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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Preventive Dental Visit: Child.

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Strategy. Preventive Oral Care Outreach with Early Head Start, Head Start, Home Visiting, and WIC Clinics. (13.2)

Approach. Collaborate with Early Head Start and Head Start programs, home visiting programs, and/for 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. Home visits by a dental care coordinator who provides education and helps families find and schedule dental appointments have been shown to improve children’s access to and utilization of oral health care.[1,2] In addition, outreach through Early Head Start programs, Head Start programs, home visiting programs, and WIC clinics appears to have comparable benefits.

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs 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. Here are sample ESMs to use as models 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?")

PROCESS MEASURES:

  • Number of Early Head Start, Head Start, home visiting, and WIC programs engaged in oral health partnerships. (Measures collaboration breadth)
  • Number of program staff trained to provide preventive oral health care and referrals. (Assesses workforce development reach)

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

PROCESS MEASURES:

  • Percent of partner program staff who demonstrate proficiency in preventive oral health care skills after training. (Assesses training effectiveness)
  • Percent of oral health education and resources provided to families that easily understood. (Measures tailoring to audience needs)

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

PROCESS MEASURES:

  • Number of memoranda of understanding (MOUs) established between partner programs and dental providers to facilitate closed-loop referrals. (Measures formalized care coordination)
  • Number of partner program sites that integrate oral health education and prevention into routine operations. (Assesses institutionalization of best practices)

OUTCOME MEASURES:

  • Number of children referred by partner programs who establish a dental home and receive regular care. (Assesses achievement of continuity of care)
  • Number of partner programs that sustain oral health integration after initial training and support. (Evaluates long-term adoption)

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

PROCESS MEASURES:

  • Percent of staff trained in preventive oral health care who serve predominantly children from families with lower incomes. (Assesses focus of workforce development)
  • Percent of partner programs that collect and review oral health data stratified by socioeconomic status. (Evaluates use of data)

OUTCOME MEASURES:

  • Percent of children in partner programs who receive oral health risk assessments and preventive care. (Measures delivery of early intervention services)
  • Percent of families who report increased knowledge and behavior change related to child oral health after education. (Assesses impact on oral health literacy)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

1 Binkley C, Garrett B, Johnson K. 2010. Increasing dental care utilization by Medicaid-eligible children: A dental care coordinator intervention. Journal of Public Health Dentistry 70(1):76–84.

2 Brickhouse TH, Haldiman RR, Evani B. 2013. The impact of a home visiting program on children’s utilization of dental services. Pediatrics 132(Supple 2):S147–S152.

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.