PROJECT SUMMARY/ABSTRACT – Research Project 2: “A public health practice investigation exploring the impact of community water fluoridation among American Indian and Alaska Native populations in Alaska” Recent trends towards community water fluoridation (CWF) cessation raise concerns regarding potential oral health disparities and the drivers of community decisions regarding CWF. Policy makers, dental and health providers and public health practitioners’ evidence-based recommendations, to facilitate informed CWF decisions and ensure oral health promotion efforts are appropriately prioritized. The long-term goal of this project is to strengthen evidence-based, audience-specific recommendations regarding oral health program planning especially among American Indian and Alaska Native populations who may suffer disproportionately more negative oral health outcomes secondary to state and local water policy processes. The objective of this application is to conduct a quantitative retrospective study to assess measures of decay prevalence utilizing electronic health records, and identify health provider, policy-maker, and community characteristics associated with local water policy decisions, and ballot box outcomes, respectively, as they relate to CWF. The rationale for the project is that analysis of changes in oral health outcomes and associated economic impacts when CWF is ceased is limited. Similarly, an understanding of the predisposing, enabling, and reinforcing factors that drive CWF policy decisions in Alaska is lacking. The project will pursue three specific aims: (1) Explore utilizing electronic dental records as a population health surveillance tool for specific age groups by region and exposure to optimal or sub-optimal levels of CWF.; (2) examine, via survey, health care providers’ knowledge, beliefs, and practices associated with CWF, fluoride applications and other supplementation and any patterns associated with demographics and fluoridation status in their community of practice; and (3) Analyze local policy-making processes and community characteristics associated with CWF through a systematic review of publicly available documents and policy-making actions through mixed-methods analysis of relevant government agency and public utility databases, traditional and social media, and local governing body meeting minutes. The project is innovative in that it utilizes electronic dental records as a population oral health surveillance strategy and it reignites a body of research on the topic of provider, policy-maker, and community characteristics and their association with CWF decisions amidst a modern social, political, economic, and technological landscape. The proposed research is significant because the results can inform health equity- oriented public policies that prioritize American Indian and Alaska Native health, support Tribal Health Organization dental and health providers with training and communication tools, and may yield a set...