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Sharma H, Suprabha BS, Rao A. Teledentistry and its applications in paediatric dentistry: A literature review. PEDIATRIC DENTAL JOURNAL 2021; 31:203-215. [PMID: 34848924 PMCID: PMC8613071 DOI: 10.1016/j.pdj.2021.08.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/08/2021] [Accepted: 08/11/2021] [Indexed: 01/08/2023]
Abstract
Background During the unfortunate event of the COVID-19 pandemic, restrictions were placed on face-to-face interactions in dentistry to promote social distancing and reduce spread of virus. In order to provide dental services teledentistry was employed. Objective This article aims to review the literature and information available on the provision and utilization of teledentistry as a method to address oral health needs of paediatric patients. Results Teledentistry has been utilised in paediatric population for the purpose of oral health education and promotion, remote diagnosis and monitoring, and behaviour guidance. Studies involving paediatric population for aforementioned applications have shown that this practice strategy is beneficial to provide dental treatment in remote locations with little access to paediatric dental specialists, monitor patients between appointments, conduct remote diagnosis and screening programmes, promote oral health of children through dental education, and in pre-appointment behaviour guidance. This method was particularly useful during the current COVID-19 pandemic where dentists use their mobile phones, computer webcams for patient appointments while maintaining safe distance and avoid exposing themselves as well as patient to the virus. Conclusion Teledentistry can be a supplement to face-to-face methods of paediatric dental care, ultimately leading to better patient management. This technology can make a significant contribution in reducing the supply-demand gap of paediatric dental specialists in places where healthcare facilities are limited and ensure safety during the pandemic whilst providing dental care to paediatric patients. Further research is required for safe, effective and evidence-based use of teledentistry in the field of paediatric dentistry.
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Affiliation(s)
- Harshita Sharma
- Department of Paediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Baranya Shrikrishna Suprabha
- Department of Paediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Arathi Rao
- Department of Paediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Lumsden CL, Edelstein BL, Basch CE, Wolf RL, Koch PA, McKeague I, Leu CS, Andrews H. Protocol for a family-centered behavioral intervention to reduce early childhood caries: the MySmileBuddy program efficacy trial. BMC Oral Health 2021; 21:246. [PMID: 33962602 PMCID: PMC8103669 DOI: 10.1186/s12903-021-01582-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although largely preventable through diet management and topical fluoride use, early childhood caries (ECC) often progresses to severity that necessitates surgical repair. Yet repair often fails to mitigate caries progression. Needed is an effective behavioral intervention to address underlying behavioral causes. METHODS This randomized controlled trial will evaluate the efficacy of a behaviorally focused, family-centered intervention, the MySmileBuddy Program (MSB Program), to reduce ECC progression in high-risk preschoolers in New York City. Recruitment will target 858 children ages 24-71 months with ECC and their parents from primary care medical and dental clinics. The study aims to assess the MSB Program's efficacy to: (1) decrease ECC progression measured 12-months post-randomization; and (2) enhance adoption of a low cariogenic diet and twice-daily fluoridated toothpaste use compared to control group. Potential causal pathways (mediators and moderators) will be explored. The MSB Program equips community health workers (CHWs) with an app that facilitates multilevel risk assessment and provides motivational interviewing-based counseling to inform parents about the caries process, develop personalized goals, and create family-level action plans to achieve targeted behaviors. Social support from CHWs (4 interactions during the 6-month intervention, supplemented by up to 4 in-person/remote contacts throughout the 12-month study period, based on need) is bolstered by automated text messages. Participants will be randomized to a Control Group (paper-based educational handout plus toothbrushes and fluoridated toothpaste for the child) or Intervention Group (MSB Program, two tooth-brushing observations with feedback and instruction, and toothbrushes and toothpaste for the entire family). All children will receive visual ICDAS dental examinations and parents will complete study measures at baseline and 12-months. An incentive up to $150 plus round-trip transit cards ($5.50 value) will be provided. DISCUSSION This study hypothesizes that the MSB Program can reduce ECC progression in a high-risk population. Sufficient incentives and a focus on establishing rapport between participants and CHWs are anticipated to mitigate recruitment and retention challenges. If successful, this study will advance the long-term goal of reducing pediatric oral health disparities by demonstrating the efficacy of an acceptable and feasible intervention that shifts attention from dental repair to behavioral risk mitigation. TRIAL REGISTRATION Trial registration was completed on 4/13/2021 through the U.S. National Library of Medicine ClinicalTrials.gov website (Identifier: NCT04845594).
