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Strengthening the evidence for maternal and child health programs

Find State ESMs


Displaying records 1 through 13 (13 total).

13.1.2 Percentage of pregnant women enrolled in WIC who receive oral health education (Massachusetts)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percent of women enrolled in WIC who receive education and referrals to oral health services during pregnancy.

Numerator: Number of pregnant women who receive oral health education

Denominator: Number pregnant women enrolled in WIC

Significance: WIC offers education and counseling about the importance of preventive oral health care services, including the importance of screening and dental cleaning. Oral health referral information is also available through WIC offices. WIC serves a high proportion of pregnant women in Massachusetts and improving the provision of oral health education and referrals for its clients will lead to improvements in NPM #13. This ESM is supported by evidence from the Strengthening the Evidence for Maternal and Child Health Programs review of NPM 13A that was completed in June 2017. The review found that there is limited rigorous evidence about effective interventions to increase dental visit during pregnancy, but one study evaluating education or counseling interventions targeting pregnant women had statistically significant favorable outcomes: 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.

Data Sources and Data Issues: Massachusetts WIC data. Potential limitations include: the numerator is not an unduplicated count, so some women might receive education more than once. There are also women who are likely receiving education but that is not documented.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

13.1.2 Number of expectant mothers and those post-partum who received oral health education (Mississippi)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of expectant mothers and those post-partum who received oral health education by 10% in the next year in order to increase the awareness of women regarding the importance of oral health.

Numerator: Number of expectant mothers and those post-partum who received oral health education

Denominator: N/A

Significance: Oral Health promotion and oral disease prevention in parents and children; referral to dental home

Data Sources and Data Issues: Office of Oral Health/PHRM/FQHC partners

Year: 2018/2020

Unit Type: Count, Unit Number: 1,000

13.1.2 Increase the proportion of at-risk pregnant women who are educated about the importance of receiving preventive dental care during pregnancy and assist with linking Medicaid insured to needed dental services by piloting the First Steps Program. (Alabama)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: To identify maternity health care providers serving Medicaid insured maternity patients. Train and educate 25% of these health care providers about the importance of maternity patients receiving preventative oral health services during pregnancy.

Numerator: The total number of currently established Maternity Care Districts in which ADPH staff have provided care coordination. Goal: Two of the 14 Maternity Care Districts.

Denominator: The total number of currently established Maternity Care Districts that provide maternity care services throughout the state. There are 14 established Maternity Care Districts.

Significance: Through the implementation of the First Steps Program, maternity health care providers will have increased knowledge of the importance of maternity patients receiving preventive oral health care services. The identified providers will educate their maternity patients with this information and assist their maternity patients with accessing preventive oral health services. In September 2017, Alabama Medicaid released a Request for Proposal (RFP) for Maternity Health Care Coordination for the 15 counties currently receiving maternity care coordination services from ADPH social work staff. Once Medicaid identifies a Maternity Care Provider, it is anticipated ADPH will transfer any open maternity case to the selected provider. Ongoing Oral Health education to maternity patients insured by Medicaid is one of the required components of the RFP. This component helps to insure maternity patients continue to receive oral health education and the importance of at least a preventive visit during their pregnancy. As of March 2018, Medicaid has not finalized their plans for Maternity Care Coordination services for Medicaid insured maternity patients. Currently, ADPH social work staff is continuing to provide maternity care coordination services in 15 counties throughout the state. ADPH staff will continue to provide education in regard to the importance of accessing preventive oral health care services and linking patients to needed services. Until Medicaid’s plans are finalized, the Office of Oral Health staff and other ADPH social work program staff will collaborate with Medicaid about continuing to educate and train maternity providers in regard to the importance of patients receiving preventive oral health care services.

Data Sources and Data Issues: Alabama Medicaid, ADPH Programs providing services to Medicaid insured maternity patients.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

13.2.1 Preventive and any dental services for children enrolled in Medicaid or CHIP (CMS-416) (New Jersey)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the use of preventive and any dental services for children enrolled in Medicaid or CHIP (CMS-416)

Numerator: Number of children (<19) enrolled in Medicaid or CHIP reported receiving any dental or oral health services

Denominator: Number for children (<19) enrolled in Medicaid or CHIP

Significance: Oral health care remains the greatest unmet health need for children. Insufficient access to oral health care and effective preventive services affects children’s health, education, and ability to prosper. Monitoring ESM #13.1 (Preventive and any dental services for children enrolled in Medicaid or CHIP) will allow the tracking of progress on NPM #13 for the large number of low-income children enrolled statewide in Medicaid or CHIP.

