WHERE DID THE MYSMILEBUDDY PROGRAM COME FROM?

Starting in 2008, the MySmileBuddy Team brought together experts from a variety of fields to ensure that the Program meets families’ needs.

Areas of expertise on the MySmileBuddy Team have included:

- pediatric dentistry

- pediatric medicine

- health education

- educational technology

- social work

- family- and community-based health interventions ,and

- behavioral nutrition.

MySmileBuddy’s current 6-member Team features experts in pediatric dentistry, behavioral nutrition, public health/health policy, educational technology, and program management.

As of 2023, we secured nearly $10M in grant support to Columbia University to develop, test, pilot, prove effectiveness, and refine the MySmileBuddy Program.

Concept: With financing from a federal CaMPR award (Collaborative and Multidisciplinary Pilot Research Award UL1TR001873) from 2008 to 2009, the MySmileBuddy Team designed the MySmileBuddy Program with guidance from national experts in caries research, dental care, and health behavior along with input from local health activists, healthcare providers, and community health workers. The Team developed a theoretical model that incorporates multiple principles of behavior change, chronic disease management, and motivational interviewing and refined that model for research purposes:

Original conceptual model

Refined research model.

Prototype: With support from the National Center on Minority Health and Health Disparities from 2009-2012 (RC1MD004257), the MySmileBuddy Team developed and refined a prototype of the MySmileBuddy digital platform.

Levine J, Wolf RL, Chinn C, Edelstein BL. MySmileBuddy: An iPad-based interactive program to assess dietary risk for ECC. J Acad Nutr Diet 2012;112(10):1539-42. DOI:10.1016/j.jand.2012.06.010;

First validation: The MySmileBuddy Team tested the prototype in a small scale study to validate its feasibility, acceptability, and utility.

Lumsden C, Wolf R, Contento I, Basch C, Zybert P, Koch P, Edelstein B. Feasibility, Acceptability, and Short-term behavioral impact of the MySmileBuddy intervention for ECC. J Health Care Poor Underserved. 2019;301(1):59-69. DOI: 10.1353/hpu.2019.0007)

Savings analyses – Return on Investment: To determine MySmileBuddy’s potential for both cost savings and improved health, the Team conducted two System Dynamics Models. Both revealed strong return on investment by reducing the need for high-cost dental repair through prevention and disease management.

Hirsch GB, Edelstein BL, Frosh M, Anselmo T. A simulation Model for Designing Effective Interventions in Early Childhood Caries. Prev Chronic Dis 2012;11_0219. DOI: 10.5888/pcd9.110219;
Edelstein BL, Hirsch G, Frosh M, Kumar J. Reducing early childhood caries in a Medicaid population: a systems model analysis. J Am Dent Assoc 2015; 146(4):224-32. DOI:10.1016/j.adaj.2014.12.024.)

Effectiveness: To test the effectiveness of the MySmileBuddy Program under “real-life circumstances,” the Team engaged families of 1207 children under age 6 with cavities. We involved 9 community health workers from 4 community based organizations in a 4 year Medicaid Innovation demonstration sponsored by the federal Center for Medicare and Medicaid Services (C1CMS331347). This study validated the value of CHWs as MySmileBuddy coaches and proved the Program’s effectiveness at improving parental knowledge, beliefs and behaviors as they relate to cries prevention.

Lumsden C, Andrews H, Leu C-S, Edelstein B. Changes in knowledge and beliefs of community health workers following an oral health intervention training program. DOI: 10.1080/10852352.2018.1547309.
Lumsden C, Edelstein B, Leu C-S, Zhang J, Levine J, Andrews H. Behavioral Outcomes of a Pragmatic Early Childhood Caries Management Trial. JDR Clin Trans Res 2023. DOI: 10.1177/23800844231189483.
Lumsden CL, Edelstein BL, Leu C-S, Zhang J, Rubin M, Levine J, Andrews H. Change in Parental Knowledge and Beliefs About ECC following a Pragmatic Community-based Trial. In review by the Journal of Public Health Dentistry.

A 5-minute documentary describes this Medicaid innovation project.

Proof of Concept: Having established MySmileBuddy’s effectiveness, in 2023 we initiated a community-based proof of concept with the Nashua NH Division of Public Health and Community Services with support from Northeast Delta Dental. Through this endeavor we are tracking how community health workers use the MySmileBuddy Program.

Taken together, these studies validate the Program’s underlying cariology and behavioral science and prove that the MySmileBuddy Program is feasible, acceptable, useful, and effective!