Center for Native Oral Health Research (CNOHR)

Background

The Center for Native Oral Health Research comprised two large scale-clinical trials of behavioral interventions for the prevention of caries in pre-school children of a Southwestern American Indian tribe, and parents of infants in a Northern Plains Tribe.

Specific aims

The first clinical trial was a cluster-randomized trial to test the efficacy of an instructional intervention with parents of Head Start children on a large Southwestern Indian Reservation; the intervention was carried out by tribal “Community Oral Health Specialists” who were trained to work within the community and provide fluoride varnish in the Head Start Centers. After two years, children in the program did not have less caries experience or lower scores, although when parents of children participated more actively in the program, their children’s caries scores were lower.

The second randomized trial tested the efficacy of Motivational Interviewing with new mothers of infants in a Northern Plains tribe over a period of three years beginning at the child’s birth. At the end of the trial, there were no differences in the caries experience and scores of the two groups of children.

Research projects

Undergraduate dental students were trained in oral health prevention research (1DP70DO18422-01).
Secondary data analyses were carried out to determine the mechanisms defining the role of health literacy in efforts of American Indian parents to improve oral health of infants (R01DE027077).
A developmental study of the relationship of periodontitis in American Indian adolescents to other health indicators.
A developmental study of the responses of Latina mothers of infants to videotaped oral health messages in the context of well-child medical visits (1R34DE022266-01).
Several studies of measures developed, adverse events, common factors were carried out in collaboration with oral health disparities centers at University of California San Francisco and Boston University.

Outcomes

As indicated above, in neither of the clinical trials did the children of those in the intervention groups differ in caries experience from those in the control groups. The trials highlighted the challenges of decreasing early childhood caries in a group with the highest caries experience of any population group in our country. Additional analyses have led to a better understanding of some of the factors that may be addressed in future programs to improve oral health of these children in the future.

Published reports of the trials and sub-studies from CNOHR

Albino J, Tiwari T. Behavior Change for Caries Prevention: Understanding Inconsistent Results. JDR Clin Trans Res. 2020;5(1):6-9. doi: 10.1177/2380084419878180

Brega AG, Jiang L, Johnson R, Wilson A, Schmiege S, Albino J. Health literacy and parental oral health knowledge, beliefs, behavior, and status among parents of American Indian newborns. J Racial Ethn Health Disparities. 2020 May. [Epub ahead of print]. doi: 10.1007/s40615-019-00688-4

Wilson AR, Tiwari T, Thomas JF, Henderson WG, Braun PA, Albino J. Validation of Psychosocial Measures Assessing American Indian Parental Beliefs Related to Control over Their Children's Oral Health. Int J Environ Res Public Health. 2020;17(2):403. Published 2020 Jan 8. doi: 10.3390/ijerph17020403

Brega AG, Henderson WG, Harper M, Thomas JF, Manson SM, Batliner TS, Braun PA, Quissell DO, Wilson AR, Tiwari T, Albino J. Association of Ethnic Identity with Oral Health Knowledge, Attitudes, Behavior, and Outcomes on the Navajo Nation. J Health Care Poor Underserved. 2019;30(1):143-160. doi: 10.1353/hpu.2019.0013

Jamieson L, Garcia R, Sohn W, Albino J. Challenges and solutions for improved oral health: Examples from Motivational Interviewing trials. JDR Clin Trans Res. 2019;5(2):107-108. doi: 10.1177/2380084419894575

Albino J, Batliner TS, Tiwari T, Henderson WG. Response to Letter to the Editor regarding, “Preventing Caries in American Indian Children: Lost Battle or New Hope?” JDR Clin Trans Res. 2018;3(2):213–214. doi: 10.1177/2380084417751343

Albino J, Tiwari T, Henderson WG, Thomas JF, Braun PA, Batliner T. Parental psychosocial factors and childhood caries progression in an American Indian Population. Community Dent Oral Epidemiol. 2018;46(4):360-368. doi: 10.1111/cdoe.12376

Batliner TS, Tiwari T, Henderson WG, Wilson AR, Gregorich SE, Fehringer KA, Brega AG, Swyers E, Zacher T, Harper MM, Plunkett K, Santo W, Cheng NF, Shain S, Rasmussen M, Manson SM, Albino J. Randomized Trial of Motivational Interviewing to Prevent Early Childhood Caries in American Indian Children. JDR Clin Trans Res. 2018;3(4):366–375. doi: 10.1177/2380084418787785

Tiwari T, Jamieson L, Broughton J, Lawrence HP, Batliner TS, Arantes R, Albino J. Reducing indigenous oral health inequalities: A review from five nations. J Dent Res. 2018;97(8):869-877. doi: 10.1177/0022034518763605

Tiwari T, Wilson AR, Mulvahill M, Rai N, Albino J. Maternal Factors associated with early childhood caries in urban Latino children. JDR Clin Trans Res. 2018;3(1):83-90. doi: 10.1177/2380084417718175

