KDH Research & Communication (KDHRC) submits this Phase II Small Business Innovation
Research (SBIR) application to expand and fully evaluate Guardians Receiving Information
through Navigators (GRIN). GRIN is a culturally competent, online professional development
course to prepare community health workers (CHWs) to provide oral health outreach to low-
income Black parents/guardians (henceforth guardians) of children and adolescents. GRIN
seeks to increase CHWs’ knowledge, attitudes and beliefs, perceived self-efficacy, and intentions
to conduct oral health outreach to Black guardians.
The need for GRIN is great. Tooth decay, especially when untreated, creates lasting and
substantial physical and psychosocial consequences for children and adolescents. Minority and
low-income populations have disproportionately high rates of tooth decay and related
consequences. Compared to non-Hispanic White children, Black children are less likely to
receive preventive dental visits, and experience more untreated tooth decay. Moreover, children
living in poverty are twice as likely as children not living in poverty to experience primary tooth
decay. To address these needs and meet calls to action for evidence-based programs to support
CHWs to conduct oral health outreach to Black guardians of children and adolescents, KDHRC
developed GRIN. Our Phase I efforts yielded a prototype with supportive feasibility results and
solid partnerships on which we base our Phase II approach. Indeed, CHW professional
organizations, including the National Maternal and Child Oral Health Resource Center, the
National AHEC Organization (NAO), and Morehouse School of Medicine, commit to the
scientific execution and commercial distribution of this project and substantiate GRIN’s
programmatic importance and commercial potential.
In Phase II, we will develop additional interactive content, film video vignettes, and finalize
GRIN. Then, we will conduct a well-powered and methodologically strong two-condition
randomized controlled trial to test GRIN’s effectiveness. Our market research suggests a
significant need and eager market, and support from myriad stakeholders committed to GRIN’s
scientific rigor and rapid dissemination further substantiate GRIN’s importance and commercial
potential to address extant oral health disparities that are likely exacerbated by the COVID-19
pandemic.
