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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. Public Insurance Coverage. (13.2)

Approach. Collaborate with Medicaid to increase the number of children and youth who have had a preventive dental visit in the past year

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Overview. Children and adolescents who have been enrolled in public health insurance. (Medicaid for CHIP) have greater access to and utilization of oral health care compared with children and adolescents recently enrolled.[1]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some 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):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • 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.

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. Policy Development and Enforcement (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 outreach events for campaigns conducted in collaboration with Medicaid to promote preventive dental visits. (Measures joint promotion efforts)
  • Number of Medicaid-enrolled children and youth tailored with information about covered dental benefits and how to access care. (Assesses reach of education)

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

PROCESS MEASURES:

  • Percent of Medicaid-enrolled children and youth who receive personalized reminders about due for overdue preventive dental visits. (Evaluates adherence to preventive care schedules)
  • Percent of Medicaid outreach materials on dental benefits that meet health literacy standards. (Measures use of health literacy principles)

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

PROCESS MEASURES:

  • Number of partnerships established between Medicaid and community organizations to promote and support child dental visits. (Measures multi-sector collaboration)
  • Number of policy changes implemented by Medicaid to reduce administrative barriers to pediatric dental care. (Assesses systems improvement)

OUTCOME MEASURES:

  • Number of Medicaid-enrolled children and youth who establish a regular source of dental care and attend recall visits. (Assesses achievement of a dental home)
  • Number of schools and early childhood programs that incorporate Medicaid dental education and referrals into their operations. (Measures integration into community settings)

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

PROCESS MEASURES:

  • Percent of Medicaid outreach and education resources dedicated to reaching communities with low dental utilization rates. (Measures focus of efforts)
  • Percent of Medicaid dental providers receiving training on delivering trauma-informed care to pediatric populations. (Evaluates workforce capacity)

OUTCOME MEASURES:

  • Percent increase in preventive dental visit rates among Medicaid-enrolled children and youth compared to the previous year. (Measures changes in utilization patterns)
  • Percent of parents/caregivers of Medicaid-enrolled children who report high satisfaction with their child's access to preventive dental care. (Evaluates patient/family experience)

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] Clemans-Cope L, Kenney G, Waidmann T, Huntress M, Anderson N. 2015. How well is CHIP addressing oral health care needs and access for children? Academy of Pediatrics 15(3 Suppl):S78–84.

[2] Kenney, G. M., Ko, G., & Ormond, B. A. (2000). Gaps in Prevention and Treatment: Dental Care for Low-Income Children. New Federalism: National Survey of America's Families, Series B, No. B-15. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies.

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.