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146 Cards in this Set
- Front
- Back
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Policy development
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Comprehensive PH policies
Use scientific knowledge |
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Policy development
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Comprehensive PH policies
Use scientific knowledge |
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Assurance
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Involves:
Key policy makers Action through regulation Provide needed services |
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Policy development
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Comprehensive PH policies
Use scientific knowledge |
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PH Essential services
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-Monitor health status to ID and monitor community health pxs
-Diagnose and investigate health pxs, hazards in community -Inform, educate, empower about health issues -Mobilize community partnerships and actions to ID and solve health pxs -Develop policies and plans -Enforce laws and regulations -Links people to services -Assures competent public and personal HC force -Evaluates effectiveness accessibility, quality of health services -Researches for new insights and innovative solutions to health pxs |
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Assurance
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Involves:
Key policy makers Action through regulation Provide needed services |
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Assessment
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Info on health of community:
Collect Analyze Assemble Makes available Community health needs |
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3 core functions of public health
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Assessment
Policy development Assurance |
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Dean's Fluorosis Index
Codes and criteria |
1. Normal
2. Questionable 3. Very mild 4. Moderate 5. Severe |
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Oral epidemiology
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Study of distribution and determinants of oral disease and injury in human populations
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Deans fluorosis Index
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Measure prevalence and severity of dental fluorosis
Based on the 2 most affected teeth If 2 teeth not equally affected score for less affected of 2 is recorded |
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Dean's Fluorosis Index
Codes and criteria |
1. Normal
2. Questionable 3. Very mild 4. Moderate 5. Severe |
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DFI - Mild
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White opacity more than 25% but less than 50%
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DFI - Normal
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Enamel surface smooth
Glossy usually pale creamy white |
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Policy development
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Comprehensive PH policies
Use scientific knowledge |
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Assurance
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Involves:
Key policy makers Action through regulation Provide needed services |
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3 categories of barriers to care
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Structural
Financial Personal cultural |
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ACSD
Assistance for Children with Severe Disabilties |
Dental care for children
Mental or physical conditions Ministry of community and social services and Ministry of children services |
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Structural barrier to care
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Relates to provider :
Number Type Concentration Location Organizational configuration |
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Financial barrier to care
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Cannot afford to pay for service
Providers not want to treat those with lower fee guide |
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Data - oral health surveillance
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Used for public health :
Planning Implementation Evaluation |
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Oral health surveillance
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Ongoing systematic:
Collection Analysis Interpretation Defined by CDC and prevention |
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ODSP
Ontario disability support program |
Basic dental tx
Program participant Spouse Dependent children up to 18 |
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CINOT
children in need of tx |
Low income dental care
17 and under Screening of school children ID treatment needs |
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6 health competencies
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Assessing and diagnosing community health needs
Planning , implementing, evaluating CH programs Health education Research and epidemiology Health policy and health care infrastructure Advocacy and change agent |
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PH Essential services
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-Monitor health status to ID and monitor community health pxs
-Diagnose and investigate health pxs, hazards in community -Inform, educate, empower about health issues -Mobilize community partnerships and actions to ID and solve health pxs -Develop policies and plans -Enforce laws and regulations -Links people to services -Assures competent public and personal HC force -Evaluates effectiveness accessibility, quality of health services -Researches for new insights and innovative solutions to health pxs |
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Disparities
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-Certain subgroups affected
more by disease than other groups -Differences in health status between groups |
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OCDO - Office of chief dental officer
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- Created 2004
- improve oral health status of Cdns - increase prevention of oral disease through awareness |
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CINOT
children in need of tx |
Low income dental care
17 and under Screening of school children ID treatment needs |
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Deans fluorosis Index
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Measure prevalence and severity of dental fluorosis
Based on the 2 most affected teeth If 2 teeth not equally affected score for less affected of 2 is recorded |
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Deans fluorosis Index
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Measure prevalence and severity of dental fluorosis
Based on the 2 most affected teeth If 2 teeth not equally affected score for less affected of 2 is recorded |
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Mortality
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Rates of death
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Rates of deaths
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Mortality rates
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First step of a study design in looking at disease
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Descriptive
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Treatment urgency scale - 1
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Early dental care recommended within several weeks
Caries present but no accompanying signs or symptoms Spontaneous bleeding Suspicious white or red soft area I'll fitting denture |
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Descriptive studies
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Looks at prevalence of disease by person, place and time to describe higher risk groups of disease development
Study amount and distribution of disease Who is affected Where cases occur When cases occur Undertaken when little is known of epidemiology of disease |
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ASTDD TREATMENT URGENCY
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Three level treatment urgency scale
Developed in 1999 Used by most public health programs Improved reliability |
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Morbidity
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Rates of disease
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Reliability
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Different observers looking at same phenomenon
Report similar levels Particular technique applied repeatedly yields the same result each time |
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Descriptive studies
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Looks at prevalence of disease
eg Cross sectional Disease status and exposure to risk factors measured at one point in time eg oral health status survey |
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Indices
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Graduated
Numerical scale Upper and lower limits Measure disease severity not just incidence and prevalence |
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Descriptive studies
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Looks at prevalence of disease
eg Cross sectional Disease status and exposure to risk factors measured at one point in time eg oral health status survey |
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Prevalence rates
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Describes the amount of any particular illness in a population
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Unusually high incidence of disease for a population
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Epidemic
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Components of community health program
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Mission statement
Goals Objectives Interventions |
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What is a mission statement
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single statement that expresses a broad, overarching purpose for the programs existence
Serves as a broad, long term program guide should not include goals , objectives, interventions |
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How is mission statement written?
