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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Preventive Dental Visit: Pregnancy.

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Strategy. Patient Education/Counseling. (13.1)

Approach. Integrate oral health messages and strategies within existing community-based maternal and infant health programs

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Overview. There is growing evidence that oral health education interventions (e.g., oral health education using instructive materials, provision of dental supplies to improve daily oral hygiene habits, encouragement of dental visits, counseling and motivational interviewing to help navigate care) for expectant parents may increase receipt of dental visits. While these results are encouraging, more research is needed for conclusive results.[1]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

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.
  • 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.

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. Outreach (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 or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of oral health education sessions provided to expectant parents through community programs. (Measures volume of services delivered in the context of community programs) Number of expectant parents provided with dental supplies and resources through community programs. (Measures reach of material supports provided through community programs)

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

  • Percent of community-based program staff trained on oral health topics and strategies. (Measures level of capacity building among community-based workforce) Percent of oral health integration strategies that are co-designed with input from expectant parents. (Measures level of community engagement in oral health intervention design and development)

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

  • Number of expectant parents assisted with scheduling dental appointments and navigating insurance by community programs. (Measures services provided that enable and support parents in scheduling dental appointments) Number of community-based programs that integrate oral health education into standard prenatal curricula for protocols. (Measures systematic integration of oral health education services into community programming) Number of expectant parents receiving education through community programs who subsequently attend a dental visit. (Measures conversion to care between provision of oral health education and appointment attendance) Number of expectant parents who develop a regular oral hygiene routine after receiving supplies and education. (Measures impact of provision of resources on behavior)

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

  • Percent of oral health education programs that address transportation for language barriers. (Measures incorporation and reach in oral health education programming) Percent of community-based programs that collect and monitor oral health integration data. (Measures level of tracking done by community programs) Percent increase in dental visit rates during pregnancy among women from various backgrounds who are engaged by community programs. (Measures impact of community programs on appointment rates) Percent reduction in oral health gaps during pregnancy (e.g., dental visit rates, oral health status) for various populations. (Measures level of support reached in oral health outcomes)

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 Cibulka NJ, Forney S, Goodwin K, Lazaroff P, Sarabia R. Improving oral health in low-income pregnant women with a nurse practitioner-directed oral care program. J Am Acad Nurse Pract. 2011;23(5):249-257

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.