DH225 Exam #2 Ch. 11-13

encompasses attitudes, values, beliefs, and history

culture

a population with shared physical characteristics

race

social groups with a shared history, sense of identity, geography, and cultural roots

ethnicity

influences health beliefs, communication, treatment acceptance, and oral health habits

culture

Lev Vygotsky’s theory suggested that an individual’s social interaction as a child leads to continuous changes in thought and behavior that can vary greatly from culture to culture

sociocultural theory

 adapting to another culture

acculturation

fully adopting another culture

assimilation

awareness of and respect for cultural differences

cultural sensitivity

oversimplified assumptions about a group

stereotyping

assuming no cultural differences exist because a patient appears similar to the provider

cultural blind spot syndrome

belief that one's culture is superior

ethnocentrism

ability to communicate effectively with populations of varying language and healthy literacy levels

linguistic competence

sociocultural theory - watching and copying

imitative learning

sociocultural theory - gets instructions and uses them independently

instructed learning

sociocultural theory - work together to understand and perform a task

collaborative learning

a group of people with a culture that differentiates them from the larger culture to which they belong.

subculture

influences how patients perceive health, seek care, and respond to treatment recommendations

culture

shared physical characteristics

race

shared cultural identity/history

ethnicity

includes culture, traditions, history, and language

ethnicity

improves trust, communication, and treatment acceptance

cultural sensitivity

includes verbal communication, eye contact, gestures, tone, personal space

cross-cultural communication

are a major cause of misunderstandings and poor outcomes

communication barriers

can damage trust, reduces quality of care, and create communication barriers

stereotyping

KEY: Never assume patients share the same beliefs or values

cultural blind spot syndrome

ability to communicate effectively with populations of varying language and health literacy levels

linguistic competence

KEY: Use simple, understandable language when educating patients

linguistic competence

use of Herbs, natural products and massage or yoga

complementary alternative medicine

patients may use this without informing providers

complementary alternative medicine

Dental hygienists should: Recognize personal biases, Listen carefully, Respect differences, Assess cultural beliefs, Adapt communication methods

cultural sensitivity

Important strategies: Learn about populations served, Respect cultural practices, Avoid stereotyping, Incorporate culturally appropriate education, Collaborate with diverse health professionals

guidelines for culturally competent care

a clear example or framework that illustrates a concept

paradigm

program planning should follow what?

the dental hygiene process of care

essential for:

prevention programs

community health initiatives

public health education

program planning

Purpose: framework for planning and evaluating programs

logic model

logic model - resources needed, funding

inputs

logic model - program actions/strategies, sealant program

activities

logic model - what is produced, number of children treated

outputs

logic model - results/impact, reduced caries rate

outcomes

focuses on planning, behavior change, and outcomes

precede-proceed model

KEY: emphasizes improving health outcomes, not just completing activities

precede-proceed model

institute of medicine (IOM) identified:

assessment

policy development

assurance

serving all functions (research)

core program planning functions

core program planning functions - identify needs and collect data

assessment

core program planning functions - develop strategies and goals

policy development

core program planning functions - ensure access to services

assurance

core program planning functions - improve programs and solutions

research

focus on prevention to decrease disease and infection

Dr. Fones’ model of dental hygiene within a school-based system

sickness side: medical professions, hospitals/clinics

health side: public schools, public health, research findings

Dr. Fones’ model of dental hygiene within a school-based system

School-based clinics

WIC collaborative clinic

Faith-based clinic

Community prevention programs

International program: Operation Smile

preventative programs

focus on reducing disease in target populations

preventative programs

International charity providing cleft lip and palate surgery, ongoing care, & professional training.

