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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 13.2: Preventive Dental Visit: Childhood

MCH Best Logo young girl receiving oral health exam

Strategy. Preventive Oral Care Outreach with Early Head Start, Head Start, Home Visiting, and WIC Clinics

Approach. Collaborate with Early Head Start and Head Start programs, home visiting programs, and/or WIC clinics to train staff to provide preventive oral health care and referrals to oral health professionals for dental visits.

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Overview. Providing home visits with a dental care coordinator who educates and assists with finding and scheduling an appointment with recruited dental practice to provide care for children has been shown to improve utilization of dental services.1 In addition, outreach through similar services such as Early Head Start, Head Start, Home Visiting, and WIC clinics appears to have comparable benefits.

Evidence. Emerging Evidence. There is recent evidence of the effectiveness for home visiting with dental practice outreach. More research is needed for conclusive results; however, the peer-reviewed literature on home visiting related to similar topic areas is promising and strongly indicates that this approach would prove effective for this topic area and population group. Access the peer-reviewed evidence about home visits and dental practice through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Caregiver and Provider.

Outcome. Percent of infants and children ages 1 to 17 with a past-year preventive dental visit. 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. There are currently 7 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Utilize home visiting programs to screen for caries and refer to early oral preventive services with recruited dental practices for children over age 6 months,” 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 program children identified at high risk for caries who receive referrals for preventive oral care.
  • Number of program staff who have been trained to provide screening for caries and referrals for early oral preventive services.

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

  • Percentage of program children identified at high risk for caries who receive referrals for preventive oral care.
  • Percent of program staff who have been trained to provide screening for caries and referrals for early oral preventive services.

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

  • Number of program children identified at high risk for caries who receive preventive dental visit.
  • Number of program staff who have been trained and indicate that they have incorporated caries risk assessment into their visits.

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

  • Percentage of program children identified at high risk for caries who receive preventive dental visit.
  • Percent of program staff who have been trained and indicate that they have incorporated caries risk assessment into their visits.

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).

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

Reference:

1 Binkley C, Garrett B, Johnson K. Increasing dental care utilization by Medicaid-eligible children: a dental care coordinator intervention. J Public Health Dent. 2010;70(1):76-84.

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.