Interactive Parent-Targeted Text Messaging in Pediatric Clinics to Reduce Caries Among Urban Children (iSmile)

This is a 3 year clincal study, to test the efficacy of a parent-targeted text message-based intervention program on caries incidence and oral health behaviors (child and parent). Parents (n= 850) across all pediatric clinic sites (Boston Medical Center and Community Health Centers (CHCs); DotHouse CHC and Codman Square CHC) will be randomized to receive either text messages (TMs) regarding oral health or TMs regarding child wellness.

The study will enroll English and Spanish speaking parents and their youngest child who is < 7 years old, has at least one tooth showing, and attends the targeted pediatric clinic to receive primary care (n= 1700). Parents will complete self-report surveys at baseline, and 2, 4, 12, and 24-months after baseline; receive and respond to TM assessments during the 4-month intervention; and will also receive TMs during a 'booster' period of one month, which will occur 12-months post baseline. Parent's children will be assessed for caries by a clinical oral examination performed by licensed Clinical Examiners at baseline, 12-and-24-months post-baseline.

 Despite the fact that early childhood caries (ECC) is preventable, it is the most common chronic childhood disease in the US, affecting 28% of those aged 2-5, and disproportionately affecting poor and minority groups. We propose an interactive text messaging intervention delivered to parents of children younger than 6 years old, which aims to foster healthy parent behaviors and reduce ECC in their children. This novel, low cost approach has the potential to expand the ability of community health center (CHC) pediatric clinics to efficiently integrate oral health promotion into their practice and could easily be disseminated to the 1200 CHCs in the United States that treat 4.5 million children younger than 6, most of whom are at high risk for ECC.