Interdisciplinary Approaches to Promote Adolescents' Oral Health and Reduce Disparities

Broadly, synergistically promote adolescent health equity

On behalf of colleagues at the UCSF Center to Address Disparities in

Oral Health (known as CAN DO), thanks for the chance to provide input.

Overall, we support the "Interdisciplinary Approaches to Promote

Adolescents' Oral Health and Reduce Disparities" initiative since

adolescence is such an important period in the lifecourse for

establishing healthy behaviors and learning to self-manage health. We

agree that research from many disciplines is important, especially

in-depth interdisciplinary and transdisciplinary (Hiatt&Breen, 2008)

research with adolescent health and development, oral health, and health

disparities experts. Also, further understanding common risk factors and

mediators that determine multiple health outcomes in formative research,

as well as, leveraging oral health promotion with ongoing health

promotion efforts such as obesity prevention and healthy diet/nutrition

promotion (especially sugar intake reduction) have strong potential for

greater impact. Specifically, such efforts have the synergistic

potential to reduce caries with obesity and periodontitis with

inflammatory disease. Supporting adolescent health promotion research

with NIH's work through the CTSAs, which Gottlieb and colleagues (Soc

Sci Med, 2016) recently argue is a vital step for increasing uptake of

efficacious preventive interventions, such as dental sealants and HPV

vaccines. We support the formative research example of

"Understanding unique causal factors and multi-level determinants

of adolescent oral health and disparities to guide development of future

interventions" and recommend including common upstream multi-level

effects such as commercial determinants and health policies. Taking

differential exposures, such as black children and teens seeing more

than double the sugar sweetened and energy beverage TV ads as their

white counterparts (Harris et al. Rudd Center, 2014, p82), may be

important in reducing health disparities. Research studies proposing

bold actions, dovetailing with the World Health Organization's

Sustainable Development Goals, on multi-level approaches to prevent

initiation of unhealthy habits including poor diet/nutrition (eg sugar

sweetened beverages, sports drinks, energy drinks), substance misuse (eg

electronic cigarettes, tobacco products, alcohol), and risky behaviors

(eg not using mouth guards, not using seat belts), as well as

incorporating commercial determinants and policy issues, will likely be

most successful. While formally testing developed interventions

through randomized controlled trials of efficacy and safety is one vital

methodology, researchers should also be encouraged to use innovative but

rigorous designs to perform formative and developmental scientific

inquiry. For example, systems science approaches are important ways to

facilitate understanding via experimenting and modeling potential

pathways and mediators. Again thank you for this opportunity to

review NIDCR research priorities and provide feedback.


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Comment No. 352