Role of the Community Health Worker in the Biobehavioral Early Childhood Caries Team Project

Tooth decay, despite being preventable, remains the most prevalent chronic disease of US children. Early childhood caries (ECC) impacts 28% of children under age six, particularly Latino low-income children like those served by Columbia University Medical Center (CUMC). NIH notes that dental surgical treatments are neither risk-based nor effective in reducing disease progression. The problem of developing an alternative clinical approach to ECC prevention and management requires a conceptual shift toward bio-behavioral interventions. With support from a Clinical and Translational Science Award planning grant, a multi-disciplinary Team from six Columbia schools with representation from Community Health Workers, Pediatricians, pediatric dentistry, social work, health education, nutrition, information technology, diabetes education, peer counseling, and policy research addressed this problem by exploring “an informatics-assisted pharmaco-behavioral therapeutic approach” to ECC management “through family-centered peer-counseling.” The Team concluded that current risk assessment models are invalid, unreliable, and/or inappropriately complex; that recommended disease management care plans are often too challenging for parents to adopt; and that Community Health Workers may be best positioned to assist families in behavioral change and medication adherence. The project aims include refining and piloting ECC risk assessment (Aim 1), family capacity assessment (Aim 2) and lay health worker engagement (Aim 3) through a combination of translational quantitative and qualitative research. Successful accomplishment of these aims will prepare the Team to conduct a future clinical trial of a bio-behavioral intervention using new media educational technology delivered by Community Health Workers in community settings. A Community Health Worker Team member will be presenting.