Data Sources and Data Issues: Annual Center for Medicaid and Medicare Services (CMS) 416 Report

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

13.2.1 Percentage of pregnant women having a dental visit during pregnancy (New Mexico)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Top level: direct services

Service Recipient: Activities directed to families/children/youth

Goal: Through dental education with WIC participants, the goal is to see more women attending a dental visit, of any kind, during pregnancy so as to avoid gum disease development.

Numerator: number of women in WIC attending a dental visit during pregnancy

Denominator: number of pregnant women served by the WIC program

Significance: Pregnancy can affect the dental health of a woman due to rising hormone levels. These changes raise the risk of women developing dental health problems which can, in turn affect the health of the baby in utero. The risks to the baby can include pre-term birth and low birth weight (March of Dimes, 2018). Getting a checkup during pregnancy is safe and important for good oral health of pregnant women and their children. Seeing a provider can take care of cleanings and provide procedures like cavity fillings before the baby is born, a dental visit can help with any pregnancy-related dental symptoms a woman might be experiencing. The American Dental Association, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics all encourage women to get dental care while pregnant.

Data Sources and Data Issues: NM PRAMS and NM DOH Oral Health Surveillance Data

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

13.2.1 Number of oral health pocket guides distributed (Alaska)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase percent of adolescents who have had a preventative dental visit

Numerator: Cumulative number of oral health pocket guides distributed

Denominator: NA

Significance: The Bright Futures Pocket Guide is a resource for all health professionals (medical and dental) that discusses oral health and dental care aspects for pregnant and post-partum women, infants, children and adolescents. The guide highlights the need for early dental visits (within 6 months of the eruption of the first tooth and no later than age 12 months) and aspects for subsequent dental visits, assessment of caries risk, education on factors to reduce risk of early childhood caries, appropriate oral health interview questions and anticipatory guidance/education at each stage for the above populations. The pocket guide information supports provider referral or provision of appropriate preventive dental services.

Data Sources and Data Issues: Alaska Oral Health Program data

Year: 2018/2020

Unit Type: Count, Unit Number: 500

13.2.1 Number of children who received dental sealants in school-based settings through the Idaho Oral Health Program (Idaho)

Measure Status: Active

Measurement Category: Category 3: measuring quantity of effect (# of "is anyone better off")

Service Type: Top level: direct services

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of children who receive dental sealants as a method to reduce dental caries.

Numerator: Number of children who received dental sealants in school-based settings through the Idaho Oral Health Program

Denominator: NA

Significance: Oral health is increasingly recognized as having overall health implications. Research has shown a link to diabetes, heart and lung disease, stroke, respiratory illnesses, and pre-term, low-birth weight infants. Childhood dental disease sets the stage for a lifetime of poor oral health and puts a financial burden on the family. Approximately 19% of Idaho children under the age of 18 experienced a toothache, decayed teeth, or unfilled cavities in the past 12 months, and approximately 20% did not receive any dental care in the past 12 months. Ninety-seven percent of Idaho is designated as a dental health professional shortage area. Because of this lack of access to dental care, it is imperative that the Idaho Oral Health Program continue focus on preventive dental care for children. To address the priority need to improve MCH population access to medical homes and linkage to dental care, the MCH Program will continue to fund the Idaho Oral Health Program’s contracts with the Public Health Districts (PHDs) for dental care among school-age children. In 2014, the PEW Charitable Trusts assigned the state of Idaho an “A” grade for protecting children from tooth decay with the application of dental sealants. Idaho was one of only five states to receive this distinguished grade. According to the Centers for Disease Control and Prevention (2015), dental sealants are a critical preventive dental service and can reduce decay by 60 to 80 percent in two years after application. Further, school-based dental sealant programs are a great way to reach children and result in cost-savings for families. All seven PHDs in Idaho provide dental sealants to elementary school children through School-Based/Linked Dental Sealant Clinics and two annual events focused on the education and application of dental sealants. Along with providing dental sealants, the PHDs also provided oral health screenings, fluoride varnish applications, oral health education, and dental home referrals as needed.

