title: Reducing disease burden and health inequalities arising from chronic disease among indigenous children: an early childhood caries intervention in Aotearoa/New Zealand.
abstract: BACKGROUND
  Maaori are the Indigenous people of New Zealand and do not enjoy the same oral health status as the non-Indigenous majority. To overcome oral health disparities, the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants. The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child. This study seeks to determine whether implementing a kaupapa Maaori (Maaori philosophical viewpoint) in an early childhood caries (ECC) intervention reduces dental disease burden among Maaori children. The intervention consists of four approaches to prevent early childhood caries: dental care provided during pregnancy, fluoride varnish application to the teeth of children, motivational interviewing, and anticipatory guidance.
  
  
  METHODS
  The participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui.This randomised-control trial will be undertaken utilising the principles of kaupapa Maaori research, which encompasses Maaori leadership, Maaori relationships, Maaori customary practices, etiquette and protocol. Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention. Self-report information will be collected in a baseline questionnaire during pregnancy and when children are aged 24 and 36 months. Clinical oral health data will be collected during standardised examinations at ages 24 and 36 months by calibrated dental professionals. All participants receive the ECC intervention benefits, with the intervention delayed by 24 months for participants who are randomised to the control-delayed arm.
  
  
  CONCLUSIONS
  The development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research processes. This study will assess an ECC intervention which could provide a meaningful approach for Maaori for the protection and maintenance of oral health for Maaori children and their family, thus reducing oral health disparities.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000111976.
authors: Department of Preventive and Social Medicine, Dunedin School of Medicine, The University of Otago, 9054 Dunedin, New Zealand. john.broughton@otago.ac.nz.
authors: John R
authors: JR
authors: Broughton
authors: Joyce Te H
authors: JT
authors: Maipi
authors: Marie
authors: M
authors: Person
authors: W Murray
authors: WM
authors: Thomson
authors: Kate C
authors: KC
authors: Morgaine
authors: Sarah-Jane
authors: SJ
authors: Tiakiwai
authors: Jonathan
authors: J
authors: Kilgour
authors: Kay
authors: K
authors: Berryman
authors: Herenia P
authors: HP
authors: Lawrence
authors: Lisa M
authors: LM
authors: Jamieson
mesh_terms: D002648:Child; D002675:Child, Preschool; D003469:Culture; D003729:Dental Care / Q000379:methods; D003731:Dental Caries / Q000517:prevention & control*; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use; D006801:Humans; D008427:Maternal Health Services / Q000379:methods; D062405:Motivational Interviewing / Q000379:methods; D009520:New Zealand / Q000453:epidemiology; D009909:Oral Health / Q000706:statistics & numerical data; D011247:Pregnancy
chemical_list: D005460:Fluorides, Topical