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To + directional statement + quality of life or category of service area + target group
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Program goals
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Address identified needs
More specific than mission statement Can be more than 1 goal Broad based statements of desired long term/short term changes If achieved alleviate identified needs |
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Program goal statements?
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To + directional statement + need area + target population
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Program objectives
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Designed to meet goals
More specific than goals They guide program interventions Address needs and reasons for needs by focus groups |
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Program objective statements
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To + directional statement + change in client or environment + target population
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SMART formula what is it?
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Guide for writing program objectives
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SMART
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Specific
Measurable Appropriate Realistic/related Time bound |
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SPECIFIC
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Focus and precision
Eliminates confusion Allows easier measurement Easier documentation |
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MEASURABLE
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Easy to ***** to gauge progress of program
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APPROPRIATE
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Needs of groups central focus of program
End result easily attainable |
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REALISTIC/RELATED
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Achievable yet challenging objectives
These help to motivate those involved Directly related to expected outcomes |
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TIME BOUND
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Timescale needs to be specified
To assess changes achieved Intermediate or end of program outcomes |
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INTERVENTIONS
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Task oriented
Matched to goals Identify what program is providing 4 types of program intervention |
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4 types of program interventions
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Educational
Direct service Organizational Power |
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Program interventions statements
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To + action term + units of service + target population
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Planning process
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Structured guides or tools
Several planning models |
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7 critical features of effective program development
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Cost effective
Proactive approach Sufficient community resources Common risk factors Targeted interventions Community recognized need Community acceptance |
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7 critical features of effective program development
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Cost effective
Proactive approach Sufficient community resources Common risk factors Targeted interventions Community recognized need Community acceptance |
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Reasons for conducting a needs assessment include ?
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Identifying the extent and severity of a need
Assessing cause of problem Determining resources needed for a program Establishing priorities |
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Program interventions statements
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To + action term + units of service + target population
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Direct program activities
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Involved in delivery of intervention
Reviewing materials drafting a lesson plan developing printing handouts scheduling / Running a pilot test Evaluating/revising/scheduling the lesson |
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Indirect activities
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Behind the scenes activities
Supportive in nature Record keeping Secretarial support Equipment maintenance |
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Components of a typical planning process
Community needs assessment CHNA |
Determines extent of needs
Collect, analysis, interpretation of info Foundation for effective program planning and successful program development |
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Components of a typical planning process
Community needs assessment CHNA |
Determines extent of needs
Collect, analysis, interpretation of info Foundation for effective program planning and successful program development |
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CHNA PURPOSE
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Collection of facts
Identification of needs Analysis of needs Prioritization of needs |
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What is the heart of the program plan?
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Goals and objectives
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"To improve the health if anytown citizens" is example of?
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Mission statement
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Examples of direct program activity
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Toothbrushing education
Data collection Convening a task force Developing a lesson plan |
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"To decrease the consumption of high sugar beverages of anytown public school". Is example of
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Program objectives
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"To decrease the consumption of high sugar beverages of anytown public school". Is example of
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Program objectives
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"To decrease dental caries of anytown citizens" is an example of?
