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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

基本信息

批准号：
9544164
负责人：
BELINDA BORRELLI
金额：
$ 117.92万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9544164
关键词：
6 year old Academy Adopted Adoption Adult Affect African American Age American Behavior Budgets Car Phone Caries prevention Caring Cellular Phone Child Childhood Chronic Client satisfaction Clinic Community Health Centers Community Healthcare Computer software Cultural Sensitivity Data Dental Dental caries Development Diet Diffusion Disease Documentation Dose Education Educational Status Electronic Health Record Ensure Ethnic Origin Evidence based program Feedback Fluoride Varnishes Fluorides Focus Groups Fostering Goals Group Interviews Guidelines Health Personnel Health Promotion Health Status Health behavior Health behavior change Home environment Incidence Income Individual Insurance Coverage Intervention Interview Latino Legal Guardians Lifting Link Lip structure Low income Measures Mediator of activation protein Minority Groups Modeling Oral Oral health Outcome Measure Parents Pediatrics Phase Population Prevalence Prevention Preventive Preventive Intervention Process Provider Publishing Race Randomized Recommendation Research Sampling Structure System Testing Text Text Messaging Textiles Theoretical model Time Toothbrushing Toothpaste Training United States Visit Work aged base cost design early childhood efficacy testing ethnic minority population experience health disparity health literacy high risk high risk population improved income disparities innovation intervention cost intervention effect literacy multidisciplinary novel primary outcome programs public health relevance racial disparity racial minority recruit response screening social cognitive theory tailored messaging theories

项目摘要

DESCRIPTION (provided by applicant): This application is in response to RFA-DE-15-006 "Multidisciplinary and Collaborative Research Consortium to Reduce Oral Health Disparities in Children: A Multi-level Approach." The prevalence of Early Childhood Caries (ECC) is increasing, disproportionately affecting racial and ethnic minorities (Dye, 2007). Prevention efforts for high risk groups require multi-level strategies. We will target parents/legal guardians of children (<6 years) during pediatric well-child visits at urban community health centers (CHCs), and provide a text-message based ECC prevention intervention. We will also target the pediatric providers in the CHCs to adopt oral health guidelines from the American Academy of Pediatrics (AAP) and also improve documentation within their Electronic Health Records (EHRs). Thus, our multi-level intervention includes children, parents, providers and the CHC system. 85% 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 Phase 1 (UH2), we will conduct focus groups and interviews with parents and CHC providers to inform the development of the oral health text message intervention, as well as assess CHC work flow to identify sustainable strategies for oral health integration and eventual dissemination. This formative work is vital to ensure cultural and environmental compatibility, as we have done previously. The text messages will be consistent with AAP guidelines, our theoretical model (Social Cognitive Theory), and our previous work. We will use the Fisher-Owens Model (2007) as an intervention planning framework. In Phase 2 (UH3), 850 parents/legal guardians of children <6 years attending our target CHCs will be randomized to receive one of two dose-equivalent text message interventions: Oral Health Texts (OHT) or Child Wellness Texts (CWT). The primary outcome variable will be 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, assess CHC changes in oral health promotion (provider practices and EHR documentation), 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 <6 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.