • Test implementation strategies for integrated care that promotes healthy lifestyles, screening, detection, self-management, and/or care coordination for dental caries and systemic comorbidities and sustainable practice adaption in vulnerable populations as well as safety-net systems.
  • Compare the effectiveness of equity-focused strategies to impact the structure, culture, and cost of delivering primary and/or secondary dental caries prevention in various settings in the target community for reducing dental caries disparities and inequities.
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References

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Last Reviewed
April 2024