Text4Tots: An Oral Health Promotion Mobile Messaging Program Rinal Patel Department of Public Health Communications and Marketing School of Public Health and Health Services The George Washington University Washington, D.C., USA CE Advisor: Lorien Abroms, ScD, MA
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Text4Tots: An Oral Health Promotion Mobile Messaging Program (Thesis Presentation)
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Text4Tots:An Oral Health Promotion
Mobile Messaging Program
Rinal PatelDepartment of Public Health Communications and Marketing
School of Public Health and Health ServicesThe George Washington University
Washington, D.C., USA
CE Advisor: Lorien Abroms, ScD, MA
Health Problem
Despite improvement in the overall oral health of Americans, the CDC has reported a significant increase in dental caries among children ages 2-5 years, setting the stage for many young children to develop a lifetime of complications from poor oral health.
Parents of children ages 2-5 in the United States.
Health Goal
Decrease the incidence of dental caries in children ages 2-5 by strengthening oral health
education skills and behaviors in parents.
Behavioral Objectives
By the end of our campaign, the number of parents of children ages 2-5 in our sample audience who:
1. supervise their children while brushing their teeth;
2. perform checks on their children's teeth for white or brown spots; and
3. whose children brush twice a day
will increase by 50%.
Communication Objective
1) By the end of our campaign, 80% of the parents will report having increased their knowledge and skills on how to properly brush their child’s teeth and how to check for dental caries. (SCT – Behavior Capability)
2) By the end of our campaign, 80% of the parents will have the confidence to perform oral health monitoring of their children (SCT – Self-efficacy)
Project Design:Participant Eligibility
• Eligibility criteria (15 participants)• Primary caregiver to a child ages 2-5• Both child and caregiver live in the United
States;• Has a cellular phone with sending/receiving
text message capabilities;• Has an active email and/or Facebook
account.
*Parents w/ multiple children were asked to enroll one child due to study limitations*
Project Design: Recruitment
• Participant recruitment via Facebook announcement• Facebook Status Update
Are you a parent or caregiver to a child ages 2 through 5?
Are you interested in making your tot's smile shine bright?
Do you own a cellphone that receives and sends text messages? If you answered YES to all of the above questions, then come join Text4Tots, a campaign aimed to decrease the incidence of dental caries in children ages 2 through 5 by strengthening oral health education skills and behaviors in parents. If you’re interested and would like more information please message or email me ([email protected]).
• Interested participants were sent invitation to join the study.• Description of the campaign, an informed consent form,
pre-test survey link, opt-in-day in day information, and conference call-in number.
• Education level: High school Diploma, Bachelor’s, or Master’s Degrees
• Parent age group (Late 20’s to Early 30’s)
• Child age demographics:
Project Design: Intervention
• Mobile Message Library • By age (2-5)• Created based on oral health literature review• Personalized messages based on pre-survey results• Goal: Tips on how to effectively supervise teeth brushing
and how to check for dental caries.• Additional tips: thumb sucking, relieve stress during
teething, etc.• Reminders sent to parents to schedule 6-month visits with
dentist.
• Mobile Messaging trial period: 14 days• Campaign launch: opt-in Day
• 3 messages a day • Sent based on parent’s schedule (Tailoring); or• sent 7:00am; 3:00pm; and 8:00pm.
Example of Mobile Message Library
Welcome Welcome to Text4Tots! Congratulations on taking a step towards making your tot smile! To opt out at any time, text STOP to this number.
First Status How old is your tot? Reply with: 2, 3, 4, or 5.
2 Most of the 20 primary teeth will appear by age 2. By age 1, your child should have made their first trip to the dentist.
3 All of your baby's primary teeth should have erupted by age 3. Make sure to visit your baby's dentist every 6 months.
4 Your child should be developing oral health skills that will last a lifetime! Lead by example by brushing your teeth twice a day and flossing regularly.
5 Your child should be developing oral health skills that will last a lifetime! Lead by example by brushing your teeth twice a day and flossing regularly.
Campaign Launch: Opt-in Day for Parent
A
Mobile Messaging Example:
• Day 3 for Parent A of 2 Year Old Child
Project Design: Follow-Up
• Congratulatory email at completion of mobile messaging intervention• Provided post-survey link
• Focus group of participants held for feedback on campaign
• Incentives provided at completion of the study• Goody bags with dentist recommended age-specific oral
health products (toothbrushes, toothpaste, floss, etc.)• Method of distribution: mail• Goal: Encourage parents to be more proactive in caring
for their child’s teeth.
Pre-Test Survey Results
• Only 26.6% of the study population had taken their child to the dentist within the last 6 months.• By age 1, all children should have made
their first trip to the dentist.
2) When was your child's last visit to the dentist?( ) 1-3 months ago( ) 4-6 months ago( ) 7-9 months ago( ) 10-12 months ago( ) More than 1 year ago( ) More than 2 years ago( ) Never
Pre-Test Survey Results
• 73.4% reported “sometimes,” “rarely,” or “never.”
4) How often do you check your child's teeth for dental caries, or cavities?( ) Always( ) Very Often( ) Sometimes( ) Rarely ( ) Never
5) How often do you brush your child's teeth or supervise their teeth brushing?( ) Always( ) Very Often( ) Sometimes( ) Rarely ( ) Never
Pre-Test Survey Results
• 20% of the children brush their teeth 2 times a day; 80% only brush once a day.
6) How many times does your child (or you) brush their teeth each day?( ) One time( ) Two times( ) Three times( ) More than three times( ) Never
Pre/Post-Test Survey Results
Pre- and Post-Test Question(s) Pre-Test Results
Post-Test Results
Pre-Test: How often do you check your child's teeth for dental caries, or cavities?
Post-Test: During the last 14 days, how often did you check your child’s teeth for dental caries?
33.4% 93.0%
Pre-Test: How often do you brush your child's teeth or supervise their teeth brushing?
Post-Test: During the last 14 days, how often did you brush your child’s teeth or supervise their teeth brushing?
39.9% 93.4%
Pre-Test: How many times does your child (or you) brush their teeth each day?
Post-Test: During the last 14 days, how many times did your child (or you) brush their teeth each day?
20% (2x) 80.0% (2x)6.7% (3x)
What did the Parents Think?
Post-Test Survey Question Post-Test Results
How often did you read Text4Tots mobile messages?
60.0% Always (n=9) 26.7% Very Often (n=4)6.7% Sometimes (n=1)0.0% Rarely (n=0)6.7% Never (n=1)
Please rate the following statement. Text4Tots has increased my oral health knowledge and skillsets for my child’s well-being.