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Personalized Digital Behavior Change Interventions to Promote Oral Health

Award Number: UH3DE028723
ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2019
PERIOD OF PERFORMANCE END DATE: 03/31/2027

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Personalized Digital Behavior Change Interventions to Promote Oral Health - Although preventable, dental disease is one of the most common chronic diseases in the United States and exacts a substantial personal and societal toll. It is closely linked to low oral health literacy and poor oral hygiene behaviors (OHBs). Using the high prevalence and burden of dental disease as a proxy, there is a large gap between knowledge about quality oral hygiene routines and what is practiced by individuals. The causes are many but ultimately distill down to a systemic failure to communicate oral hygiene instructions (OHIs) effectively or to engage and motivate patients in their own oral self-care. To address the know-do gap, we begin by distilling desired brushing behaviors into a simple 2x2x4 OHI (brushing 2 times a day, for 2 minutes each time, all 4 dental quadrants). We will leverage tracking capabilities of our innovative eBrush platform to remotely monitor tooth-brushing activities in home settings. Using the 2x2x4 OHI and eBrush as foundational elements, we will develop and evaluate the effectiveness of personalized Digital Oral Health Interventions (DOHI) for promoting ideal OHBs in at-risk individuals. In the UG3 phase, we will build out the technologic infrastructure for collecting brushing data and delivering the DOHI. Then, we will engage target end-users in the co-design of an app for oral self-care and establish the usability and feasibility of the system. In the UH3 phase, we will build and validate computational models to infer the quality of OHBs from brushing data and personalize the DOHI. Using a cohort of 130, we will conduct a 10-week Micro-Randomized Trial to optimize the adaptive tailoring of engagement strategies. Finally, we will evaluate effectiveness of the computationally-driven, adaptive DOHI in promoting sustained engagement in the 2x2x4 OHB. We hypothesize that a dynamic and personalized DOHI will be more effective than traditional, static, clinician-delivered OHI in improving oral health and adherence to 2x2x4 OHBs. We will test our hypothesis through a 6-month, pragmatic, randomized, controlled, parallel-group clinical trial. Eligible adults from safety-net dental clinics will be equipped with an electronic toothbrush and the smartphone app for tracking brushing data. After a run-in period (4 weeks) to ensure technical proficiency and establish baseline OHBs, 260 at-risk subjects will receive a clinician-delivered 2x2x4 OHI and randomized to either: (a) an intervention arm where subjects receive ongoing, personalized DOHIs at opportune times; or (b) a control arm where subjects lack such feedback. Subjects will be followed for 20 weeks. Trained dental examiners will conduct assessments at each visit (baseline, randomization and after 20 weeks). Primary outcomes are changes in dental health from baseline (Modified Gingival Index and Plaque Index). Secondary outcome is the quality of adherence to the 2x2x4 OHI. We will explore subject-level features that predict the magnitude of response to the DOHI. Our team science approach presents a potentially paradigm shifting opportunity to leverage the growing ubiquity and reach of digital technologies to activate, educate, and engage patients in optimal oral health self-care in ways and at a scale previously unimaginable.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $751,195 )
2025	2025	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	5	3/27/2025	NON-COMPETING CONTINUATION	$676,076
2025	2025	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	001	5	5/9/2025	NON-COMPETING CONTINUATION	$75,119
														Subtotal = $751,195

Issue Date FY: 2024 ( Subtotal = $780,636 )
2024	2024	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	4	7/1/2024	NON-COMPETING CONTINUATION	$780,636
														Subtotal = $780,636

Issue Date FY: 2023 ( Subtotal = $781,245 )
2023	2023	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	002	3	8/21/2023	NON-COMPETING CONTINUATION	$0
2023	2023	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	001	3	4/5/2023	NON-COMPETING CONTINUATION	$781,245
2023	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	2	1/31/2023	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $781,245

Issue Date FY: 2022 ( Subtotal = $710,574 )
2022	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	000	2	4/15/2022	EXTENSION WITH OR WITHOUT FUNDS	$775,097
2022	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	002	2	4/22/2022	EXTENSION WITH OR WITHOUT FUNDS	-$7,177
2022	2022	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Oral Diseases and Disorders Research	001	2	4/21/2022	EXTENSION WITH OR WITHOUT FUNDS	-$57,346
														Subtotal = $710,574

Grand Total All Awards = $3,023,650

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Personalized Digital Behavior Change Interventions to Promote Oral Health

Award Number: UH3DE028723

ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2019

PERIOD OF PERFORMANCE END DATE: 03/31/2027

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