Data Sources and Data Issues: Idaho Oral Health Program

Year: 2018/2020

Unit Type: Count, Unit Number: 5,000

13.2.1 Number of children that receive dental sealants per school year. (North Dakota)

Measure Status: Active

Measurement Category: Category 3: measuring quantity of effect (# of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of children receiving dental sealants through the school-based sealant program.

Numerator: Number of students receiving sealants per school year

Denominator: Not Applicable

Significance: Oral health is a vital component of overall health. People with limited access to preventive oral health services are at greater risk for oral disease. The burden of oral disease is not uniformly distributed throughout North Dakota (ND). Access to oral health services is an ongoing concern and challenge. Vulnerable and underserved populations face a variety of barriers to oral health care including transportation issues, lack of insurance or ability to pay for care, inability to take time off work to go to the dentist or transport their children, limited availability of providers accepting Medicaid and lack of understanding of the importance of good oral health and its impact on overall health. The limited oral public health infrastructure, particularly in rural counties and lower economically impacted state regions, provides limited options for families in need. The existing oral health safety-net facilities are overburdened and cannot take on more patients without expanding their infrastructure. Sealants in childhood are cited as one of the most cost-effective evidence-based practices of reducing the likelihood of tooth decay later in life. The Seal!ND is a program was established in ND in 2008 to increase access to preventive dental care to underserved populations. Public Health Hygienists administer the program and provide oral health screenings, oral health education, dental sealants, and fluoride varnish. Between 2008 and 2015, the Seal!ND program provided preventive oral health services to 2,893 children. The program will continue to expand targeting schools with 40 percent or more students enrolled in a free and reduced-fee lunch program.

Data Sources and Data Issues: North Dakota Department of Health – Oral Health Program – Seal!ND School-based Sealant Program Database. Note: The data is collected based on the school year (August through July).

Year: 2018/2020

Unit Type: Count, Unit Number: 1,995

13.2.1 Number of children and youth provided with preventive oral health services through a SBHC. (District of Columbia)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Top level: direct services

Service Recipient: Activities directed to families/children/youth

Goal: To increase oral health referrals among children and youth through the SBHCs. Increase SBHC oral health education and referrals for children and youth.

Numerator: Number of children and youth provided with preventive oral health services through a SBHC.

Denominator: N/A

Significance: Oral healthcare remains the greatest unmet health need among youth. Insufficient access to oral health care and effective preventive services affects children’s health, education, and ability to prosper. Early dental visits teach children the importance of dental health, and increase the likelihood that they will seek dental care proactively throughout life. Adult family members who receive regular oral health care are more likely to take their children to a dentist and teach them appropriate health behaviors at home. Additionally, adults that seek regular oral health care are less likely to transmit tooth decay bacteria to their children. State Title V Maternal Child Health programs have long recognized the importance of improving the availability and quality of oral health services for children and their families. States monitor and guide service delivery to assure that all children have access to preventive oral health services. Strategies for promoting oral health include increasing the capacity of State oral health programs to provide school-based preventive services, monitor oral health epidemiologic trends, and implement programs that enhance the dental healthcare system. Here is an update for the data passage using the FY 2015 CMS-416 data: Oral Health: During Fiscal Year 2015, 59% of children ages 3-9 years that were enrolled in Medicaid for 90 or more continuous days received preventive dental care. Utilization was 51% among such children 10-18 years of age, however only 17% of enrolled children under 3 years of age utilized preventive dental services.

Data Sources and Data Issues: 1. DOH Oral Health Program 2. District of Columbia School Based Health Centers

Year: 2018/2020

Unit Type: Count, Unit Number: 100,000

13.2.2 Percentage of children who received a consent form for the MDPH SEAL program who were screened by one of the program dental hygienists. (Massachusetts)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percent of children receiving oral health care in schools.

Numerator: Number of children who were screened by an MDPH SEAL dental hygienist

Denominator: Number of children who received a consent form for the SEAL program

Significance: The MDPH SEAL program is a school-based sealant program in which dental hygienists use portable dental equipment to provide screenings, education, dental sealants and fluoride, as well as referrals to a dental home, for children in need of restorative services. The rules and regulations governing the practice of dentistry in the Commonwealth (August 20, 2010) allow for a registered dental hygienist practicing in a public health setting to provide dental hygiene services, including placement of sealants, without first having a dentist examine the patient. This ESM is supported by evidence from the Strengthen the Evidence for Maternal and Child Health Programs review of NPM 13B that was completed in August 2017. The review found that there was moderate evidence of effectiveness of school-based oral health interventions. Two studies that focused on access to school-based oral health care (e.g., screening and referral) were: - Kaplan DW, Brindis CD, Phibbs SL, Melinkovich P, Naylor K, Ahlstrand K. A comparison study of an elementary school-based health center: effects on health care access and use. Arch Pediatr Adolesc Med. 1999;153(3):235-243. - Chalmers D. An enhanced screening and referral program: a community dental hygiene pilot project. Probe. 2003;37(1):35-37.

