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

ISMILE研究是NIDCR多学科和合作研究联盟的一部分，以减少 儿童口腔健康的差异。儿童早期龋齿(ECC)的患病率正在上升， 对种族和少数民族造成不成比例的影响。针对高危人群的预防工作需要多个 水平策略。我们将以儿童(&lt；7岁)的父母/法定监护人为目标，在儿科健康儿童探视期间 城市社区卫生中心和以医院为基础的儿科诊所，并提供短信 以ECC为基础的预防干预。85%的成年人使用短信，没有差异 种族/民族、教育程度或收入。短信干预的好处包括使用 随时随地、低成本、可扩展到大量人群、能够定制消息内容和强度，以及 实时提供战略。社区健康中心是促进个人口腔健康的理想场所。 在人口层面(有90家社区健康中心)和在人口层面(有90家社区健康中心 本地和全国1,100个社区卫生中心的电子连接)。在UH2，我们开发了一条基于理论的短信 自动化、互动性和游戏化的程序，并涉及到更好地口语的行为塑造 健康。文本的内容符合AAP指南和社会认知理论。我们使用了 Fisher-Owens模型(2007)作为干预规划框架。在目前的UH3阶段，754 在我们的目标儿童保健中心就读7年的儿童的父母/法定监护人随机接受以下两项之一的治疗 剂量等效短信干预：口腔健康短信(OHT)或儿童健康短信(CWT)。全 参与者已经完成干预，结果数据的收集正在进行中。主要结果是 变量为24个月时的ECC发病率。我们将评估干预效果的调解人和主持人， 执行预算影响分析，以确定采用、传播和 儿童保健中心OHT干预的可持续性，并评估儿科和家长口腔健康的变化 行为。这项研究有很大的潜力成为一个基于证据的计划，可以很容易地在 在美国治疗近450万高危儿童的1128家CHC中，低成本和低提供者负担 &lt；7岁。我们的短信干预是创新的，因为它涉及系统生成的实时 支持、定制、反馈和互动。我们的研究具有理论意义，因为它整合了一个 可测试性理论和干预计划模型在多个层面上解释变化机制。到期 针对新冠肺炎导致的开工延误和意外费用，本行政副刊要求 资金是完成最初资助的研究的目标所必需的。

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.