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：
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
项目类别：
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

项目摘要

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 多学科合作研究联盟的一部分，旨在减少儿童口腔健康差异。儿童早期龋齿 (ECC) 的患病率正在增加，对高危群体的预防工作影响尤为严重，需要采取多种措施。我们将在儿科健康儿童就诊期间针对儿童（<7 岁）的父母/法定监护人。城市社区卫生中心 (CHC) 和医院儿科诊所，并提供短信百分之八十五的成年人使用短信，两者之间没有差异。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、可扩展至大量人群、定制消息内容和强度的能力，以及 CHC 提供实时策略，是个人口腔健康促进的理想场所。水平（他们为 ECC 风险最高的群体提供护理）和人口水平（有 90 个 CHC）在 UH2 中，我们开发了一种基于理论的短信。自动化、交互式和游戏化的程序，涉及行为塑造以实现更好的口语文本内容符合 AAP 指南和社会认知理论。 Fisher-Owens 模型（2007 年）作为干预计划框架在当前的 UH3 阶段，754 参加我们的目标 CHC 的 7 岁以下儿童的父母/法定监护人被随机分配接受以下两项中的一项剂量当量短信干预：口腔健康短信 (OHT) 或儿童健康短信 (CWT)。参与者已完成干预，并且正在收集结果数据。变量是 24 个月时的 ECC 发生率，我们将评估干预效果的中介因素和调节因素，进行预算影响分析，以确定采用、传播和推广的财务后果 CHC 的 OHT 干预的可持续性，并评估儿科和家长口腔健康的变化这项研究很有可能成为一项基于证据的计划，很容易被采用。美国 1,128 个 CHC 治疗近 450 万高危儿童，费用低，提供者负担低 <7岁。我们的短信干预是创新的，因为涉及系统实时生成。我们的研究具有理论意义，因为它整合了支持、定制、反馈和交互性。可检验的理论与干预计划模型，以阐明多个层面的变革机制。由于新冠肺炎 (COVID-19) 导致启动延迟和意外成本，本行政补充请求资金对于完成最初资助的研究的目标是必要的。