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Affiliation(s)
- Christie L. Lumsden
- Columbia University College of Dental Medicine, Section of Oral, Diagnostic, and Rehabilitation Sciences, 622 West 168th Street, PH7-322, New York, NY 10032 USA
| | - Burton L. Edelstein
- Dental Medicine and Health Policy & Management at Columbia University Irving Medical Center, Columbia University College of Dental Medicine, 622 West 168th Street, PH7-322, New York, NY 10032 USA
| | - Charles E. Basch
- Department of Health and Behavior Studies, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10027 USA
| | - Randi L. Wolf
- Department of Health and Behavior Studies, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10027 USA
| | - Pamela A. Koch
- Department of Health and Behavior Studies, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10027 USA
| | - Ian McKeague
- Mailman School of Public Health, Department of Biostatistics, Columbia University Irving Medical Center, 722 West 168th Street, 6th Fl, Rm 639, New York, NY 10032 USA
| | - Cheng-Shiun Leu
- Mailman School of Public Health, Department of Biostatistics, Columbia University Irving Medical Center, 722 West 168th Street, 6th Fl, Rm 639, New York, NY 10032 USA
| | - Howard Andrews
- Mailman School of Public Health, Columbia University Irving Medical Center, 1051 Riverside Drive, Unit 47, New York, NY 10032 USA
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Featherstone JDB, Crystal YO, Alston P, Chaffee BW, Doméjean S, Rechmann P, Zhan L, Ramos-Gomez F. A Comparison of Four Caries Risk Assessment Methods. FRONTIERS IN ORAL HEALTH 2021; 2:656558. [PMID: 35048004 PMCID: PMC8757708 DOI: 10.3389/froh.2021.656558] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.
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Affiliation(s)
- John D. B. Featherstone
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Yasmi O. Crystal
- Pediatric Dentistry Department, College of Dentistry, New York University, New York, NY, United States
- Comprehensive Pediatric Dentistry, Bound Brook, NJ, United States
| | - Pamela Alston
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin W. Chaffee
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Sophie Doméjean
- Department of Operative Dentistry and Endodontics, UFR d'Odontologie de Clermont-Ferrand, Clermont-Ferrand, France
- EA 4847, Clermont-Ferrand, France
- Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Ling Zhan
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Francisco Ramos-Gomez
- Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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Christian B, Armstrong R, Calache H, Carpenter L, Gibbs L, Gussy M. A systematic review to assess the methodological quality of studies on measurement properties for caries risk assessment tools for young children. Int J Paediatr Dent 2018; 29:106-116. [PMID: 30412330 DOI: 10.1111/ipd.12446] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/05/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND At present, there are numerous caries risk assessment tools (CRATs) being promoted for disease management. However, the evidence to inform CRAT selection is unclear. AIM This review aimed to assess the strength of evidence to inform the selection of CRATs for children ages 6 years and less. DESIGN MEDLINE was the principal search database for this review. Other key databases, the reference lists of included articles, known cariology literature and experts were also consulted. Peer-reviewed papers describing CRATs and their development methodology were included. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist guided the quality assessment. The reporting of the key measurement properties (reliability, validity and responsiveness) informed the quality assessment. RESULTS The search resulted in ten papers, reporting on eight different CRATs. The identified CRATs were: Caries Management By Risk Assessment (CAMBRA), Cariogram, National University of Singapore CRAT (NUS-CRAT), MySmileBuddy, Dundee Caries Risk Assessment Model, University of North Carolina Risk Assessment Models, University of Michigan pediatric dental clinic caries risk assessment sheet and American Academy of Pediatric Dentistry (AAPD) CRAT. Common across all CRATs was the lack of information to determine the levels of evidence for the measurement properties of reliability and construct validity. Studies on tools that were assessed as having strong evidence for content validity, identified the relevant risk factors for caries in the population being studied, before developing and testing their respective CRATs. CONCLUSIONS The evidence to inform the selection of current CRATs for children is mostly yet to be established. Overall, the NUS-CRAT studies reported the most information to inform the assessment of its measurement properties and as a result this tool attained a higher quality rating than other CRATs studied. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bradley Christian
- Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Australia
| | - Rebecca Armstrong
- Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Hanny Calache
- Deakin Health Economics, Centre for Population Health Research, Deakin University
| | - Lauren Carpenter
- Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Mark Gussy
- Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Australia
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Doméjean S, Banerjee A, Featherstone JDB. Caries risk/susceptibility assessment: its value in minimum intervention oral healthcare. Br Dent J 2018; 223:191-197. [PMID: 28798458 DOI: 10.1038/sj.bdj.2017.665] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2017] [Indexed: 11/09/2022]
Abstract
This narrative review describes the intimate connection between minimum intervention (MI) oral healthcare and caries risk/susceptibility assessment (CRA). Indeed CRA is the corner stone of an MI care plan, allowing the determination of the appropriate interventions (non-invasive as well as invasive [restorative]) and recall consultation strategies. Various CRA protocols/models have been developed to assist the oral healthcare practitioner/team in a logical systematic approach to synthesising information about a disease that has a multifactorial aetiology. Despite the criticisms toward the lack of clear-cut validation of the proposed protocols/models, CRA still has great potential to enhance patient care by allowing the oral healthcare practitioner/team and the patient to understand the specific reasons for their caries activity and to tailor their care plans and recall intervals accordingly.
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Affiliation(s)
- S Doméjean
- Université Clermont Auvergne, UFR d'Odontologie, CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - A Banerjee
- Chair/Head of Department, Conservative &MI Dentistry, King's College London Dental Institute at Guy's Hospital, King's Health Partners, London, UK
| | - J D B Featherstone
- School of Dentistry, University of California San Francisco, San Francisco, USA
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Karasz A, Bonuck K. Reducing pediatric caries and obesity risk in South Asian immigrants: randomized controlled trial of common health/risk factor approach. BMC Public Health 2018; 18:680. [PMID: 29855352 PMCID: PMC5984363 DOI: 10.1186/s12889-018-5317-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/14/2018] [Indexed: 11/28/2022] Open
Abstract
Background This paper describes the design and methods of a multi-phase study to reduce early childhood caries and obesity in vulnerable South Asian (SA) immigrants in the United States. Early childhood caries and obesity are the most common diseases of early childhood. Risk factors for both diseases are rooted in early childhood feeding practices such as bottle feeding and intake of sweets and sweetened beverages. The Common Health/Risk Factor Approach to addressing oral health is widely promoted by the WHO and other policy makers. This approach recognizes links between oral health and other diseases of modernity. Our CHALO! (“Child Health Action to Lower Obesity and Oral health risk”--from a Hindi word meaning "Let's go!") study targets SA families at high risk for early childhood caries and obesity. CHALO! addresses common risk factors associated with these two common diseases of childhood. Methods This two part project includes a randomized controlled trial, and a Knowledge Translation campaign. A randomized controlled trial will enroll n = 360 families from pediatric practices serving South Asians in the New York metro area. The intervention group will receive home visits by SA community health workers at 6, 8, 10, 12, 14, and 16 months of age. Controls will receive culturally tailored educational material. Primary outcomes-- cariogenic and obesogenic feeding practices at 6, 12, and 18 months-- will be assessed with the MySmileBuddy iPad based tool. Secondary outcomes include: oral hygiene practices, anthropometrics, and caries incidence at 18 months. A public education campaign will focus on both families and health care providers. Discussion There are few Common Health/Risk Factor Approach published studies on obesity and oral health risk in children, despite health morbidity and costs associated with both conditions. CHALO! comprises a multi-level interventions designed to promote culturally competent, sustainable change. Trial registration ClinicalTrials.govNCT03077425. Electronic supplementary material The online version of this article (10.1186/s12889-018-5317-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alison Karasz
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, 10461, USA.
