14: Community Health and Research Principles

Community Health and Research Principles

QUESTIONS

Questions 1 through 5 refer to information in the following testlet.

A school district contracts with a local dental hygienist to begin a caries prevention program after a national report has indicated that the state had the highest tooth decay rate in the nation based on DMFS (decayed, missing, filled tooth surfaces) indices. The dental hygienist is asked to develop a pit and fissure sealant and fluoride varnish program in all the elementary schools in a rural district for children in grades K–5. This culturally diverse population consists primarily of children from lower socioeconomic status (SES) families. The only prior program in the schools is annual dental education conducted by the school nurses, based on their assessment that the oral hygiene of the school children is poor. The concentration of fluoride in the water is 0.3 parts per million (ppm), and a previous fluoridation campaign was unsuccessful. The DMFT (decayed, missing, filled teeth) and dft will be measured at the baseline with plans to repeat the measures annually to monitor the effectiveness of the program.

1. Which of the following is the FIRST data collection method needed for this program?

2. Which of the following factors should be considered to determine the optimal level of water fluoridation for this community?

3. All of the following are important risk factors for development of dental caries in this population EXCEPT one. Which one is the EXCEPTION?

4. Which change in the DMFT scores would indicate the most successful outcome 5 years after implementation of the program?

5. The “e” in the index used to assess this population indicates teeth that are (Select all that apply.)

Questions 6 through 11 refer to information in the following testlet.

A dental hygienist in a community clinic is working with the medical clinic staff to develop an interdisciplinary program to improve the oral care of pregnant women who are treated in the community clinic. The population of the community clinic is primarily Hispanic and of low SES. Approximately 30% of the pregnant women in this population develop gestational diabetes. When a woman first sees the nurse practitioner in the medical clinic for prenatal care, she is referred to the dental clinic for a dental examination and for routine dental treatment. Only 20% of the patients referred over the previous 6 months complied with the dental referral. As a result, the medical and dental staff collaborated to conduct a survey of the pregnant women served by this clinic. Results revealed that the women do not realize their risk for diabetes and are unaware of the relationship between oral health status and diabetes. The women do not understand the benefits of an oral health assessment in relation to their overall health and the health of their babies. For the purpose of discussing the problem and possible solutions, the dental hygienist arranged a meeting of the medical clinic director, the dental clinic director, one of the nurse practitioners, a prominent leader of the Hispanic community, and a dental clinic staff member from the community.

6. Which of the following would be the MOST effective intervention to implement to increase compliance with the dental referral?

7. Based on the results of the survey, which of the following health education theories would be the MOST appropriate to use as the foundation for an oral health education intervention to improve compliance with the dental referral?

8. Which of the following is a valid conclusion about the population from the results of the survey?

9. Which characteristic of public health is exemplified by the dental referral by the medical clinic?

10. The process of involving and activating members of the community in a meeting is an example of which theory of health promotion?

11. Lower-SES populations are identified as a high priority target populations in the United States because these populations are identified as having unmet oral health needs by the Surgeon General’s Report.

Questions 12 through 15 refer to information in the following testlet.

A dental hygienist is employed as a dental hygiene coordinator at a local, federally subsidized facility that provides assisted-living and full nursing home care. The hygienist’s duties include (1) conducting initial assessments by utilizing a tongue blade and available light for new residents, (2) developing individual dental hygiene treatment plans, (3) planning educational and other oral health programs to meet residents’ needs, (4) utilizing intermittent measurements of oral health status and oral hygiene for evaluation purposes, and (5) coordinating annual examinations. The dental hygiene coordinator arranges for another hygienist from the Health Department to help conduct annual epidemiologic examinations of oral health status and oral hygiene to monitor progress of the program. The O’Leary plaque index is used to evaluate oral hygiene. The dental hygiene coordinator and Health Department hygienist participate in a team calibration exercise prior to the annual examinations.

12. Which type of examination is used for the initial assessment of new residents?

13. Which of the following BEST describes the purpose for calibrating the second dental hygienist before the team conducts the annual examinations?

14. In this testlet, the initial assessment of oral hygiene status performed by the dental hygiene coordinator is comparable with which component of private practice?

15. Which of the following could be an effect of using a disclosant in the application of the O’Leary plaque index to measure plaque in this program? (Select all that apply.)

Questions 16 through 21 refer to information in the following testlet.

