Center for Health Equity

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CATCH Healthy Smiles.

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Project Overview

CATCH Healthy Smiles is a school-based oral health intervention grounded in theory and evidence, designed to equip students, parents, and school communities with the knowledge and skills to prevent dental caries. Currently, UTHealth Houston School of Public Health, in partnership with Harris County Public Health and CATCH Global Foundation, is conducting a National Institutes of Health-funded cluster randomized controlled trial across 34 elementary schools in Greater Houston, primarily serving under-resourced families, to evaluate the program's effectiveness.

Project Details

The CATCH Healthy Smiles program provides a comprehensive approach to oral health education and skill-building for kindergarten through 2nd-grade students.

Its curriculum includes five engaging 25-minute classroom sessions per grade, PowerPoint presentations, vocabulary word walls, and over 40 TEKS-aligned extension activities to deepen understanding. Additional resources like PE and extension supplemental activities, videos, visual materials, and printable posters enhance learning. A key feature is the classroom toothbrushing routine, supported by toothbrushes, toothpaste, storage solutions, and a Teacher Success Toolkit to ensure effective implementation. Teachers receive training, a coordination guide for school-wide engagement, and ongoing technical support to streamline program delivery.

Beyond the classroom, the program emphasizes community engagement with parent outreach materials, including bilingual fact sheets, goal-setting activities, videos, and social media resources to reinforce oral health at home. School-wide initiatives, such as morning announcements, Family Fun Night guides, and cafeteria labeling for tooth-friendly foods, extend its impact. The program also fosters collaboration among educators through a CATCH Healthy Smiles Teacher Facebook Group and surveys to guide continuous improvement, creating a well-rounded oral health promotion effort that engages students, families, and school staff.

The Study: CATCH Healthy Smiles cluster randomized control trial

This is a school-based cluster-randomized controlled trial to determine the efficacy of CATCH Healthy Smiles behavioral intervention in reducing incidence of dental caries among children starting in kindergarten and following through 2nd grade enrolled across 34 schools serving low-income, ethnically diverse children in Houston, Texas.

The school-based, teacher-led intervention comprises four main components: classroom curriculum, tooth-brushing routine, parent outreach, and changes to the school environment. Students will receive intervention components starting in kindergarten, and the same group of students will be followed through 1st, and 2nd grade. Children will be measured for caries incidence and parents for changes in psychosocial constructs at four-time points, baseline (kindergarten at the start of the spring semester of the kindergarten school year before starting the intervention), in the fall semester of the 1st grade school year, end of 1st grade school year, and end of 2nd-grade school

Primary Aim:

To determine the efficacy of CATCH Healthy Smiles in reducing incidence of dental caries among children in intervention schools compared to children in the control schools. The primary outcome of the trial is incidence of dental caries in primary teeth as measured at the tooth surface level (dfs).

Secondary Aims:

To determine the impact of CATCH Healthy Smiles Similar on incidence of dental caries at the tooth level for primary teeth (dft) and for permanent teeth (DFT and DFS).

To determine the impact of CATCH Healthy Smiles on child behavioral, psychosocial, and environmental outcomes beginning in K through 2nd grade, compared to children in the control schools. These secondary outcomes include: (a) toothbrushing frequency; (b) dietary intake, including increased intake of fruits and vegetables, and decreased intake of sugary cariogenic foods; (c) oral health-related quality of life; and (d) school and home nutrition environment.