| | - Karen Bonuck
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, 10461, USA
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Edelstein BL. Pediatric Dental-Focused Interprofessional Interventions: Rethinking Early Childhood Oral Health Management. Dent Clin North Am 2017; 61:589-606. [PMID: 28577639 PMCID: PMC5512453 DOI: 10.1016/j.cden.2017.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Evidence of effectiveness for prevention of early childhood caries suggests that parent engagement needs to occur perinatally and that unconventional providers, helping professionals like social workers and dietitians and lay health workers like community health workers, are most effective. This finding, coupled with the emergence of population-based accountable care, value-based purchasing with global payments, understanding of common risk factors for multiple conditions, and social determinants of health behaviors, calls for a rethinking of early childhood oral health care. A population-based model that incorporates unconventional providers is suggested together with research needed to achieve caries reductions in at-risk families.
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Affiliation(s)
- Burton L Edelstein
- The Columbia University Medical Center, College of Dental Medicine, Section of Population Oral Health, 622 West 168th Street, PH7, Box 20, New York, NY 10032, USA; Children's Dental Health Project, Washington, DC 20036, USA.
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Furberg RD, Ortiz AM, Zulkiewicz BA, Hudson JP, Taylor OM, Lewis MA. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol. JMIR Res Protoc 2016; 5:e136. [PMID: 27350013 PMCID: PMC4940603 DOI: 10.2196/resprot.5400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/26/2016] [Accepted: 03/31/2016] [Indexed: 11/13/2022] Open
Abstract
Background Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Objective Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. Methods The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care–related infections were reviewed to develop the infection control protocol to support tablet maintenance. Results This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. Conclusions These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings.
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Custodio-Lumsden CL, Wolf RL, Contento IR, Basch CE, Zybert PA, Koch PA, Edelstein BL. Validation of an early childhood caries risk assessment tool in a low-income Hispanic population. J Public Health Dent 2015; 76:136-42. [PMID: 26440728 DOI: 10.1111/jphd.12122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 08/28/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There is a recognized need for valid risk assessment tools for use by both dental and nondental personnel to identify young children at risk for, or with, precavitated stages of early childhood caries (i.e., early stage decalcifications or white spot lesions).The aim of this study is to establish concurrent criterion validity of "MySmileBuddy" (MSB), a novel technology-assisted ECC risk assessment and behavioral intervention tool against four measures of ECC activity: semi-quantitative assays of salivary mutans streptococci levels, visible quantity of dental plaque, visual evidence of enamel decalcifications, and cavitation status (none, ECC, severe ECC). METHODS One hundred eight children 2-6 years of age presenting to a pediatric dental clinic were recruited from a predominantly Spanish-speaking, low-income, urban population. All children received a comprehensive oral examination and saliva culture for assessment of ECC indicators. Their caregivers completed the iPad-based MSB assessment in its entirety (15-20 minutes). MSB calculated both diet and comprehensive ECC risk scores. Associations between all variables were determined using ordinal logistic regression. RESULTS MSB diet risk scores were significantly positively associated with salivary mutans (P < 0.05), and approached significance with visible plaque levels (P < 0.1). MSB comprehensive risk scores were significantly associated with both oral mutans and visible plaque (P < 0.05). Neither was associated with visually evident decalcifications or cavitations. CONCLUSIONS Findings suggest that MSB may have clinical utility as a valid risk assessment tool for identifying children with early precursors of cavitations but does not add value in identifying children with extant lesions.
