Limitations of manual messaging, unable to adapt to everyone’s schedules, and keep up with responses to BRUSH, etc.
Chris Burton Kristal DailKitty Harding
Concept Text4Tots is an oral health text messaging campaign designed to educate parents with children between the ages of 2-5 on oral health education and information The program’s goal is to reduce the incidence of cavities in the children of our target audience by 10% over two years A series of 4 text messages were sent per day The Health Belief Model was used to achieve the program’s goal
Morning Messages Morning messages included an encouraging reminder to brush their child’s teeth. Perceived efficacy: Parents self assessment of ability to successfully adopt the desired behavior Cues to action: Text4Tots promoting the desired behavior Morning messages influenced brushing your child’s teeth as a routine behavior, one of our health objective goals
Afternoon Messages The two afternoon messages included oral health education, information, tips and interactive activities to encourage good oral health for children. Perceived susceptibility: Parents assessment of their child’s risk of getting cavities Perceived severity: Parents assessment of the consequences of eating sugary foods Perceived barriers: Low self efficacy, lack of knowledge Perceived benefits: Parents understanding of the health benefits of good oral health. Afternoon messages provided knowledge and awareness of beneficial oral health practices, one of our communication objective goals
Evening Messages Evening messages included an encouraging reminder to brush their child’s teeth before bed. Perceived efficacy: Parents self assessment of ability to successfully adopt the desired behavior, Cues to action: Text4Tots promoting the desired behavior Evening messages influenced brushing your child’s teeth as a routine behavior, one of our health objective goals
“BRUSH” Responses After every morning and evening reminder text, we asked participants to text the word “BRUSH” when done We would then respond in the mornings, “ Great job! Brushing in the morning will set your tot up for a smile-filled day!” and in the evenings, “ Good work! Brushing is a great way to end your tot’s day!” This provided reinforcement that parents were doing a good job and helped to motivate them to continue brushing their child’s teeth every morning and night
Survey DataPre-TestHow many children do you have an what ages are they? 1—age 4 1—age 5 1—age 2 1—age 2 3—ages 5, 4, and 2months 2—ages 5 and 8 1—age 3 1—age 4 2—ages 3 and 1
Survey DataPre-TestCell Phone Capabilities Receive texts- 9/9 Receive email- 9/9 Connect to the internet- 9/9 View video- 8/9 Click through dial- 9/9
Survey DataWhen was the last time your child went to the dentist? 1-3 months ago: 2/9 4-6 months ago: 4/9 7-9 months ago: 0 10-12 months ago: 1/9 More than a year ago: 0 Never: 2/9My child has had: No cavities: 9/9
Survey Data Do you brush your child’s teeth or supervise their brushing?Pre-Test Post-TestAlways: 8/9 Always: 7/8Most of the time: 0 Most of the time: 0Sometimes: 1/9 Sometimes: 1/8Rarely: 0 Rarely: 0Never: 0 Never: 0
Survey Data How often does your child (or you) brush their teeth each day?Pre-Test Post-TestNever: 0 Never: 01 time: 1/9 1 time: 02 times: 7/9 2 times: 6/83 times: 1/9 3 times: 2/8More than 3 times: 0 More than 3 times: 0
Survey Data Do you floss your child’s teeth? If yes, how oftenPre-Test Post-TestDaily: 2/9 Daily: 1/9A few times a week: 2/9 A few times a week: 3/9Weekly or less: 2/9 Weekly: 1/9No: 3/9 No: 3/9
Survey Data Please rate the following statements from 1- not important to 5 very importantPre-Test 1 2 3 4 5Clean teeth are important to my child’s healthy development 0 0 0 0 9I think children should go to the dentist every 6 months 0 0 2 0 7I know where to find information about taking care of my 0 0 1 2 6kid’s teethChildren should be supervised when brushing and flossing 0 0 0 1 8Post-Test 1 2 3 4 5Clean teeth are important to my child’s healthy development 0 0 0 0 8I think children should go to the dentist every 6 months 0 0 1 1 6I know where to find information about taking care of my 0 0 0 0 8kid’s teethChildren should be supervised when brushing and flossing 0 0 0 0 8
Survey Data Please list as many things as you can think of that you can do to keep your childs teeth healthy.Pre-Test Post-Test9 responses, average 2.5 items 6 responses, average 3.3 items Brushing and diet monitoring. (2) Offering healthy snacks instead of Kids have to drink plenty of water and less juice and candy, brushing, flossing and dental definitely NO sodas. Children should also floss at night and brush their teeth at night and in the check ups. (4) morning. They also need to see a dentist every six months. (4) Brushing at least twice a day, flossing Brush regularly, keep routine dentist appointments. at least twice a week, minimal sweets (2) and diets high in calcium. (4) Minimize sweets. Tooth brushing after every meal. (2) They eat cheese regularly as I have read that is good for Brush after every meal, floss. (2) oral care. Brushing themselves and teaching them to Brush twice a day, floss, regular dental brush as well as minimizing sugar/candy intake. No soda. (3) check ups, no sodas, and lots of water. Try to avoid to much candy, chewy especially and floss (5) after eating. (2) 1. Brushing and flossing. 2. Monitoring candy intake. Limit sugars and brush daily. 3. Dental check ups. (3) (2) Proper brushing, limited sweets and candy (2) . Brushing, flossing, monitoring food Make it fun, routine, drink less juice and eat less and drink intake. (3) sweets. (3)
Survey DataI liked the Text4Tots program.Yes: 100%Comments1. I liked the text reminders to brush your toddlers teeth. I used it as an alarm with my 3yr old son. I would say "ok Bj your tooth brush alarm is ringing, time to brush your teeth & get the stinky out” lol. I enjoyed the text msgs, I thought they were informative. Im going to set a set a "tooth brush alarm", on my cell phone to motivate my toodler to brush his teeth. As a parent, Im always trying to find fun and creative ways to promote healthy habits with my son.2. Texts were sent too early, should adjust per schedule.3. I liked the program however if it could be customized per family schedules I think the responses might be better. Such as the first Brush of the day some may sleep in on certain days.
Survey DataI would continue receiving Text4Tots messages, if it was possible. Yes: 50% No: 50%I would recommend Text4Tots to a friend. Yes: 88% No: 12%Text4Tots sends too many messages. Yes: 0% No: 100%Fill in the blank: I read _____ of the Text4Tots messages. All: 75% Most: 12% Some: 0% Few: 12% None: 0%
Suggested Improvements Automated delivery system to better fit participants schedules. More reinforcing messages after BRUSH text. Addition of FLOSS response, and corresponding messaging. Possibility for targeted modules based on tot’s age Enhanced interaction: Text pictures of you and your tot brushing. Develop quizzes or oral health games/activities Goal setting (# of BRUSH’s per week) Ability to report dentist visits.