The community oral health project is an opportunity for dental hygiene students to take what they have learned in the Community Oral Health course and apply it in a setting of their choice. Community projects allow students to interact in the community at a level that will produce positive behavioral change and impact the oral health of the population being served. Because of the constraints of time within a dental hygiene curriculum, the project impact may be limited. Therefore it is important to include follow-up plans for sustainability of the project activities once the initial project is complete. The student community project varies from the traditional one-time presentations since it includes assessing the needs of the population, planning for and implementation of disease prevention and health promotion activities, and evaluation of the project. The project can be a service-learning project if it contains service-learning components, including learning objectives and service objectives that will equally benefit both the student and the population being served (see Chapter 11). The goal of the community project is to improve the oral health of the selected population, although the project does provide a learning experience for the student.
In the previous chapters, it has been documented that despite improvements in oral health, profound disparities remain in specific population groups in the United States. People who are at highest risk for poor oral health are children from low-income families, children and adults with special health care needs, and vulnerable elderly citizens. If 80% of dental disease is found in 25% of the citizens, as stated in Oral Health in America: A Report of the Surgeon General, it makes sense to plan community projects that will target the 25% who are at most risk.1 Students can use community resources, the Internet, and organizations such as the United Way to select a facility that serves the population they want to work with. The needs of at-risk populations have been documented and described in various journals and publications. Students should do a literature search (see Chapter 7) and review two to three recent articles describing the oral health status for the population they target for their community project. Healthy People 2010 and Healthy People 2020 provide data on oral health status and trends, as well as goals for improving the oral health of the nation (see Chapter 5). Students should also review the Healthy People national health objectives (see Chapters 4 and 5) that relate to the selected target population. This connection will allow the students to see how their project not only makes a difference in the health of persons in one local site but also persons in the nation.
Once the target population has been selected and a form is turned in to the instructor (Form A can be accessed on the Evolve website), the following steps should be taken (see also Guiding Principles). The first step would be to contact the intended site through a phone call to explain interest in setting up a community project to improve the oral health of the population served by this organization. If there is interest by the site, a visit is set up to discuss the project, which would include a tour of the facility and time to discuss the needs of the target population. If necessary, a letter of introduction for the students, written by the community instructor, can be obtained and brought to this first meeting. A first-visit form (Form B can be accessed on the Evolve website) is filled out listing attendees at the meeting, describing the target population, and their oral health needs. The student group (usually two to four students) needs to gather enough information at this meeting to prepare a written agreement of the project goal, objectives, activities, and evaluation methods. Dates for conducting the project should also be discussed with a minimum of two visits: to conduct pretesting and begin project activities. A third visit will be needed to complete activities and conduct final evaluation or posttesting. The length of time is important to the impact on the population. Once the agreement is written and signed, the project can begin as planned. (Form C can be accessed on the Evolve website.) Evidenced-based practices should be employed as the interventions that will make a difference in the oral health of the target population. For an example, see the Head Start Project in the section on Head Start Oral Health Project.
Evaluation measures are to be designed during the planning of the project. Evaluation measures should be connected to the project objectives and are the means of determining if the project accomplished what it was designed to do. Evaluation can include information from questionnaires, pretests, and posttests of knowledge, focus groups, numbers of participants, and student reflections (see Chapters 6 and 11). The student community project can be considered a “mini” project compared with a state level intervention or a government-organized program; however, many of the same steps and efforts can be applied (see Chapter 6). For example, short-term measurement of knowledge and attitude change can be determined as evaluation within the target population and possibly some short-term behavioral changes might be measured if time allows. The long-term changes, however, such as disease rates or health changes, take more time than the student project can determine. With the student project, long-term health outcomes cannot be guaranteed. The student community project provides a taste of public health and how to plan, implement, and evaluate a project to improve oral health. It is a valuable tool in getting students involved in their communities with the hope that they will continue to be involved as professionals in future interventions and educational programs in their communities.
The next section describes the Head Start population as a possible target population for conducting student community oral health projects, as well as a population needing the continued support and involvement of oral health professionals to improve the oral health of Head Start children and families.
The Head Start program was founded in 1965 as part of President Johnson’s War on Poverty. It began as a summer program that was designed to break the cycle of poverty by providing comprehensive services to low-income preschool children and their families. The overall mission of Head Start is to prepare children for school. Head Start programs promote school readiness by enhancing the social and cognitive development of children through the provision of educational, health, nutritional, social, and other services to enrolled children and families. They engage parents in their children’s learning and help them make progress toward their educational, literacy, and employment goals. Significant emphasis is placed on the involvement of parents in the governance of local Head Start programs. Parents are an integral part of the program and are seen as the child’s primary and first teacher (Figure 12-1).
In terms of socioeconomic status, the Head Start program serves our nation’s most vulnerable children. From 1965 until the most recent Head Start Reauthorization in December 2007, eligibility for Head Start services was at or below 100% of the federal poverty level (FPL). The 2010 FPL for a family of four is $22,050.00.2 The 2007 Reauthorization of Head Start allows Head Start programs to serve up to 35% of children whose family income is up to 130% of the FPL. For a family of four, this is $28,665.00. In contrast, eligibility for Medicaid is 133% of the FPL (states have the option to expand eligibility beyond federal guidelines); eligibility for the Children’s Health Insurance Program (CHIP) has been set by the states as up to or above 200% of the FPL. In 2009, eligibility for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) was increased to 185% of the FPL.
|Number of 5-year-olds and older||3%|
|Number of 4-year-olds||51%|
|Number of 3-year-olds||36%|
|Number younger than 3 years of age||10%|
|American Indian/Alaska Native||4.0%|