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Affiliation(s)
| | - Randi L Wolf
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Isobel R Contento
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Charles E Basch
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Patricia A Zybert
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Pamela A Koch
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Burton L Edelstein
- Section of Population Oral Health, Columbia University College of Dental Medicine, New York, NY, USA
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Marcano Belisario JS, Jamsek J, Huckvale K, O'Donoghue J, Morrison CP, Car J. Comparison of self-administered survey questionnaire responses collected using mobile apps versus other methods. Cochrane Database Syst Rev 2015; 2015:MR000042. [PMID: 26212714 PMCID: PMC8152947 DOI: 10.1002/14651858.mr000042.pub2] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Self-administered survey questionnaires are an important data collection tool in clinical practice, public health research and epidemiology. They are ideal for achieving a wide geographic coverage of the target population, dealing with sensitive topics and are less resource-intensive than other data collection methods. These survey questionnaires can be delivered electronically, which can maximise the scalability and speed of data collection while reducing cost. In recent years, the use of apps running on consumer smart devices (i.e., smartphones and tablets) for this purpose has received considerable attention. However, variation in the mode of delivering a survey questionnaire could affect the quality of the responses collected. OBJECTIVES To assess the impact that smartphone and tablet apps as a delivery mode have on the quality of survey questionnaire responses compared to any other alternative delivery mode: paper, laptop computer, tablet computer (manufactured before 2007), short message service (SMS) and plastic objects. SEARCH METHODS We searched MEDLINE, EMBASE, PsycINFO, IEEEXplore, Web of Science, CABI: CAB Abstracts, Current Contents Connect, ACM Digital, ERIC, Sociological Abstracts, Health Management Information Consortium, the Campbell Library and CENTRAL. We also searched registers of current and ongoing clinical trials such as ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform. We also searched the grey literature in OpenGrey, Mobile Active and ProQuest Dissertation & Theses. Lastly, we searched Google Scholar and the reference lists of included studies and relevant systematic reviews. We performed all searches up to 12 and 13 April 2015. SELECTION CRITERIA We included parallel randomised controlled trials (RCTs), crossover trials and paired repeated measures studies that compared the electronic delivery of self-administered survey questionnaires via a smartphone or tablet app with any other delivery mode. We included data obtained from participants completing health-related self-administered survey questionnaire, both validated and non-validated. We also included data offered by both healthy volunteers and by those with any clinical diagnosis. We included studies that reported any of the following outcomes: data equivalence; data accuracy; data completeness; response rates; differences in the time taken to complete a survey questionnaire; differences in respondent's adherence to the original sampling protocol; and acceptability to respondents of the delivery mode. We included studies that were published in 2007 or after, as devices that became available during this time are compatible with the mobile operating system (OS) framework that focuses on apps. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from the included studies using a standardised form created for this systematic review in REDCap. They then compared their forms to reach consensus. Through an initial systematic mapping on the included studies, we identified two settings in which survey completion took place: controlled and uncontrolled. These settings differed in terms of (i) the location where surveys were completed, (ii) the frequency and intensity of sampling protocols, and (iii) the level of control over potential confounders (e.g., type of technology, level of help offered to respondents). We conducted a narrative synthesis of the evidence because a meta-analysis was not appropriate due to high levels of clinical and methodological diversity. We reported our findings for each outcome according to the setting in which the studies were conducted. MAIN RESULTS We included 14 studies (15 records) with a total of 2275 participants; although we included only 2272 participants in the final analyses as there were missing data for three participants from one included study.Regarding data equivalence, in both controlled and uncontrolled settings, the included studies found no significant differences in the mean overall scores between apps and other delivery modes, and that all correlation coefficients exceeded the recommended thresholds for data equivalence. Concerning the time taken to complete a survey questionnaire in a controlled setting, one study