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.

iSmile研究是NIDCR多学科和合作研究联盟的一部分， 儿童口腔健康差异。幼儿龋齿（ECC）的患病率正在增加， 不成比例地影响到种族和族裔少数群体。针对高危人群的预防工作需要多方面的努力， 水平战略。我们将针对儿童（<7岁）的父母/法律的监护人在儿科健康儿童访视期间， 城市社区卫生中心（CHC）和医院儿科诊所，并提供短信 基于ECC的预防干预。85%的成年人使用短信， 种族/民族、教育或收入。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 真实的提供策略。社区健康中心是促进口腔健康的理想场所， 在人口层面（有90间社区卫生中心）， 在当地建立电子联系，在全国建立超过1，100个社区卫生中心）。在UH 2中，我们开发了一种基于理论的短信 程序是自动化的，互动的和游戏化的，涉及行为塑造，以更好的口头 健康课文的内容与AAP指南和社会认知理论一致。我们使用了 Fisher-Owens模型（2007年）作为干预规划框架。在目前的UH 3阶段，754 在我们的目标社区卫生中心就诊的7岁以下儿童的父母/法律的监护人被随机分配接受两种治疗之一 剂量等效的短信干预：口腔健康短信（OHT）或儿童健康短信（CWT）。所有 参与者已完成干预，正在收集成果数据。主要结局 变量为24个月时的ECC发生率。我们将评估干预效果的中介者和调节者， 进行预算影响分析，以确定采用、推广和 OHT干预在CHCs的可持续性，并评估儿童和父母口腔健康的变化 行为。这项研究有很强的潜力成为一个基于证据的计划，可以很容易地被采用， 在美国1,128个治疗近450万高危儿童的社区卫生中心中， <7岁。我们的短信干预是创新的，因为涉及系统生成的真实的时间 支持、定制、反馈和交互。本研究具有理论意义，因为它整合了 可检验的理论与干预规划模型，以阐明多层次的变化机制。由于 由于COVID-19造成的启动延迟和意外成本，本行政补充申请 要完成原先获资助的研究目标，便需要拨款。