Randomized Efficacy Trial of MySmileBuddy, a Family-centered Behavioral Intervention to Reduce Early Childhood Caries

MySmileBuddy 的随机功效试验，一种以家庭为中心的减少儿童早期龋齿的行为干预措施

• 批准号: 10005037
• 负责人: CAROL KUNZEL
• 金额: $ 78.77万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10005037
• 关键词: 5 year old; Academy; Address; Adoption; Affect; Age; American; Behavior; Behavior Therapy; Behavioral; Caregivers; Cariogenic Diet; Child; Childhood; Chronic Disease; Clinic; Communities; Community Health Aides; Consensus; Consumption; Counseling; Coupled; Dental; Dental Hygiene; Dental caries; Diet; Disease; Disease Management; Education; Enrollment; Ethnic Origin; Evaluation; Family; Goals; Health Educators; Hispanics; Hygiene; Individual; Instruction; Intervention; Knowledge; Learning; Low income; Maintenance; Measures; Mediating; Mediator of activation protein; Medical; Minority; Motivation; New York City; Nutritionist; Operative Surgical Procedures; Oral health; Parents; Pathway interactions; Pediatric Dentistry; Pediatrics; Population; Preschool Child; Prevention; Preventive; Public Health; Race; Randomized; Randomized Controlled Trials; Research; Risk; Science; Scientist; Social support; Surface; System; Testing; Therapeutic; Tooth Diseases; Tooth structure; Toothpaste; Translating; Treatment Efficacy; United States; Universities; Water fluoridation; Work; base; community setting; design; disease natural history; early childhood; efficacy trial; health disparity; health information technology; high risk; high risk population; improved; innovation; novel; payment; personalized care; programs; recruit; repaired; scale up; social; social disadvantage

ABSTRACT/ PROJECT SUMMARY Longstanding practice has treated early childhood caries (ECC) primarily through surgical dental repair, reinforced by current payment systems, an approach that does not address the natural history of the disease or the oral hygiene and dietary behaviors that mediate its occurrence. Professional consensus on the value of ECC disease management is emerging but behavioral strategies remain largely unstudied among Hispanic children in the United States. The long-term goal of the proposed study is to reduce oral health disparities and inform a paradigm shift from a focus on treatment to one that also embraces prevention. It is known that using fluoridated toothpaste twice daily and consumption of a low cariogenic diet has both preventive and therapeutic value. What is not known is how to best translate the adoption and maintenance of salutary behaviors to populations at greatest risk. The proposed randomized controlled trial will evaluate the efficacy of a family focused behavioral intervention, MySmileBuddy, to reduce ECC progression in high-risk Hispanic preschoolers. We propose to recruit and enroll 858 two to five year-old children, all with ECC, along with their caregiver from pediatric medical clinics in northern Manhattan, New York City. Specific Aims are: (1) to assess MySmileBuddy's efficacy (versus control) to decrease ECC progression (defined as positive change in number of decayed, missing, or filled teeth (∆dmft>0) or surfaces (∆dfs>0)) measured 12-months post-randomization (and assessed again 24-months post-randomization); (2) to assess MySmileBuddy's efficacy (versus control) to enhance adoption of twice daily fluoridated toothpaste use and consumption of a low cariogenic diet; and (3) to assess causal pathways through which MySmileBuddy influences twice daily fluoridated toothpaste use and consumption of a low cariogenic diet. The proposed research is innovative and represents a departure from the status quo by shifting focus from treatment to prevention, shifting education from verbal instructions and written materials provided by dental professionals to using interactive Health Information Technology delivered by Community Health Workers, and capitalizing on general pediatrics practices as a conduit for promoting children's oral health. At the completion of this study, we will know the extent to which MySmileBuddy promotes parents' acquisition and maintenance of oral hygiene and dietary behaviors that reduce ECC progression in a high-risk population of Hispanic preschool children. Ultimately, such knowledge has the potential to reduce the number of children needlessly affected by this preventable disease.

摘要/项目总结