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Program goal
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"To decrease dental caries of anytown citizens" is an example of?
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Program goal
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"To ban soft drinks at anytown high school" is an example of?
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Program intervention
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Components of typical planning process
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Community needs assessment
Collect the facts Demographic data Community knowledge and self care practices Oral health status indicators Impact if oral health levels facts about dental resources and existing programs Investigation of other interested agencies and advisory groups of key leaders and stakeholders |
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Epidemiology
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Study of distribution and determinants of disease and injuries in the human population
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A disease constantly and persistently in a population
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Endemic
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4 parts of epidemiological triangle
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Time
Environment Agent Host |
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Number of new disease cases that have occurred during a specific time
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Incidence
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First step of a study design in looking at disease
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Descriptive
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Study design following a group of people
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Prospective cohort study
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Types of epidemiological studies
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Descriptive
Analytic Experimental Observational |
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Analytic studies
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Aetiology leads already available
Experimental or observational studies Impact if controlled factor |
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Descriptive studies
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Looks at prevalence of disease
eg Cross sectional Disease status and exposure to risk factors measured at one point in time eg oral health status survey |
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What is validity
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Does an instrument or induce measure what irbid intended to measure
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Morbidity
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Rates of disease
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Mortality
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Death rates in a population
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Indices
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Graduated
Numerical scale Upper and lower limits Measure disease severity not just incidence and prevalence |
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Purpose of CHNA
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Collection of facts
Identification of needs Analysis of needs Prioritization of needs |
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Treatment urgency scale of 0
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no obvious problems
Routine dental care recommended |
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Treatment urgency scale - 1
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Early care within several weeks
Caries without S&S Spontaneous bleeding White/red soft tissue areas I'll fitting denture |
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Treatment urgency scale - 2
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Urgent care within 24 hours
S&S = pain, infection, swelling, soft tissue ulceration of more than 2 weeks |
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Deans fluorosis Index
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Measure prevalence and severity of dental fluorosis
Based on the 2 most affected teeth If 2 teeth not equally affected score for less affected of 2 is recorded |
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Dean's Fluorosis Index
Codes and criteria |
1. Normal
2. Questionable 3. Very mild 4. Moderate 5. Severe |
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DFI - Normal
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Enamel surface smooth
Glossy usually pale creamy white |
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SFI- Questionable
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Slight enamel aberrations
Few white flecks to occasional spots |
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DFI - Very mild
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Scattered - small opaque paper white areas
Less than 25% labial surfaces |
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DFI - Mild
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White opacity more than 25% but less than 50%
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CPITN
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Community periodontal index of treatment needs
Used to evaluate periodontal status rather than periodontal treatment needs now |
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Ramfjord Index Teeth
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Used for time saving
Evaluate subset of teeth 16, 21, 24, 36, 41, 44 Maxillary right first molar, left central incisor, left first premolar, mandibular left first molar, right central incisor, right first premolar, |
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Measuring dental caries
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Permanent: Coronal caries
-DMF INDEX Primary: Coronal caries. -df index -dmf index |
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DMFT - 0 to 28
DMFS - 0 to 128 |
Decayed missing filled teeth
Decayed missing filled surfaces |
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DMFT
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Decayed - loss of enamel tooth structure
Missing - tooth loss due to caries Filled - Restorative treatment due to caries Lost teeth due to ortho or injury not included in missing Third molars often excluded |
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DMFS
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Score 0 to 128
16 posterior X 5 surfaces 12 anterior X 4 surfaces |
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df index
dmf index |
Modified DMF for use in primary teeth
dft decayed, filled teeth dfs decayed, filled surfaces missing teeth not included in index because cannot alway determine why teeth not present exfoliation, extraction Less than 5 years can use dmft or dmfs Greater than 5 years in exfoliation stage: dft or dfs must be used |
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DFI - Moderate
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Enamel surfaces significant wear
Brown stain disfiguring feature |
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DFI - Severe
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General form of tooth may be affected
Pitted and worn areas Widespread brown stains Corroded appearance of teeth |
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Indices for perio status
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CPI - Community Periodontal Index
GI - Gingival Index LOA - Scoring Loss Of Attachment OHI-S - Simplified Oral Hygiene Index PI1 - Plaque Index |
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CPI - Community Periodontal Index