found that an app was faster than paper, whereas the other study did not find a significant difference between the two delivery modes. In an uncontrolled setting, one study found that an app was faster than SMS. Data completeness and adherence to sampling protocols were only reported in uncontrolled settings. Regarding the former, an app was found to result in more complete records than paper, and in significantly more data entries than an SMS-based survey questionnaire. Regarding adherence to the sampling protocol, apps may be better than paper but no different from SMS. We identified multiple definitions of acceptability to respondents, with inconclusive results: preference; ease of use; willingness to use a delivery mode; satisfaction; effectiveness of the system informativeness; perceived time taken to complete the survey questionnaire; perceived benefit of a delivery mode; perceived usefulness of a delivery mode; perceived ability to complete a survey questionnaire; maximum length of time that participants would be willing to use a delivery mode; and reactivity to the delivery mode and its successful integration into respondents' daily routine. Finally, regardless of the study setting, none of the included studies reported data accuracy or response rates. AUTHORS' CONCLUSIONS Our results, based on a narrative synthesis of the evidence, suggest that apps might not affect data equivalence as long as the intended clinical application of the survey questionnaire, its intended frequency of administration and the setting in which it was validated remain unchanged. There were no data on data accuracy or response rates, and findings on the time taken to complete a self-administered survey questionnaire were contradictory. Furthermore, although apps might improve data completeness, there is not enough evidence to assess their impact on adherence to sampling protocols. None of the included studies assessed how elements of user interaction design, survey questionnaire design and intervention design might influence mode effects. Those conducting research in public health and epidemiology should not assume that mode effects relevant to other delivery modes apply to apps running on consumer smart devices. Those conducting methodological research might wish to explore the issues highlighted by this systematic review.
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Affiliation(s)
- José S Marcano Belisario
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthLondonUK
| | - Jan Jamsek
- University of LjubljanaFaculty of MedicineVrazov trg 2LjubljanaSlovenia1000
| | - Kit Huckvale
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthLondonUK
| | - John O'Donoghue
- School of Public Health, Imperial College LondonDepartment of Primary Care and Public HealthRoom 326, The Reynolds BuildingSt Dunstans RoadLondonUKW6 8RP
| | - Cecily P Morrison
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthLondonUK
| | - Josip Car
- Imperial College & Nanyang Technological UniversityLee Kong Chian School of Medicine3 Fusionopolis Link, #03‐08Nexus@one‐northSingaporeSingapore138543
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Skinner J, Byun R, Blinkhorn A, Johnson G. Sugary drink consumption and dental caries in New South Wales teenagers. Aust Dent J 2015; 60:169-75. [DOI: 10.1111/adj.12310] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J Skinner
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales
| | - R Byun
- Centre for Research; Evidence Management and Surveillance; Sydney and South Western Sydney Local Health Districts; New South Wales
| | - A Blinkhorn
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales
| | - G Johnson
- Population Oral Health Unit; Faculty of Dentistry; The University of Sydney; New South Wales
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Chinn CH, Levine J, Matos S, Findley S, Edelstein BL. An interprofessional collaborative approach in the development of a caries risk assessment mobile tablet application: My Smile Buddy. J Health Care Poor Underserved 2013; 24:1010-20. [PMID: 23974376 PMCID: PMC4523798 DOI: 10.1353/hpu.2013.0114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Given the rising trend in early childhood caries (ECC) and the wide disparities that exist in pediatric oral health, risk assessment for ECC has become increasingly important. The purpose of this paper is to describe lessons learned from an Interprofessional Collaboration (IPC) approach in the planning, development, and pilot testing of an electronic interactive ECC risk assessment application--My Smile Buddy (MSB). METHODS Five focus groups were conducted during the assessment and development phases of MSB. Community Health Workers (CHW) then facilitated MSB with 35 mothers from the local community. RESULTS MSB was well accepted by mothers and scored well in usability and usefulness by CHWs. Lessons learned during MSB development included recognizing CHW understanding of local community attitudes regarding oral health and access to dental care and that power-sharing is required in order to create an intervention that is both engaging and accepted by the community.
