title: Reducing disease burden and health inequalities arising from chronic disease among Indigenous children: an early childhood caries intervention.
abstract: BACKGROUND
  This study seeks to determine if implementing a culturally-appropriate early childhood caries (ECC) intervention reduces dental disease burden and oral health inequalities among Indigenous children living in South Australia, Australia.
  
  
  METHODS
  This paper describes the study protocol for a randomised controlled trial conducted among Indigenous children living in South Australia with an anticipated sample of 400. The ECC intervention consists of four components: (1) provision of dental care; (2) fluoride varnish application to the teeth of children; (3) motivational interviewing and (4) anticipatory guidance. Participants are randomly assigned to two intervention groups, immediate (n = 200) or delayed (n = 200). Provision of dental care (1) occurs during pregnancy in the immediate intervention group or when children are 24-months in the delayed intervention group. Interventions (2), (3) and (4) occur when children are 6-, 12- and 18-months in the immediate intervention group or 24-, 30- and 36-months in the delayed intervention group. Hence, all participants receive the ECC intervention, though it is delayed 24 months for participants who are randomised to the control-delayed arm. In both groups, self-reported data will be collected at baseline (pregnancy) and when children are 24- and 36-months; and child clinical oral health status will be determined during standardised examinations conducted at 24- and 36-months by two calibrated dental professionals.
  
  
  CONCLUSIONS
  Expected outcomes will address whether exposure to a culturally-appropriate ECC intervention is effective in reducing dental disease burden and oral health inequalities among Indigenous children living in South Australia.
authors.affiliation: Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, Adelaide, Australia. jessica.merrick@adelaide.edu.au
authors.forename: Jessica
authors.initials: J
authors.lastname: Merrick
authors.forename: Alwin
authors.initials: A
authors.lastname: Chong
authors.forename: Eleanor
authors.initials: E
authors.lastname: Parker
authors.forename: Kaye
authors.initials: K
authors.lastname: Roberts-Thomson
authors.forename: Gary
authors.initials: G
authors.lastname: Misan
authors.forename: John
authors.initials: J
authors.lastname: Spencer
authors.forename: John
authors.initials: J
authors.lastname: Broughton
authors.forename: Herenia
authors.initials: H
authors.lastname: Lawrence
authors.forename: Lisa
authors.initials: L
authors.lastname: Jamieson
mesh_terms: D001315:Australia; D002675:Child, Preschool; D002908:Chronic Disease; D017281:Cost of Illness; D054521:Cultural Competency; D003731:Dental Caries / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D011247:Pregnancy; D015397:Program Evaluation; D011795:Surveys and Questionnaires