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: 10298023
• 负责人: BELINDA BORRELLI
• 金额: $ 83.16万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-18 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10298023
• 关键词: 7 year old; Address; Adopted; Adoption; Adult; Affect; Algorithms; Behavioral; COVID-19; COVID-19 pandemic; Car Phone; Caries prevention; Caring; Child; Childhood; Clinic; Clinic Visits; Clinical; Collection; Custom; Dental; Dental Care; Dental caries; Diet; Diffusion; Dose; Education; Educational Status; Employment; Enrollment; Ethnic Origin; Evidence based program; Family; Family member; Fluorides; Goals; Health Knowledge, Attitudes, Practice; Health Promotion; Health Services Accessibility; Health Status; Health behavior; Health behavior change; Hospitals; Incidence; Income; Institutional Review Boards; Insurance Coverage; Intake; Intervention; Lifting; Lip structure; Low Income Population; Measures; Mediator of activation protein; Minority; Natural experiment; Neighborhood Health Center; Oral; Oral health; Outcome Measure; Ownership; Parents; Participant; Prevalence; Prevention; Preventive; Principal Investigator; Protocols documentation; Provider; Public Health; Quality of life; Race; Randomized; Research; Resources; Schedule; Shapes; Site; Testing; Text Messaging; Textiles; Time; Toothbrushing; Toothpaste; Urban Community; Visit; arm; base; behavior change; budget impact; clinical outcome measures; comparison group; coronavirus disease; cost; design; early childhood; efficacy testing; ethnic minority population; experience; follow-up; health assessment; high risk; high risk population; improved; income disparities; intervention cost; intervention effect; pandemic disease; parent grant; preventive intervention; primary outcome; programs; racial minority; recruit; safety net; social cognitive theory; sugar; sweetened beverage; text messaging intervention; theories; urban underserved

The purpose of this competitive revision application is to request additional resources to complete collection of our primary outcome measure and fulfill the parent grant’s primary aim, which is to test the efficacy of a parent- targeted text message-based ECC prevention intervention. This additional time is necessary due unanticipated start-up delays and COVID-19 closures which halted clinical oral exams for 7 months. Enrollment and intervention delivery is complete. We are currently conducting 12 and 24 month follow ups. We also wish to use the natural experiment of the COVID-19 pandemic to examine the effect of the pandemic on pediatric oral health behaviors (tooth brushing, diet, sugar-sweetened beverage intake, fluoride toothpaste use), oral health quality of life, and preventive dental visits. We will examine these factors pre-and post COVID among the 754 families already enrolled. We will also assess the impact of potential moderators such as the effect of minority status/income and whether those families affected more by COVID-19 were more likely to have unhealthy changes in pediatric oral health behaviors pre-post COVID than those who were less severely impacted by COVID-19. The rationale for the main study is to target groups disproportionately affected by Early Childhood Caries (ECC). Our study enrolled 754 parents of children (<7 years) during pediatric clinic visits at three urban community health centers (CHCs) and one safety-net hospital-based clinic. Participants were randomized to either Oral Health Text messages (OHT) or Child Wellness Text messages (CWT). Participants received texts for four months, plus one-month of ‘booster’ texts 8 months later. Texts were in English or Spanish, automated, interactive, customized and gamified, and included a behavioral shaping algorithm to help parents move toward the goal of the arm to which they are randomized (e.g., improved pediatric oral health or improved child wellness). Caries increment at 24 months, our objective primary outcome variable, is measured by calibrated examiners at the 12- and 24-month follow-up visits. We will also 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 intervention, and assess changes in oral health behaviors. Effective prevention efforts for high-risk groups require minimally burdensome strategies involving proactive reach through existing channels, such as CHCs and text messaging. More than 85% of adults text message with no disparity by income, education, or ethnicity. The benefits of text message interventions include: use anywhere/anytime, low cost, scalability, and ability to tailor content/dose. Community Health Centers (CHCs) are an ideal venue for oral health promotion; they provide care to the groups at highest risk for ECC. This research has strong potential to be an evidence-based program that could easily be adopted at low cost and provider burden in the 1,362 CHCs that treat almost 7.5 million, high risk U.S. children.

此竞争性修订申请的目的是要求其他资源以完成收集 我们的主要结果措施并履行父母赠款的主要目的，即测试父母的效率 - 有针对性的基于文本消息的ECC预防干预。由于意外而需要此额外的时间 启动延迟和共同封闭，使临床口腔检查停止了7个月。注册和 干预交付完成。我们目前正在进行12个月和24个月的随访。我们也希望 使用COVID-19大流行的自然实验检查大流行对小儿口服的影响 健康行为（牙刷，饮食，糖甜床的摄入量，氟化物牙膏的使用），口腔健康 生活质量和预防性牙科访问。我们将在754中研究这些因素前后的因素 家庭已经入学。我们还将评估潜在主持人的影响，例如少数族裔的影响 身份/收入以及那些受到互联19的家庭是否更可能患有不健康的家庭 小儿口腔健康行为的变化与那些受到严重影响的人相比 新冠肺炎。主要研究的基本原理是针对幼儿时期影响不成比例的群体 龋齿（ECC）。我们的研究在三个城市的小儿诊所就诊期间招募了754名儿童父母（<7岁） 社区卫生中心（CHC）和一个基于安全网的医院诊所。参与者是随机的 口腔健康短信（OHT）或儿童健康短信（CWT）。参与者收到了文字 四个月，8个月后的“助推器”文本中的一个月。文本用英语或西班牙语，自动化， 互动，定制和游戏化，并包括一种行为塑造算法，以帮助父母移动 达到其随机的手臂的目标（例如，改善儿科口腔健康或改善的孩子 健康）。龋齿在24个月时增加了我们的客观主要结果变量，通过校准测量 在12个月和24个月的随访访问中的审查员。我们还将评估调解员和主持人 干预效果，执行预算影响分析以确定采用的财务后果， 干预的扩散和可持续性以及口腔健康行为的评估变化。有效的 高风险群体的预防工作需要涉及主动覆盖的最低限制性策略 通过现有渠道，例如CHC和文本消息传递。超过85％的成人短信没有 收入，教育或种族差异。短信干预措施的好处包括：使用 随时随地，低成本，可伸缩性和量身定制内容/剂量的能力。社区卫生中心（CHC） 是口腔健康促进的理想场所；他们为ECC风险最高的小组提供护理。这 研究具有强大的潜力，成为一个基于证据的计划，可以轻松以低成本和 提供者在1,362个CHC中燃烧，这些CHC治疗近750万，高风险美国儿童。