Wilson AR, Brega AG, Thomas JF, Henderson WG, Lind KE, Braun PA, Batliner TS, Albino J. Validity of measures assessing oral health beliefs of American Indian parents. J Racial Ethn Health Disparities. 2018;5(6):1254-1263. doi: 10.1007/s40615-018-0472-3

Wilson AR, Fehringer KA, Henderson WG, Venner K, Thomas J, Harper M, Batliner TS, Albino J. Fidelity of motivational interviewing in an American Indian oral health intervention. Community Dent Oral Epidemiol. 2018;46(3):310-316. doi: 10.1111/cdoe.12368

Albino J, Batliner TS, Tiwari T. Preventing Caries in American Indian Children: Lost Battle or New Hope? JDR Clin Trans Res. 2017;2(4):406-409. doi: 10.1177/2380084417725690

Albino J, Tiwari T, Gansky SA, Henshaw MM, Barker JC, Brega AG, Gregorich SE, Heaton B, Batliner TS, Borrelli B, Geltman P, Kressin NR, Weintraub JA, Finlayson TL, Garcia RI, Early Childhood Caries Collaborating Centers. The basic research factors questionnaire for studying early childhood caries. BMC Oral Health. 2017;17(1):83. doi: 10.1186/s12903-017-0374-5

Garcia RI, Gregorich S, Ramos-Gomez F, Braun PA, Wilson A, Albino J, Tiwari T, Harper M, Batliner TS, Rasmussen M, Cheng NF, Santo W, Geltman PL, Henshaw M, Gansky SA. Absence of Fluoride Varnish–Related Adverse Events in Caries Prevention Trials in Young Children, United States. Prev Chronic Dis. 2017;16:14:E17. doi: 10.5888/pcd14.160372

Garcia RI, Tiwari T, Ramos-Gomez F, Heaton B, Orozco M, Rasmussen M, Braun P, Henshaw M, Borrelli B, Albino J, Diamond C, Gebela C, Batliner TS, Barker JC, Gregorich S, Gansky SA, Early Childhood Caries Collaborating Centers. Retention Strategies for Health Disparities Preventive Trials: Findings from the Early Childhood Caries Collaborating Centers. J Public Health Dent. 2017;77(1):63-77. doi: 10.1111/jphd.12182

Tiwari T, Baker S, Albino JE. Reducing Oral Health Disparities: Social, Environmental and Cultural Factors. Front Public Health. 2017;5:298. doi: 10.3389/FPUBH.2017.00298

Albino J, Shapiro AL, Henderson WG, Tiwari T, Brega AG, Thomas JF, Bryant LL, Braun PA, Quissell DO. Validation of the Sense of Coherence Scale in an American Indian Population. Psychol Assess. 2016;28(4):386-93. doi: 10.1037/pas0000193

Albino J, Tiwari T. Preventing Childhood Caries: A Review of Recent Behavioral Research. J Dent Res. 2016;95(1):35-42. doi: 10.1177/0022034515609034

Batliner T, Wilson A, Davis E, Gallegos J, Thomas J, Tiwari T, Fehringer K, Wilson K, Albino J. A Comparative Analysis of Oral Health on the Santo Domingo Pueblo Reservation. J Community Health. 2016 Jun;41(3):535-40. doi: 10.1007/s10900-015-0127-9

Braun PA, Quissell DO, Henderson WG, Bryant LL, Gregorich SE, George C, Toledo N, Cudeii D, Smith V, Johs N, Cheng J, Rasmussen M, Cheng NF, Santo W, Batliner T, Wilson A, Brega A, Roan R, Lind K, Tiwari T, Shain S, Schaeffer G, Harper M, Manson SM, Albino J. A Cluster-Randomized, Community-Based, Tribally-Delivered Oral Health Promotion Trial in Navajo Head Start Children. J Dent Res. 2016;95(11):1237-44. doi: 10.1177/0022034516658612

Brega AG, Thomas JF, Henderson WG, Batliner TS, Quissell DO, Braun PA, Wilson A, Bryant LL, Nadeau KJ, Albino J. Association of Parental Health Literacy with Oral Health of Navajo Nation Preschoolers. Health Educ Res. 2016; 31(1): 70-81. doi: 10.1093/her/cyv055

Bryant LL, Quissell DO, Braun PA, Henderson WG, Johs N, George C, Smith V, Toledo N, Thomas J, Albino J. A Community-Based Oral Health Intervention in Navajo Nation Head Start: Participation Factors and Contextual Challenges. J Community Health. 2016;41(2):340-53. doi: 10.1007/s10900-015-0102-5

Wilson AR, Brega AG, Campagna E, Braun PA, Henderson WG, Bryant LL, Batliner TS, Quissell DO, Albino J. Validation and Impact of Caregivers’ Oral Health Knowledge and Behavior on Children’s Oral Health Status. Pediatr Dent. 2016;38(1):47-54.

Tiwari T, Albino J, Batliner T. Challenges Faced in Engaging American Indian Mothers in an Early Childhood Caries Preventive Trial. Int J Dent. 2015; 2015: 179189. doi: 10.1155/2015/179189

Tiwari T, Sharma T, Harper M, Zacher T, Roan R, George C, Swyers E, Toledo N, Batliner T, Braun PA, Albino J. Community Based Participatory Research to Reduce Oral Health Disparities in American Indian Children. J Fam Med. 2015;2(3): 1028.

