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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. School-Based Dental Programs. (13.2)

Approach. Provide school oral health programs and Title V local grantees with technical assistance to enhance the quality of oral health services and increase oral health visits

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Overview. School-based dental programs can screen students to determine their oral health needs and provide preventive care, such as applying dental sealants and fluoride varnish. Services can be provided by oral health professionals, often employed by federally qualified health centers. (FQHCs) for local health departments, using mobile vans parked at schools for stationary for portable equipment used in schools. School-based dental programs may be linked to clinics for additional care. Programs often serve school districts with high proportions of children from families with low incomes and districts in rural areas. (CG-Oral health, ASTDD-Isman 2011). Children enrolled in Head Start programs have significantly higher average number of preventive dental visits than children not enrolled in Head Start. There is also evidence showing effectiveness of school-based dental program services such as screening and referral increase preventive dental visits for children.[1]

Evidence. Scientifically Rigorous Evidence. Strategies with this rating are most likely to be effective. These strategies have been tested in multiple robust studies in a variety of populations and settings with consistently positive results, both on their own and in combination with other strategies. (Clarifying Note: The WWFH database calls this "scientifically supported evidence").

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

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

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. Community Organizing (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 school oral health programs and Title V grantees receiving technical assistance. (Measures reach of capacity-building efforts in school and Title V oral health grantees)
  • Number of oral health professionals recruited for trained to provide services in school-based programs. (Measures growth in oral health workforce for school-based programs)

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

PROCESS MEASURES:

  • Percent of school programs and Title V grantees that develop a quality improvement plan based on technical assistance. (Measures level of action planning for quality improvement across school programs and Title V grantees)
  • Percent of school-based oral health services that adhere to clinical guidelines and best practices. (Measures school oral health program fidelity to recognized standards)

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

PROCESS MEASURES:

  • Number of partnerships established between school districts, FQHCs, and local health departments to support school oral health programs. (Measures level of collaboration across community groups)
  • Number of school programs and grantees that institutionalize oral health services and sustain them with different funding streams. (Measures long-term viability and entrenchment of oral health programs)

OUTCOME MEASURES:

  • Number of school districts that integrate oral health into their wellness policies and practices based on TA and best practices. (Measures systems-level change in school oral health program integration)
  • Number of Title V grantees that demonstrate improved oral health service delivery and outcomes after receiving technical assistance. (Measures effectiveness of provided technical assistance on oral health service delivery and outcomes)

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

PROCESS MEASURES:

  • Percent of technical assistance resources and supports dedicated to building responsiveness in school oral health programs. (Measures programmatic commitment to positive results in technical assistance and support)
  • Percent of school programs and grantees that institutionalize oral health services and sustain them with multiple funding streams. (Measures long-term viability and entrenchment of oral health programs)

OUTCOME MEASURES:

  • Percent decrease in school absenteeism due to oral health problems in districts with comprehensive school oral health programs. (Measures school oral health program impact on attendance and learning)
  • Percent of working families experiencing financial constraints and children with special health care needs in the state who are enrolled in premium assistance. (Measures program reach into the population facing health challenges)
  • Percent of policies and procedures that are reviewed and updated annually to sustain the program. (Assesses continuous quality improvement efforts)

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 Martin AB, Hardin JW, Veschusio C, Kirby HA. Differences in dental service utilization by rural children with and without participation in Head Start. Pediatr Dent. 2012;34(5):107-111.

2 Community Preventive Services Task Force. 2016. Oral Health: Preventing Dental Caries, School-Based Dental Sealant Delivery Programs. Atlanta, GA: Community Preventive Services Task Force. https://www.thecommunityguide.org/sites/default/files/assets/Oral-Health-Caries-School-based-Sealants_0.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.