Data Sources and Data Issues: MDPH SEAL database. Data is collected by dental hygienists on site and enter into an Access database. Consent forms are distributed to all schools who agree to participate in the program. Whether or not schools participate is determined by the school district and whether or not there are other sealant programs in those areas. Some schools only distribute consent forms to certain grades, which is determined by the school administration.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

13.2.2 Number of oral health promotion activities conducted within the year to promote the importance of oral and general health. (New Mexico)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: The goal is to increase the exposure that children and pregnant women in New Mexico have to education on the importance of dental health.

Numerator: Number of dental health promotion activities done through the NM DOH Office of Oral Health

Denominator: 100

Significance: Being informed about health issues relating to pregnancy will help women to make informed choices about their health and the health of their children. Oral health education teaches skills for good oral hygiene in order to prevent oral diseases and other dental problems. Oral health is important to the overall health and the well-being of infants, children, adolescents and adults. Oral health promotion covers a range of health promotion and disease prevention concerns, including dental caries; periodontal (gums) health; proper development and alignment of facial bones, jaws, and teeth; other oral diseases and conditions; and trauma or injury to the mouth and teeth. Promoting oral health includes integrating chronic diseases as they relate to general health. The oral health promotion campaign will be designed to target New Mexico residents.

Data Sources and Data Issues: NM DOH Office of Oral Health

Year: 2018/2020

Unit Type: Count, Unit Number: 100

13.2.2 Number of children ages 1-17 years receiving preventive dental care from a dentist. (District of Columbia)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Top level: direct services

Service Recipient: Activities directed to families/children/youth

Goal: Increase oral health prevention among children between the ages of 1-13 years.

Numerator: Number of children ages 1-13 years receiving preventive dental care from a dentist.

Denominator: N/A

Significance: Oral healthcare remains the greatest unmet health need among youth. Insufficient access to oral health care and effective preventive services affects children’s health, education, and ability to prosper. Early dental visits teach children the importance of dental health, and increase the likelihood that they will seek dental care proactively throughout life. Adult family members who receive regular oral health care are more likely to take their children to a dentist and teach them appropriate health behaviors at home. Additionally, adults that seek regular oral health care are less likely to transmit tooth decay bacteria to their children. State Title V Maternal Child Health programs have long recognized the importance of improving the availability and quality of oral health services for children and their families. States monitor and guide service delivery to assure that all children have access to preventive oral health services. Strategies for promoting oral health include increasing the capacity of State oral health programs to provide school-based preventive services, monitor oral health epidemiologic trends, and implement programs that enhance the dental healthcare system. Here is an update for the data passage using the FY 2015 CMS-416 data: Oral Health: During Fiscal Year 2015, 59% of children ages 3-9 years that were enrolled in Medicaid for 90 or more continuous days received preventive dental care. Utilization was 51% among such children 10-18 years of age, however only 17% of enrolled children under 3 years of age utilized preventive dental services.

Data Sources and Data Issues: 1. DOH Oral Health Program

Year: 2018/2020

Unit Type: Count, Unit Number: 14,000

13.2.4 Number of students who have received oral health education through the programs facilitated by the NM Office of Oral Health (New Mexico)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: To ultimately increase the number of adolescents that attend a dental visit in the past year by providing health education on oral health directly to adolescents.

Numerator: The number of students in attendance at health education presentations given through the NM Office of Oral Health

Denominator: Total number of students that could receive an oral health training by the NM Office of Oral Health

Significance: To improve the oral health status of children they should understand the importance of good oral hygiene, seeing a dental provider, eating healthy and reduce those risk factors that develop poor oral health. Educating children and adults will improve their oral health literacy; and implement good oral health and eating habits and impacting the use of tobacco and other risk factors.

Data Sources and Data Issues: NM DOH Office of Oral Health Program

Year: 2018/2020

Unit Type: Count, Unit Number: 100,000

   

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.