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Affiliation(s)
- Courtney H. Chinn
- Assistant Professor at Columbia University College of Dental Medicine (CU-CDM)
| | - June Levine
- registered dietician and serves as a project manager at CU-CDM
| | - Sergio Matos
- Director for CHW Development at Columbia University Mailman School of Public Health (CU-MSPH) and Executive Director at Community Health Worker Network of New York City
| | - Sally Findley
- Professor in Population and Family Health at CU-MSPH
| | - Burton L. Edelstein
- Professor and Chair of the Section of Social and Behavioral Sciences at CU-CDM
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Henderson VA, Barr KL, An LC, Guajardo C, Newhouse W, Mase R, Heisler M. Community-based participatory research and user-centered design in a diabetes medication information and decision tool. Prog Community Health Partnersh 2013; 7:171-84. [PMID: 23793248 PMCID: PMC4117400 DOI: 10.1353/cpr.2013.0024] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Together, community-based participatory research (CBPR), user-centered design (UCD), and health information technology (HIT) offer promising approaches to improve health disparities in low-resource settings. OBJECTIVES This article describes the application of CBPR and UCD principles to the development of iDecide/Decido, an interactive, tailored, web-based diabetes medication education and decision support tool delivered by community health workers (CHWs) to African American and Latino participants with diabetes in Southwest and Eastside Detroit. The decision aid is offered in English or Spanish and is delivered on an iPad in participants' homes. METHODS The overlapping principles of CBPR and UCD used to develop iDecide/Decido include a user-focused or community approach, equitable academic and community partnership in all study phases, an iterative development process that relies on input from all stakeholders, and a program experience that is specified, adapted, and implemented with the target community. RESULTS Collaboration between community members, researchers, and developers is especially evident in the program's design concept, animations, pictographs, issue cards, goal setting, tailoring, and additional CHW tools. CONCLUSIONS The principles of CBPR and UCD can be successfully applied in developing health information tools that are easy to use and understand, interactive, and target health disparities.
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Evans EW, Hayes C, Palmer CA, Bermudez OI, Naumova EN, Cohen SA, Must A. Development of a pediatric cariogenicity index. J Public Health Dent 2013; 73:179-86. [PMID: 23488811 PMCID: PMC9773634 DOI: 10.1111/jphd.12009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 12/21/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study was designed to develop food and liquid cariogenicity indices and to preliminarily test their utility using dietary data from a study of children with and without severe early childhood caries (S-ECC), defined as 3 + smooth surface carious lesions, including at least one pulpally involved tooth. METHODS Data were collected in a diverse cohort of low-income preschool-aged children made up of 454 children with S-ECC and 429 caries-free children who presented for care at pediatric dental clinics in Washington, DC, Columbus, OH, and Cincinnati, OH. The cariogenicity indices were used to score dietary data from a Food Frequency Questionnaire (FFQ) and a 24-hour recall (24HR). RESULTS There were no statistically significant differences in mean food cariogenicity scores between groups. The liquid cariogenicity score was higher in the S-ECC group as compared with caries-free children (24HR: 5.28 versus 4.66, respectively, P < 0.001; FFQ: 5.03 versus 4.38, P < 0.001). The food cariogenicity score did not discriminate between those with and without S-ECC, while the liquid cariogenicity score did differentiate between the two groups (24HR: OR: 1.2; 95 percent CI: 1.1, 1.3; FFQ: 1.7; 95 percent CI 1.4, 2.0). The liquid cariogenicity score was also associated with number of carious lesions. CONCLUSIONS The liquid cariogenicity index has potential in research and clinical settings to provide a liquid cariogenicity score and help quickly identify modifiable risk factors within a child's diet. Further research is needed to test its utility in clinical and public health settings.
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Affiliation(s)
- E. Whitney Evans
- Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA 02111
| | - Catherine Hayes
- Health Resources in Action 95 Berkeley Street, Boston, MA 02116
| | - Carole A. Palmer
- Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA 02111,Tufts University School of Dental Medicine, 1 Kneeland Street Boston, MA 02111
| | | | - Elena N. Naumova
- Tufts University School of Engineering, 200 College Avenue, Anderson Hall, Tufts University, Medford, MA 02155
| | - Steven A. Cohen
- Virginia Commonwealth University School of Medicine 830 E. Main St Richmond, VA 23298
| | - Aviva Must
- Tufts University School of Medicine, 136 Harrison Ave, Boston, MA 02111
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