A dental hygienist is employed by the local health department and participates in a weekly school sealant program for children in kindergarten through sixth grade. The program is located in a lower and middle SES, multiethnic city with an adequately fluoridated community water supply. Although the community water supply is adequately fluoridated, DMF scores taken in the initial screening indicate much higher than expected caries rates. The hygienist’s role is to place the sealants on the children’s teeth and to provide classroom educational programs to teach proper oral hygiene. Children are screened at the beginning of the year to determine caries status and identify teeth to be sealed. Low-SES children who need treatment for active caries are referred to local dental offices for treatment. The program is evaluated by tracking the number of sealants placed, monitoring the participation level, and measuring the reduction in caries by comparing “D” in the DMF scores at baseline and at 1, 2, and 3 years.

16. What term correctly describes the rate of disease that is constant in a population?

17. Which of the following programs would be MOST recommended to provide safe and cost effective caries prevention, in addition to the sealant program for this high caries risk population?

18. Which of the following are possible funding sources for this program? (Select all that apply.)

19. Which of the following is the MOST effective teaching strategy to evaluate learning for toothbrushing in the educational programs with these school children? (Select all that apply.)

20. A public health problem is a condition that is widespread and has an actual or potential cause of morbidity or mortality. Using this definition, the school system has a public health problem based on the high DMF scores of the school children.

21. If the DMF scores of the different SES groups are compared, which of the following would be the expected results?

Questions 22 through 25 refer to information in the following testlet.

A dental hygienist employed by a children’s hospital dental clinic is responsible for coordinating programs to serve medically compromised children in the service area. The population consists of a mix of diverse SES and ethnic groups. The dental hygienist’s responsibilities include managing the clinic that provides dental and dental hygiene treatment for the children, training hospital staff in daily oral care of hospitalized children, serving as a resource to the hospital staff, conducting oral hygiene educational programs for clinic patients and their parents, and supervising the distribution of self-care fluoride products. The effectiveness of the educational programs is evaluated by comparing pretest and posttest scores of knowledge and oral health behaviors of the clinic patients.

22. Which of the following are the three characteristics that compose epidemiologic factors of disease? (Select all that apply.)

23. Which type of evaluation involves comparison of the pretest and posttest scores?

24. The primary role of the public health dental hygienist is to provide direct patient treatment. The dental hygienist’s role in this program is primarily coordination, training, and serving as a resource that fulfills the role of the public health hygienist.

25. Assessment data are collected from each pediatric patient to determine his or her dental experiences. Which of the following terms describes the children’s annual visits to a dentist or dental hygienist?

Questions 26 through 30 refer to information in the following testlet.

A dental hygienist consulted with a Head Start program to plan a program in a metropolitan community with optimally fluoridated water. The needs of the children are assessed with the Basic Screening Survey (BSS), including classification as treatment needed or having no treatment needs. Children who required treatment are classified as immediate treatment needed, treatment needed in the near future, and treatment that can be delayed. A fluoride varnish program is planned for the children along with oral health educational programs for children, parents, and staff.

26. What level of prevention is addressed by this program?

27. Which of the following is an appropriate instructional objective for the Head Start teachers in this program?

28. Which of the following types of data is represented by the classification of treatment needs?

29. Which of the following is the MOST appropriate use of the data generated by the screening? Select the two that are most applicable.

30. Which of the following is the BEST fluoride program for this project?

Questions 31 through 34 refer to information in the following testlet.

A dental hygienist is interested in conducting an oral health program for a nursing home in her community. The intraoral screening reveals that out of 100 residents, 50 are fully edentulous (50%), and of those edentulous residents, 75% have dentures. The majority of residents require assistance with basic self-care. A program is planned to train the nurses’ aides to provide daily oral care, including cleaning of dentures. The educational program for the aides includes their own personal oral care.

31. Which of the following is the purpose of including personal oral care for the nurses’ aides?

32. Which of the following actions should occur next in this program?

33. Which of the following is the BEST program to implement after the nurse aides are trained in personal oral care?

34. Who is the responsible party to contact if the dental hygienist identifies possible oral cancer lesions during the intraoral screening?

Questions 35 through 40 refer to information in the following testlet.

A group of students in a dental hygiene program conduct a study to determine the best method to increase periodontal patients’ compliance with their periodontal maintenance schedule. The research question to be answered is, “What effect does modifying the scheduling procedure for a periodontal disease maintenance appointment have on patient compliance with their appointments?” A survey is administered to all patients at their final visit about their attitudes, beliefs, and opinions about the importance of periodontal maintenance.

