title: Splash!: a prospective birth cohort study of the impact of environmental, social and family-level influences on child oral health and obesity related risk factors and outcomes.
abstract: BACKGROUND
  Dental caries (decay) is the most prevalent disease of childhood. It is often left untreated and can impact negatively on general health, and physical, developmental, social and learning outcomes. Similar to other health issues, the greatest burden of dental caries is seen in those of low socio-economic position. In addition, a number of diet-related risk factors for dental caries are shared risk factors for the development of childhood obesity. These include high and frequent consumption of refined carbohydrates (predominately sugars), and soft drinks and other sweetened beverages, and low intake of (fluoridated) water. The prevalence of childhood obesity is also at a concerning level in most countries and there is an opportunity to determine interventions for addressing both of these largely preventable conditions through sustainable and equitable solutions. This study aims to prospectively examine the impact of drink choices on child obesity risk and oral health status.
  
  
  METHODS
  This is a two-stage study using a mixed methods research approach. The first stage involves qualitative interviews of a sub-sample of recruited parents to develop an understanding of the processes involved in drink choice, and inform the development of the Discrete Choice Experiment analysis and the measurement instruments to be used in the second stage. The second stage involves the establishment of a prospective birth cohort of 500 children from disadvantaged communities in rural and regional Victoria, Australia (with and without water fluoridation). This longitudinal design allows measurement of changes in the child's diet over time, exposure to fluoride sources including water, dental caries progression, and the risk of childhood obesity.
  
  
  CONCLUSIONS
  This research will provide a unique contribution to integrated health, education and social policy and program directions, by providing clearer policy relevant evidence on strategies to counter social and environmental factors which predispose infants and children to poor health, wellbeing and social outcomes; and evidence-based strategies to promote health and prevent disease through the adoption of healthier lifestyles and diet. Further, given the absence of evidence on the processes and effectiveness of contemporary policy implementation, such as community water fluoridation in rural and regional communities it's approach and findings will be extremely informative.
authors.affiliation: McCaughey Centre, Melbourne School of Population Health, The University of Melbourne, Carlton Australia. andreams@unimelb.edu.au
authors.forename: Andrea M
authors.initials: AM
authors.lastname: de Silva-Sanigorski
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Waters
authors.forename: Hanny
authors.initials: H
authors.lastname: Calache
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.forename: Lisa
authors.initials: L
authors.lastname: Gold
authors.forename: Mark
authors.initials: M
authors.lastname: Gussy
authors.forename: Anthony
authors.initials: A
authors.lastname: Scott
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lacy
authors.forename: Monica
authors.initials: M
authors.lastname: Virgo-Milton
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003731:Dental Caries; D004781:Environmental Exposure; D005195:Family Relations; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D009765:Obesity / Q000209:etiology*; D009909:Oral Health; D011446:Prospective Studies; D012307:Risk Factors; D012931:Social Environment; D011795:Surveys and Questionnaires; D014739:Victoria