WHAT ARE MYSMILEBUDDY’s CONCEPTUAL FOUNDATIONS?
1. Chronic Disease Management (CDM)
The National Academy of Medicine places CDM on a spectrum of care between preventive services and rehabilitative treatments. CDM is designed to reduce disease risks, empower patients to actively engage in their own care, and improve health outcomes. CDM involves “productive interactions” between “informed activated patients” and “prepared proactive practice teams within contexts of health systems and community resources. MySmileBuddy applies these medical CDM concepts to children’s oral health by shifting gears from surgical to medical caries management and from treatment of disease to disease control, management, and suppression.
2. Motivational Interviewing (MI)
MI is a counseling technique that engages providers in empathic listening, non-judgmental communication, respect for patients’ autonomy, evocation of patients’ perspectives, and collaboration with patients to address any given challenge, problem, or health concern. A 2016 effectiveness review of behavioral research in pediatric oral health validates MI’s effectiveness when applied to counseling families of young children on oral health. Through its design and interactive App, the MySmileBuddy Program fulfills these key MI components in ways that engage and empower families to reduce their children’s risk for tooth decay.
3. Behavior-Change Theories
MSB incorporates key elements of the Social Cognitive Theory and the Health Belief Model. The Social Cognitive Theory supports translation of behavioral motivation into action. It recognizes socio-environmental factors in health behavior interventions by noting that individuals and their environments mutually influence each other. The Health Belief Model builds on perceived benefits and barriers to taking action. Based on these theories, MSB incorporates several mediators that extend beyond parental knowledge. These mediators include attitudes and beliefs that may influence parents’ ability to engage in healthful behaviors (e.g., outcome expectations, self-efficacy, perceived seriousness and susceptibility). The MSB Program influences these mediators to enhance participants’ adoption of salutary diet- and hygiene-related oral health behaviors, specifically therapeutic toothbrushing (i.e., adult-assisted toothbrushing with fluoridated toothpaste twice or more each day for at least one minute) and low-cariogenic dietary and feeding practices (i.e., limiting snacks and sugary beverages, minimizing saliva-sharing feeding behaviors).
4. Principles of Educational Technology
​Through the MySmileBuddy App, parents actively engage in learning about tooth decay as a controllable disease process and in creating their own goals and action plans. The MySmileBuddy App’s design is customizable, fluid and flexible. It allows users to tailor their learning and health experience. The App is rich with videos, animations, interactive modules, and downloadable handouts as well as automated text and/or email messages that encourage and support behavior change over time.
5. Bright Futures Guidelines
Bright Futures is a national health promotion and prevention initiative led by the American Academy of Pediatrics. Its theory-based and evidence-driven guidelines on oral health on early intervention, risk assessment, healthy diets and oral hygiene are all built into the MySmileBuddy Program’s design and messaging.
6. Telehealth Practices
Spurred by the COVID-19 pandemic, many dentists turned to telehealth for patient assessment and education and many states relaxed regulations on virtual care. The Oral Health Workforce Research Center at the University at Albany reports that this COVID experience “allowed for providers and patients to understand the utility of these teledentistry modalities for improving capacity to meet the needs of patients.” The MySmileBuddy Program is a prime example of how oral care can be delivered through teledentistry for the convenience of both providers and families.