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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. Mobile Dental Care Programs. (13.2)

Approach. Use mobile dental clinics to perform preventive care for individuals who otherwise would not have access to services

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Overview. Research indicates that expanded insurance coverage needs to be partnered with oral-health-workforce and delivery site expansion to achieve further progress.[1] To increase access to oral health care, oral health professionals have been deployed to work in mobile sites and school-based health centers. Mobile oral health care programs can increase the availability of both preventive and restorative oral health care for individuals who otherwise do not have access oral health care.[2] Increasingly sophisticated portable imaging technologies and treatment modalities have evolved to enable oral health professionals to provide a range of oral health services in community settings using portable equipment for in mobile vans equipped with fixed dental suites.[3]

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.
  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
  • 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. Direct Care (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 mobile dental clinics deployed to communities with limited access to oral health services. (Measures availability of mobile access points)
  • Number of community sites (e.g., schools, community centers) hosting mobile dental clinics. (Evaluates partnerships for service delivery)

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

PROCESS MEASURES:

  • Percent of mobile dental clinic staff trained in serving different populations. (Assesses workforce preparedness)
  • Percent of mobile dental services that adhere to evidence-based guidelines and quality standards. (Measures fidelity to best practices)

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

PROCESS MEASURES:

  • Number of partnerships established between mobile clinic operators, community organizations, and dental providers. (Assesses care coordination infrastructure)
  • Number of policies for funding mechanisms secured to support the long-term viability of mobile dental clinics. (Evaluates sustainability planning)

OUTCOME MEASURES:

  • Number of individuals served by mobile clinics who establish a dental home and receive regular comprehensive care. (Assesses success in promoting continuity of care)
  • Number of communities that demonstrate sustained improvements in oral health access and outcomes after introduction of mobile clinics. (Evaluates long-term impact)

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

PROCESS MEASURES:

  • Percent of mobile dental clinics deployed to communities experiencing the greatest oral health access barriers. (Measures resource allocation)
  • Percent of mobile clinic staff and providers who are characteristically similar to the communities served. (Measures representation)

OUTCOME MEASURES:

  • Percent of individuals receiving preventive care at mobile clinics who report high satisfaction with the experience. (Measures patient-centered care)
  • Percent of individuals referred for restorative treatment by mobile clinics who complete the recommended care. (Assesses continuity of care)

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 Mertz EA, Finocchio L. 2010. Improving oral healthcare delivery systems through workforce innovations: An introduction. Journal of Public Health Dentistry 70(Suppl 1):S1–S5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3325903

2 Spetz J, Pourat N, Chen X, Lee C, Martinez A, Xin K, Hughes D. 2019. Expansion of dental care for low‐income children through a mobile services program. Journal of School Health 89(8):619–628. https://pubmed.ncbi.nlm.nih.gov/31144337

3 Langelier M, Moore J, Carter R, Boyd L, Rodat C. 2017. An Assessment of Mobile and Portable Dentistry Programs to Improve Population Oral Health. Rensselaer, NY: University at Albany, State University of New York, Center for Health Workforce Studies, Oral Health Workforce Research Center. https://www.chwsny.org/wp-content/uploads/2017/09/OHWRC_Mobile_and_Portable_Dentistry_Programs_2017-1.pdf

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.