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***** and described periodontal status of a community
Promoted by WHO Evaluates bleeding, calculus, pockets Does not measure attachment loss or pocket depth |
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CPI
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0 - Healthy
1 - Bleeding observed after probing 2 - Calculus 3 - Pocket 4-5mm 4 - Pocket 6mm > X - Excluded sextant < 2 teeth 9 - Not recorded |
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Gingival Index - GI
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Probe inserted into sulcus and gently swept around tooth
M, D, Bu, Li surfaces of each tooth scored 0-3 based on criteria |
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Gingival Index - GI
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0 - normal gingival
1 - mild inflammation, no BOP 2 - moderate inflammation redness, edema, BOP 3 - severe inflammation marked redness, edema, ulceration and spontaneous bleeding |
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LOA - Scoring Loss of Attachment
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Codes and criteria recommended by WHO
Record loss of attachment in community based surveys |
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LOA - Scoring Loss of Attachment
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0 - LOA 0-3mm
1 - LOA 4-5mm 2 - LOA 6-8mm 3 - LOA 9-11mm 4 - LOA 12mm and greater X - excluded sextant 9 - Not recorded |
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RCI ROOT CARIES INDEX
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Measure of root caries that includes the number of exposed root surfaces as the denominator
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3 core functions of public health
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Assessment
Policy development Assurance |
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Policy development
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Comprehensive PH policies
Use scientific knowledge |
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Assurance
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Involves:
Key policy makers Action through regulation Provide needed services |
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PH Essential services
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-Monitor health status to ID and monitor community health pxs
-Diagnose and investigate health pxs, hazards in community -Inform, educate, empower about health issues -Mobilize community partnerships and actions to ID and solve health pxs -Develop policies and plans -Enforce laws and regulations -Links people to services -Assures competent public and personal HC force -Evaluates effectiveness accessibility, quality of health services -Researches for new insights and innovative solutions to health pxs |
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6 health competencies
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Assessing and diagnosing community health needs
Planning , implementing, evaluating CH programs Health education Research and epidemiology Health policy and health care infrastructure Advocacy and change agent |
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10 greatest public health achievements
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1- vaccination
2- motor vehicle safety 3- work place safety 4- infectious disease control 5- death reduction from heart disease and CVA 6- safer healthier food 7- healthier mothers and babies 8- family planning 9- Fluoridated drinking water 10- recognition of tobacco use hazards |
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Disparities
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-Certain subgroups affected
more by disease than other groups -Differences in health status between groups |
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Oral health disparities
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- age
- sex - race/ethnicity - SES - language - geography - medical status - lifestyle - demographics |
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CINOT
children in need of tx |
Low income dental care
17 and under Screening of school children ID treatment needs |
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ODSP
Ontario disability support program |
Basic dental tx
Program participant Spouse Dependent children up to 18 |
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OW Ontario Works
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Through ministry of community and social services
Basic coverage up to 18 Discretionary coverage - adults Each municipality decides level of coverage |
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Federally funded dental care programs
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IFPH- interim federal health program - EMERG dentistry refugees
DVA - department of veteran affairs - basic coverage to qualifying veterans of CAF FNIHB - First Nations Inuit health branch - covers registrants under Indian Act |
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Structural barrier to care
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Relates to provider :
Number Type Concentration Location Organizational configuration |
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Cultural barrier to care
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Beliefs of tx or providers
Fear of tx or providers |
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Oral health surveillance
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Ongoing systematic:
Collection Analysis Interpretation Defined by CDC and prevention |
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Leveraging resources
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Response to difficulty trying to provide programs dependent on government funding
Greatly expands program potential Combine resources with other programs Community coalitions/partners to achieve mutual goals |
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Barriers to care
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Structural
Financial Personal cultural |
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Financial barriers to care
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Patients inability to pay
Refusal of HCW to service those on lower fee guide or financial restrictions |
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"To decrease the consumption of high sugar beverages of anytown public school". Is example of
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Program objectives
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Endemic
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Constant presence of disease within a given population
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Endemic
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Constant presence of disease within a given population
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Epidemic
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Occurrence of disease in a given population or geographic area clearly exceeds normal expectancy
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Endemic
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Constant presence of disease within a given population
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Epidemic
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Occurrence of disease in a given population or geographic area clearly exceeds normal expectancy
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Pandemic
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Worldwide epidemic
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Surveillance
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Ongoing systematic collection, analysis,and interpretation of outcome specific data for use in planning, implementing and evaluating public health practices
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