The students divide the patient population into three groups, using sequential assignment based on the order that they appear for treatment in the clinic. One group is appointed for the next periodontal maintenance appointment prior to leaving the clinic. The other group is entered into the computer to be called for an appointment when due. The third group is not scheduled at all. In the process of assigning patients to their method of appointment scheduling, the groups are matched to ensure that each group is similar for periodontal case types and gender. The groups are given the same verbal and written instructions about the importance of complying with periodontal maintenance on a recommended schedule in relation to their treatment outcomes. Review of past research indicates that the strength of the relationship between periodontal health and periodontal maintenance is a coefficient correlation of 0.62.

35. For each variable in the study and listed below, select the MOST closely linked type of variable from the list provided.

Variable in the Study Type of Variable
___ 1. Age A. Dependent
___ 2. Compliance with periodontal maintenance B. Extraneous
___ 3. Gender C. Independent
___ 4. Instructions about the importance of periodontal maintenance D. Relevant and controlled
___ 5. Method of appointment scheduling
___ 6. Periodontal status

36. Which of the following is the purpose of giving the same verbal and written instructions about periodontal maintenance to all groups of patients?

37. The entire dental hygiene faculty in the dental hygiene clinic uses the same standardized design of periodontal probe at all times to measure clinical attachment loss to classify patients’ periodontal status and has calibrated with each other on the use of this probe. Select the two factors that are enhanced by using the same periodontal probe and calibration.

38. If the survey had been conducted on a sample of the population, which of the following would have been the BEST sampling method to use?

39. On the basis of the correlation coefficient, which of the following types of relationship was found between periodontal health and compliance with periodontal maintenance?

40. Which of the following is the BEST graphing technique to depict the compliance of both groups when the results are presented to the professional and administrative staff of the clinic?

Questions 41 through 45 refer to information in the following testlet.

Local dentists, hygienists, and assistants join together with second-year dental hygiene students and their faculty to provide a sealant and fluoride varnish clinic for children of migrant workers; the workers are employed at a meat packing plant in a rural town in southwestern United States. The migrant families are primarily Spanish speaking. The program is conducted in the local elementary school, and portable dental equipment is used. There are 300 children attending the school at the time the clinic is held. The school nurse selects the children enrolled in free lunch program from first, second, and fifth grade levels to participate in the program and obtains the necessary consent forms signed by parents. Working in teams, a dentist, a hygienist, an assistant, and a dental hygiene student provide screening for sealant placement and referral to Medicaid providers for additional treatment needed. Some teams provide oral hygiene instruction, and some place sealants, and some apply the fluoride varnish.

41. Which of the following is the BEST group to target for an oral health in-service to continue ongoing oral health education after the program has been implemented?

42. All of the following are stakeholders of this program EXCEPT one. Which one is the EXCEPTION?

43. Which of the following is the BEST way to evaluate the outcomes of the sealant program?

44. Which of the following is the MOST culturally sensitive procedure to use during the presentation of an oral health education program for parents?

45. The program exemplifies all of the following recommendations of the National Call to Action to Promote Oral Health initiative EXCEPT one. Which one is the EXCEPTION?

Questions 46 through 49 refer to information in the following testlet.

A public health dental hygienist coordinates an annual assessment of the oral health needs of a local preschool with an enrollment of 90 3- to 4-year-old children. The children are from Hispanic, African American, and non-Hispanic White families of low SES, and 85% qualify for Medicaid or the Children’s Health Insurance Program (CHIP). The preschool is located in a city that is not optimally fluoridated. A consent form is required to participate in the oral health assessment survey. The results of the screening revealed an average dmfs score of 1.0. The children that were screened were referred to a dental facility. A summary report of the results of the assessment and referral was prepared for the children’s parents.

46. The dmfs of this population indicates that the children suffer from early childhood caries. The dmfs is the appropriate index used for detection of early childhood caries.

47. After seeing the high levels of ECC in the children, the public health hygienist is motivated to organize a fluoridation campaign for this community. Which of the following would be the BEST first step?

48. What other index could be used to screen these children for dental caries in public health settings?

Related posts:

  1. 5: General and Oral Pathology
  2. 2: Physiology
  3. 1: Anatomic Sciences
  4. 10: Performing Periodontal Procedures
  5. 11: Using Preventive Agents
  6. 13: Professional Responsibility

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Jan 1, 2015 | Posted by in Dental Hygiene | Comments Off on 14: Community Health and Research Principles

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