Interactive Parent-targeted Text Messaging in Pediatric Clinics to Reduce ECC

儿科诊所中针对家长的交互式短信可减少 ECC

• 批准号: 10220440
• 负责人: BELINDA BORRELLI
• 金额: $ 25.9万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10220440
• 关键词: 7 year old; Administrative Supplement; Adopted; Adoption; Adult; Affect; Algorithms; Behavior; Behavioral; COVID-19; Car Phone; Caries prevention; Caring; Child; Child Health; Childhood; Chronic; Clinic; Clinic Visits; Clinical; Collection; Custom; Data; Dental; Dental caries; Depressed mood; Diet; Diffusion; Disease; Dose; Education; Educational Status; Electronic Health Record; Ethnic Origin; Evidence based program; Feedback; Fluorides; Fostering; Funding; Goals; Guidelines; Health Knowledge, Attitudes, Practice; Health Promotion; Health Status; Health behavior; Health behavior change; Hospitals; Incidence; Income; Individual; Insurance Coverage; Intervention; Interview; Leadership; Legal Guardians; Lifting; Link; Lip structure; Measures; Mediator of activation protein; Minority Groups; Modeling; National Institute of Dental and Craniofacial Research; Neighborhood Health Center; Oral; Oral health; Outcome; Outcome Measure; Ownership; Parents; Participant; Phase; Population; Prevalence; Prevention; Preventive; Preventive Intervention; Provider; Race; Randomized; Reading; Research; Sampling; Shapes; System; Testing; Text Messaging; Textiles; Time; Toothbrushing; Toothpaste; United States; Visit; Work; aged; arm; base; budget impact; clinical examination; cost; design; early childhood; efficacy testing; ethnic minority population; experience; follow up assessment; health disparity; high risk; high risk population; improved; income disparities; innovation; intervention effect; multidisciplinary; novel; primary outcome; programs; racial disparity; racial minority; social cognitive theory; sugar; sweetened beverage; tailored messaging; theories; urban setting

The iSmile study is part of the NIDCR’s Multidisciplinary and Collaborative Research Consortium to Reduce Oral Health Disparities in Children. The prevalence of Early Childhood Caries (ECC) is increasing, disproportionately affecting racial and ethnic minorities. Prevention efforts for high risk groups require multi- level strategies. We will target parents/legal guardians of children (<7 years) during pediatric well-child visits at urban community health centers (CHCs) and a hospital-based pediatric clinic, and provide a text-message based ECC prevention intervention. Eighty five percent of adults use text messaging, with no disparities by race/ethnicity, education or income. The benefits of text message interventions include the use anywhere/anytime, low cost, scalability to large populations, ability to tailor message content and intensity, and provision of strategies in real time. CHCs are an ideal venue for oral health promotion both at an individual level (they provide care to the groups at highest risk for ECC) and at a population level (there are 90 CHCs electronically linked locally and >1,100 CHCs nationally). In UH2, we developed a theory-based text message program that is automated, interactive and gamified, and involves behavioral shaping towards better oral health. The content of the texts are consistent with AAP guidelines, and Social Cognitive Theory. We used the Fisher-Owens Model (2007) as an intervention planning framework. In the current UH3 phase, 754 parents/legal guardians of children <7 years attending our target CHCs were randomized to receive one of two dose-equivalent text message interventions: Oral Health Texts (OHT) or Child Wellness Texts (CWT). All participants have completed the intervention and collection of outcome data is ongoing. The primary outcome variable is ECC incidence at 24 months. We will assess mediators and moderators of the intervention effect, perform a budget impact analysis to determine the financial consequences of adoption, diffusion, and sustainability of the OHT intervention at CHCs, and assess changes in both pediatric and parent oral health behaviors. This research has strong potential to be an evidence based program that could easily be adopted at low cost and low provider burden in the 1,128 CHCs in the U.S. that treat almost 4.5 million high risk children <7 years old. Our text message intervention is innovative because involves system-generated real time support, tailoring, feedback, and interactivity. Our study has theoretical significance because it integrates a testable theory with an intervention planning model to elucidate mechanisms of change at multiple levels. Due to delays in start-up and the unanticipated costs due to COVID-19, this administrative supplement request for funding is necessary to complete the aims of the originally funded research.

微笑研究是NIDCR的多学科合作研究联盟的一部分