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Research Project

COordinated Oral Health Promotion (CO-OP) Chicago

Principal Investigator
Martin, Molly A.
Start Date
End Date


Almost half of children 11 years old and younger suffer from dental caries, making caries one of the most common chronic diseases of childhood. Low-income and minority children bear a disproportionate portion of this burden. We see this disparities clearly in the Chicago area, where 63% of third-graders have dental caries, and over half of those caries are untreated.

Pediatric dental caries are associated with pain, more severe infections, malnutrition, speech difficulties, poor school performance, cosmetic problems, and an overall lower quality of life. While many oral health interventions have been developed to reduce the incidence of caries, even the most successful programs have limited effectiveness in high-risk children. The delivery and receipt of proper preventive oral healthcare involves social and environmental factors that operate on individual, family, and community levels. Multi-level interventions recognize the need to target these levels simultaneously, but multi-level oral health interventions for the primary prevention of dental caries are lacking.

COordinated Oral health Promotion (CO-OP) Chicago brings together a team of clinical pediatricians and dentists, researchers, health psychologists, and policy experts to rigorously test the ability of an oral health promotion intervention to improve child and family oral health.

The primary intervention is family-focused education and support from community health workers (CHWs); this intervention will be applied in a range of settings to determine which settings, or combination of settings, result in the best outcomes.

The aim of the UH2 Phase is to formalize partnerships and finalize study design and protocol, which includes:

  • A formative assessment to determine partner operations, resources, and needs
  • CHW training
  • Pilot testing of recruitment and intervention protocols
  • Creation of a final manual of procedures
  • Obtaining clearances/contracts from all institutional and community partners.

The UH3 Phase then implements and evaluates the intervention in 15 clinics, 15 WIC sites, and 1,520 individual families.

This project has four aims:

  1. Evaluate the ability of a clinic-based family-focused CHW intervention to improve child oral health.
  2. Evaluate the ability of a WIC-based family-focused CHW intervention to improve child oral health.
  3. Evaluate the ability of a home-based family-focused CHW intervention to improve child oral health.
  4. Determine the added value of combining interventions.

Our hypothesis is that participants receiving home-based CHWs and clinic-based or WIC-based CHW interventions will have the best oral health outcomes at 12 months.

The study employs the RE-AIM framework (reach, efficacy, adoption, implementation, maintenance) to evaluate program effectiveness. The results of this study have the potential to influence oral health programming, workforce development, and reimbursement on the local, state, and national levels.

About this grant

This work is supported by a phase initiative awards cooperative agreement from the NIDCR to support a multidisciplinary and collaborative research consortium that reduces oral health disparities in children using a multilevel approach.


Visit CO-OP Chicago online at

Funding Source

National Institute of Dental & Craniofacial Research of the National Institutes of Health (Grants No. UH2 DE025483 and No. UH3DE025483)

Research Partner(s)

Illinois Chapter, American Academy of Pediatrics

Related Publication(s)

Martin M, Rosales G, Sandoval A, Lee H, Pugach O, Avenetti D, Alvarez G, Diaz A. What really happens in the home: a comparison of parent-reported and observed tooth brushing behaviors for young children. BMC Oral Health. 2019 Feb 21;19(1):35. doi: 10.1186/s12903-019-0725-5.

Martin MA, Lee HH, Landa J, Minier M, Avenetti D, Sandoval A. Formative research implications on design of a randomized controlled trial for oral health promotion in children. Pilot Feasibility Stud. 2018 Oct 4;4:155. doi: 10.1186/s40814-018-0344-y.

Martin M, Frese W, Lumsden C, Sandoval A. Building a pediatric oral health training curriculum for community health workers. J Public Health Manag Pract. 2018 May/Jun;24(3):e9-e18. doi: 10.1097/PHH.0000000000000582.

News Release(s)

Preventing cavities for kids starts with the family (UIC News Release, 9/29/2015)