Early childhood caries (ECC), defined as the occurrence of tooth decay in children less than six years of age, is a chronic, highly prevalent1 and consequential2 disease of US children that is overwhelmingly diet dependent. 3 Although ECC is a multi-factorial disease that is only partially explained by sugar intake,4 the importance of diet has long been well established through laboratory, clinical, and epidemiological studies.5 This knowledge has been translated into dietary recommendations for the prevention or suppression of caries activity in young children, 3 often with only limited success.6
In an effort to reduce ECC prevalence and its consequences in a high-risk, economically-stressed Latino population in Northern Manhattan, New York City, a multidisciplinary team of Columbia University researchers—including experts from behavioral nutrition, pediatric medicine and dentistry, community health, social work, and information technology—has developed MySmileBuddy (MSB), a prototype web-based application for the iPad (Apple, Inc, Cupertino, CA) that facilitates community health workers’ (CHW) engagement of parents in dental caries prevention with funding support from the National Institute on Minority Health and Health Disparities (1RC1MD004257-01). The prototype was designed for the iPad but can be used by CHWs with parents on any laptop, desktop, tablet, or smart phone because this program operates in common web browsers. Central to its utility is its diet recall function (Figure 1), a subprogram designed to engage families in a modified 24 hour recall that contributes to a risk score for individual children. This paper describes the challenges confronted and approaches adopted in designing this diet recall function for initial dietary screening by non-professional peer counselors.