# Interactive Parent-targeted Text Messaging in Pediatric Clinics to Reduce ECC

> **NIH NIH UH3** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $831,634

## Abstract

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 adopte...

## Key facts

- **NIH application ID:** 10298023
- **Project number:** 3UH3DE025492-05S2
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** BELINDA BORRELLI
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $831,634
- **Award type:** 3
- **Project period:** 2015-09-18 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10298023

## Citation

> US National Institutes of Health, RePORTER application 10298023, Interactive Parent-targeted Text Messaging in Pediatric Clinics to Reduce ECC (3UH3DE025492-05S2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10298023. Licensed CC0.

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