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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 13.1: Preventive Dental Visit: Pregnancy

MCHbest Logo young woman receiving oral health exam

Strategy. Provider Education (Early Head Start, Home Visiting, WIC)

Approach. Collaborate with Early Head Start programs, home visiting programs, and/or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics to train staff to conduct oral health risk assessments, provide preventive oral health care, and refer pregnant women for dental visits.

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Overview. Provider education is an evidence-based strategy that has shown utility in increasing use of professional services including oral health by MCH population groups.1,2 Examples of topics focused on preventive oral health care include providing anticipatory guidance on feedback practices, providing tooth brush instruction, and conducting lift the lip screenings.

Evidence. Moderate Evidence. Provider education in Early Head Start, Home Visiting, and WIC appear to be effective in improving dental care for pregnant people. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).. Also see Holt K, Louie R. 2019. Strengthening State and Jurisdiction Efforts Related to Title V Maternal and Child Health National Performance Measure 13 (Oral Health). Washington, DC: National Maternal and Child Oral Health Resource Center and other backtround resources.3

Target Audience. Providers.

Outcome. Proportion of pregnant people with a dental claim. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.

Examples from the Field. Access descriptions of ESMs from across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Collaborate with Early Head Start programs, home visiting programs, and/or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics to train staff to provide preventive oral health care to pregnant women and referrals to oral health professionals for dental visits,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of staff in Title V programs and/or clinics trained in preventive oral health care in the past 12 months.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of staff in Title V programs and/or clinics trained in preventive oral health care in the past 12 months.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of staff in programs and/or clinics trained in preventive oral health care that demonstrate an increase in awareness and knowledge (pre-/post-tests) in the past 12 months.
  • Number of staff in programs and/or clinics providing preventive oral health care or referrals to oral health professionals for dental visits in the past 12 months.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of staff in programs and/or clinics trained in preventive oral health care that demonstrate an increase in awareness and knowledge (pre-/post-tests) in the past 12 months.
  • Percent of staff in programs and/or clinics providing preventive oral health care or referrals to oral health professionals for dental visits in the past 12 months.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Possible Data Sources for ESMs:

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1 Lipper J. Advancing Oral Health through the Women, Infants, and Children Program: A New Hampshire Pilot Project. (2016). Center for Health Care Strategies.

2 Perkins, R. B., Zisblatt, L., Legler, A., Trucks, E., Hanchate, A., & Gorin, S. S. (2015). Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine, 33(9), 1223-1229.

3 Additional Background Resources:

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.