CH3: Assessment for Community Oral Health Program Planning

Objectives

Public health practice

Professional work in community health is dynamic due to constantly changing environment:

• social

• demographic

• political

• economic

• technology

Mission-prevent disease, provide environment where peeps can live and function healthily

Myriad of many public health professionals

Assessment in relation to epidemiology

Professional Prep of the Public Health Workforce

Comprehensive

Several health disciplines

Collaborative

Measures + improves competency and consistency nationwide

Certified in Public Health

National Commission for Health Education Credentialing

Public Health Prep of the Oral Health Workforce

American Dental Education Association (ADEA)

• developed competencies standards

Commission on Dental Accreditation (CODA)

• developed accreditation standards

• emphasize community in terms of advocacy

• Dental therapists

• Have to be able to assess needs of the community, plan + implement oral health program, evaluate effectiveness

Both:

• emphasize dental public health in the education or oral health nationwide

• greater emphasize on community oral health

Collab in public health practice

public, nonprofit, private partners across many levels of gov, disciplines

Partnership

• broad representation of constituency and stakeholders

• private, voluntary, nonprofit, public agencies or organizations (public health, mental health, substance abuse, environmental health protection, oral and overall health)

Coalition

• alliance of multiple groups, organizations, peeps whose combined actions are aimed at meeting specific, common goals

• may disband

• power=mobilization of resources, identify and implement solutions

Assessment: CORE PUBLIC HEALTH FUNCTION

Public health agencies promote, facilitate, perform community health assessments, monitor changes, evaluate program performances

Systematic collection, analysis of data

Includes stats of health status, trends, community health needs, epidemiologic and other studies, determinants of health, etc

Surveillance-continual assessment of needs

Roles of public health professionals in assessment

effective use of info

• tech influence capacity and ability to generate and access

Evidence based decision making shapes policies, programs, practices

Skills in collecting, analyzing, disseminating, effectively using data and info

Other functions

DH play leadership role in community oral health assessments

• national, state, local levels

• skills to asses problems, evaluate outcomes of population based and personal oral health services in public, private, nonprofit sectors

Epidemiology

Population based study of health

Study of distribution and determinants of health related states and events in specific populations and application of this study to the prevention and control of health problems

Make comparisons

Assess distribution and determinants of health events

Principle factors Analyzed:

• distribution

• population dynamics

• occurrences

• affected populations

• place characteristics

• time

• determinants

Most oral diseases (caries) are endemic

Epidemiologic triangle

multifactorial approach

• host-sus and resistance via immunity, knowledge, cognitions, behavior mod, screening, personal power, age, gender, SES, ethnicity, culture, genetics, conditions, nutrition, previous exposure

• environmental-physical, sociocultural, sociopolitical, economic, media, beliefs, job, food sources, geography, climate, housing, social roles, tech

• agent-biologic or mechanical means, virus, bacteria, parasite, vectors, chemicals, drugs, trauma, radiation

• time-damage, symptoms, death, recovery, threshold

health problems occur when there’s an imbalance due to changes over time

Prevention-maintain or initiate balance

Depicts disease as the outcome of these multiple factors

Use of epidemiology

provide different types of data and information

surveillance, investigation, analysis, evaluation

Changing perspectives of health

Risk factors

Other factors-language, learning, recreation, self esteem, personal control

Ecological approach-health more than absence of fisease

Health promotion

Determinants of health

contribute to health status of peeps and populations

healthy can be determined largely by circumstances and environment, context of peep’s lives

unlikely to control

interact and influence each other

Social

• shapes by distribution of money, power, resources and policy choices

• affect health risks, outcomes

• primarily responsible for health inequities (differences in health status)

Determinants of health in relation to oral health

Efforts

• cultural competence, health literacy, frameworks

• collabs

• holistic approach

Community health program planning process

model

• assess community to identify issues

• plan process

• interventions

• implement

• evaluate

• continuous, flexible

Assessment of Oral Health In Communities

1st step Community Oral Health Assessment

• aims, goals

• available resources

• expertise in community

• multifaceted, community oriented and directed

• considers gaps, needs, problems, resources, solutions, partnerships

Asset-oriented

Deficiency based-focus on problems without looking at assets

Questions

Phases of community needs assessment process

Phase 1: Cultivate Partnerships and Select Advisory Committee

1) public, private, nonprofit

agencies, organizations, business, peeps combine resources

mobilization key

build support, financial

empowerment

2)