Department of Dental Hygiene, The Graduate School of Namseoul University1
Department of Dental Hygiene, Namseoul University2
Objectives: This study aimed to develop the CAMBRA-kids application for the systematic management of dental caries among preschoolers, activate the dental caries management system, and contribute to the dental caries management of preschoolers. Methods: The collected data were analyzed using R studio 1.2.1335 for Windows (RStudio Inc., Boston, MA, USA, 2018). Algorithm evaluation, heuristic evaluation and usability evaluation were analyzed using descriptive statistics. Results: Both expert evaluations of the application’s algorithms were calculated as 100%, for proficiency and efficiency. The application worked well with the designed algorithms, the risk group level of participants was categorized appropriately, and the risk management method was guided properly according to the risk group level. Of the five problems presented in the heuristic evaluation, 'the lack of security' and 'the lack of information on oral health care' received 'high severity' scores. The usability evaluation of the application produces an overall score of 3.27. In the subscales (participation, functionality, aesthetics, and information) of the Mobile App Rating Scale (MARS), the 'participation' domain received the lowest score of 2.56 and the 'functional' domain received the highest score of 3.70. Conclusions: The CAMBRA-kids application is expected to be applied and used in the field of preschoolers’ oral health care management, and to contribute to the prevention of dental caries of preschoolers by activating the dental caries management system using the application.
1. Cho YS, Park DY, Choi YH, Lee BJ, Son CK. Korean children’s oral health survey(2015). Sejong: Ministry of health and welfare; 2016: 162.
2. Fleming E, Afful J. Prevalence of total and untreated dental caries among youth: united states(2015–2016). NCHS Data Brief 2018;307:1-6.
3. Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis–a comprehensive review. J Clin Periodontol 2017;44(18):94-105. https://doi.org/10.1111/jcpe.12677
4. Murray JJ, Vernazza CR, Holmes RD. Forty years of national surveys-an overview of children's dental health from 1973-2013. Br Dent J 2015;219(6):281-5.
5. Cho YS. Clinical preventive dental and dental hygiene practice by caries management by risk assessment (CAMBRA). J Dent Hyg Sci 2012;12(6):545-57.
6. Kim BI. Korean caries management by risk assessment(K-CAMBRA). Korean Dent Assoc 2014;52(8):456-63.
7. Ramos-Gomez FJ, Kim YJ, Ng MW, Stephanie Y. New visions in pediatric dentistry keeping healthy teeth caries free-pediatric CAMBRA protocol. J Korean Acad Pediatr Dent 2013;40(1):73-80.
8. Ramos-Gomez FJ, Crall J, Gansky SA, Slayton RL, Featherstone JD. Caries risk assessment appropriate for the age 1 visit(infants and toddlers). J Calif Dent Assoc 2007;35(10):687-702.
9. Ramos-Gomez FJ, Crystal YO, Ng MW, Crall JJ, Featherstone JD. Pediatric dental care: prevention and management protocols based on caries risk assessment. J Calif Dent Assoc 2010;38(11):746-61.
10. Lee JC. Caries management by risk assessment CAMBRA. J Korean Dent Assoc 2011;49(1):16-21.
11. Koo SY, Lee SY. Caries management of high-risk children by caries risk assessment. J Dent Hyg Sci 2018;18(2):97-104.
12. Lee SN, Lim SR. In-depth interview of parents experienced first infant oral examination. J Dent Hyg Sci 2017;17(6):543-51.
13. Woo GJ, Kim EK, Kim KT, Song KB, Choi YH. Development of a smart oral examination system for tablet personal computers. J Korean Acad Oral Health 2013;37(2):89-94.
14. Jeong SJ, Lim K, Ko YJ, Sim HA, Kim KY. The analysis of trends in smart phone applications for education and suggestions for improved educational use. J Digit Cont Soc 2010;11(2):203-16.
15. Kim GH, Lee KH. Perception of smartphone applications for oral health care education in infants and toddlers. J Korean Soc Dent Hyg 2018;18(6):987-1001.
16. Jeon EJ. Development and effectiveness evaluation of diabetes self-management mobile application based on imb model[Doctoral dissertation]. Seoul:Univ. of Seoul National, 2017.