operation smile

Population needs

Demographics

Existing resources

Workforce availability

Funding needs

Facility availability

Methods

• Surveys

• Dental screenings

• Existing data

assessment

Prioritize needs

Diagnose to provide goals and objectives

diagnosis

Developing program blueprint

Creating goals/objectives

Identifying evaluation methods

Addresses barriers and alternatives

KEY- determines how the program will operate

planning

Starting program activities

Managing workforce/resources

Revising program as needed

KEY - programs often require adjustments during this phase

implementation

Purpose - determines whether goals were achieved

Surveys

Dental indices

Qualitative/quantitative data

TIP - is ongoing

evaluation

Purpose - record data, outcomes, revision, and program activities

KEY - supports accountability and future planning

documentation

determines whether a dental public health program is effective, cannot demonstrate effectiveness without it

program evaluation

helps identify:

Strengths, Weaknesses, Outcomes, Needed improvements of a program

program evaluation

A method used to evaluate a program based on program objectives

measurement

examples:

Surveys, Dental indices, Interviews, Screenings

measurement

non-numerical, how well did we do?, attitudes/perceptions

qualitative

numerical, how much did we do?, counts/statistics

quantitative

examples:

Interviews, Observations, Focus groups

qualitative

examples:

DMFT scores, Number of sealants placed, Caries rates

quantitative

screenings, epidemiologic exams, dental indices, clinical assessments

clinical evaluation

surveys, interviews, focus groups, observation

nonclinical evaluation

Conducted after implementation, Measures overall effectiveness

summative evaluation

Conducted during planning/program development, Improves program while in progress

formative evaluation

evaluation methods that do not include clinical data

nonclinical evaluation

methods used to measure clinic data such as screenings or exams that use dental indexes

clinical evaluation

Comprehensive including all tests, it is the least commonly used in public health and is not required for epidemiological studies, least commonly used

Type 1 - complete examination

Performed with a mouth mirror, explorer, and adequate illumination and exposed posterior bite-wing radiographs and selected periapicals, this is useful for a public health treatment program but is not required for oral health surveys

Type 2 - limited examination

The most common type used in public health programs employs a mouth mirror, explorer, and adequate illumination

Type 3 - inspection

The least valid type uses a tongue depressor and available illumination and produces the largest number of false negatives

Type 4 - screening

characteristic of dental indices - Criteria are understandable

clarity

characteristic of dental indices - Results are easily measured

simplicity

characteristic of dental indices - Results are not subject to individual interpretation

objectivity

characteristic of dental indices - Index measures what is intended, reliability, accuracy

validity

characteristic of dental indices - Examiner consistency and calibration are reproducible

reliability

characteristic of dental indices - Statistics can be applied

quantifiability

characteristic of dental indices - Small degrees of difference can be detected

sensitivity

characteristic of dental indices - Subjects experience no pain and index expense is minimal

acceptability

Name the Ramjford teeth in periodontal indices

#3, #9, #12, #19, #25, #28

Measures plaque and debris after disclosing

Patient Hygiene Performance (PHP)

Measures debris and calculus

Oral Hygiene Index (OHI/OHI-S)

Measures gingival inflammation and bleeding

Sulcular Bleeding Index (SBI)

Measures gingival inflammation, color, edema, & bleeding.

Gingival Index (GI)

Measures periodontal disease severity & attachment loss.

Periodontal Index & Periodontal Disease Index

Screens patients to determine periodontal treatment needs

Community Periodontal Index of Treatment Needs (CPITN)

Uses colored probe markings to evaluate pocket depth

Periodontal Screening & Recording (PSR)

Measures decayed, missing & filled teeth or surfaces.

   -   Most commonly tested caries index

Decayed, Missing, & Filled Teeth (DMFT)

Measure severity of dental fluorosis.

Dean’s Fluorosis Index & Tooth Surface Index of Fluorosis (TSIF)

Screens severity of malocclusion and orthodontic treatment need

Treatment Priority Index

Focus is on improving oral health and access to care

Key concerns: reduce caries & periodontal disease, improve access to care, & increase preventive services

health.gov

healthy people 2030

Tracks caries experience, sealants, tooth loss, fluoridation, oral cancer, & dental visits

CDC

national oral health surveillance system (NOHSS)

name some specific national oral health surveillance system indicators

dental visits, teeth cleaning, untreated caries, dental sealants, complete tooth loss, caries experience