Warren JJ, Weber-Gasparoni K, Tinanoff N, Batliner TS, Jue B, Santo W, Garcia RI, Gansky SA. Early Childhood Caries Collaborating Centers. Examination criteria and calibration procedures for prevention trials of the Early Childhood Caries Collaborating Centers. J Public Health Dent. 2015;75(4):317-26. doi: 10.1111/jphd.12102

Albino J, Tiwari T, Henderson WG, Thomas JF, Bryant LL, Batliner T, Braun PA, Wilson A, Quissell DO. Learning from Caries-Free Children in a High Caries American Indian Population. J Public Health Dent. 2014;74(4): 293-300. doi: 10.1111/jphd.12058

Batliner T, Fehringer KA, Tiwari T, Henderson WG, Wilson A, Brega, A, Albino J. Motivational Interviewing with American Indian Mothers to Prevent Early Childhood Caries: Study Design and Methodology of a Randomized Control Trial. Trials. 2014; 15: 125. doi: 10.1186/1745-6215-15-125

Batliner T, Wilson A, Tiwari T, Glueck D, Henderson WG, Thomas JF, Braun P, Cudeii D, Quissell DO, Albino J. (2014). Oral health status in Navajo Nation Head Start Children. J Public Health Dent. 2014; 74(4): 317-325. doi: 10.1111/jphd.12061

Braun PA, Lind KE, Batliner T, Brega AG, Henderson WG, Nadeau K, Wilson A, Albino J. (2013). Caregiver reported oral health-related quality of life in young American Indian children. J Immigr Minor Health. 2014 Oct; 16(5): 951-958. doi: 10.1007/s10903-013-9870-0

Braun PA, Lind KE, Henderson WG, Brega AG, Quissell DO, Albino J. Validation of a pediatric oral health-related quality of life scale in Navajo children. Qual Life Res. 2014;24(1):231-9. doi: 10.1007/s11136-014-0751-3

Quissell D, Bryant LL, Braun P, Cudeii D, Johs N, Smith V, George C, Henderson W, Albino J. Preventing caries in preschoolers: An innovative community-based clinical trial in Navajo Nation Head Start programs. Contemp Clin Trials. 2014 Mar; 37(2): 242-251. doi: 10.1016/j.cct.2014.01.004

Tiwari T, Casciello A, Gansky SA, Henshaw M, Ramos-Gomez F, Rasmussen M, Garcia RI, Albino J, Batliner T. Recruitment for Health Disparities Preventive Intervention Trials: The Early Childhood Caries Collaborating Centers. Prev Chronic Dis. 2014; 11:E133. doi: 10.5888/pcd11.140140

Tiwari T, Quissell DO, Henderson WG, Thomas JF, Bryant LL, Braun PA, Albino J. Factors associated with oral health status in American Indian children. J Racial Ethn Health Disparities. 2014; 1(3): 148-156. doi: 10.1007/s40615-014-0017-3

Wilson A, Brega AG, Batliner T, Henderson WG, Campagna EJ, Fehringer K, Gallegos J, Daniels D, Albino J. Assessment of parental oral health knowledge and behaviors among American Indians of a Northern Plains tribe. J Public Health Dent. 2014 Spring; 74(2): 159–167. doi: 10.1111/jphd.12040

Batliner TS, Tiwari T, Wilson A, Janis M, Brinton J, Daniels DM, Gallegos JR, Lind KE, Glueck DH, Albino J. An assessment of oral health on the Pine Ridge Reservation. Fourth World Journal, 2013; 12(1): 5-17.

Albino JE, Inglehart M, Tedesco LA. Dental education and changing oral health care needs: Disparities and demands. J Dent Educ. 2012 Jan;76(1):75-88.

Albino JE, Orlando VA. Promising directions for caries prevention with American Indian and Alaska Native children. Int J Dent. 2010; 60 (Suppl 2),3: 216-222.

Parker EJ, Jamieson LM, Broughton J, Albino JE, Lawrence H, Roberts-Thomson K. The oral health of indigenous children: A review of four nations. J Paediatr Child Health. 2010; 46(9): 483-486. doi: 10.1177/0022034515609034

Centers for American Indian & Alaska Native Health

Colorado School of Public Health

CU Anschutz

Nighthorse Campbell Native Health Building

13055 East 17th Avenue

Mail Stop F800

Aurora, CO 80045

colorado school of public health

coloradoSPH

Centers for American Indian & Alaska Native Health

Center for Native Oral Health Research (CNOHR)

Background

Specific aims

Research projects

Outcomes

Published reports of the trials and sub-studies from CNOHR

Centers for American Indian & Alaska Native Health

Colorado School of Public Health

Center for Native Oral Health Research (CNOHR)

Background

Specific aims

Research projects

Outcomes

Published reports of the trials and sub-studies from CNOHR

2016-2020

2010-2015

Centers for American Indian & Alaska Native Health

Colorado School of Public Health