17. Byun AJ. Development and evaluation of smartphone app “healthy kids” for children’s weight control with their parents[Master's thesis]. Seoul:Univ. of Seoul National, 2018.
18. U.S. Food and Drug Administration. Medical devices[Internet]. U.S. Food and Drug Administration;2014.[cited 2019 Mar 24]. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/mobile-medical-applications
19. Chang WS, Ji YG. Usability evaluation for smart phone augmented reality application user interface. J Soc e-Business Studies 2011;16(1):35-47. https://doi.org/10.7838/jsebs.2011.16.1.035
20. Nielsen J. Heuristics evaluation. 1st ed. Newyork: John Wiley and Sons; 1994: 25-64.
21. Martins SB, Lai S, Tu S, Shankar R, Hastings SN, Hoffman BB, et al. Offline testing of the athena hypertension decision support system knowledge base to improve the accuracy of recommendations. AMIA Annu Symp Proc 2006;2006(1):539-43.
22. Choi J, Bakken S. Creation of a gold standard for validation of a computer-interpretable depression screening guideline. Stud Health Technol Inform 2006;122(1):95-9.
23. Jeon EJ. Development smartphone application for clinical guideline based obesity management[Master's thesis]. Seoul:Univ. of Seoul National, 2013.
24. Bertini E, Gabrielli S, Kimani S. Appropriating and assessing heuristics for mobile computing. In proceedings of the working conference on advanced visual interfaces. Assoc Comput Mach 2006;1(8):119-26.
25. Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR mhealth uhealth 2015;3(1):27.  Ministry of health Manatū Hauor. Health applications assessment guidance[Internet]. Ministry of health Manatū Hauor;2017.[cited 2019 Jan 30]. Available from: .
26. Ministry of health Manatū Hauor. Health applications assessment guidance[Internet]. Ministry of health Manatū Hauor;2017.[cited 2019 Jan 30]. Available from:https://www.health.govt.nz/our-work/ehealth/digital-health-sector-architecture-standards-and-governance/health-applications-assessment-guidance.
27. Kang TD. A study on service-oriented mobile application development process[Doctoral dissertation]. Jeonju:Univ. of Jeonju, 2012.
28. Kim JS, Kang YM, Lee SY. A needs analysis oral health education contents for teachers and parents using borich priority formula and the locus for focus model. J Dent Hyg Sci 2018;18(4):252-64. https://doi.org/10.17135/jdhs.2018.18.4.252
29. Alqarni AA, Alfaifi HM, Aseeri NA, Gadah T, Togoo RA. Efficacy of a self-designed mobile application to improve child dental health knowledge among parents. J Int Soc Prev Community Dent 2018;8(5):424-30. https://doi.org/10.4103/jispcd.JISPCD_195_18
30. 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(3):1010-20. https://doi.org/10.1353/hpu.2013.0114
31. Reese HY, Dickson KW, Eddie HT, Kevin KW, Patrick Lo. Heuristic usability evaluation of university of hong kong libraries' mobile website. J Acad Librarianship 2016;42(5):581-94. https://doi.org/10.1016/j.acalib.2016.06.004
32. Mohd KO, Muhd NS, Shaziti A. Heuristic evaluation: comparing generic and specific usability heuristics for identification of usability problems in a living museum mobile guide app. Advances in Human Computer Interaction 2018;2018(1518682):13. https://doi.org/10.1155/2018/1518682
33. Park JH, Han SH, Park JH, Park WG, Kim HG, Hong SW. Comparison of usability evaluation methods for mobile application. Ergonomics Soc 2012;14(30):154-7.
34. Zhang H, Gil TS, Kang EJ. A feasibility study of Korean mobile application rating scale(MARS) for evaluating the quality of blood pressure management apps. Korean J Health Educ Promot 2018;35(3):41-51. https://doi.org/10.14367/kjhep.2018.35.3.41
35. Jeon JH. Development and evaluation of smartphone application for self-care performance of patients with chronic hepatitis B[Master’s thesis]. Seoul:Univ. of Jungang, 2015.
36. Kim ML, Kim JE. Usability test of serious game robot app for hospitalized children. J Korea Academia Industrial Cooperation Soc 2019;20(2):228-34. https://doi.org/10.5762/KAIS.2019.20.2.228