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Dental Public Health Activities: Descriptive Summaries

Oral Health Coalitions: Connecting People and Systems to Influence Oral Health Outcomes

Practice Number: 38009
Submitted By: Oral Health Ohio
Submission Date: December 2019
Last Reviewed: February 2020
Last Updated: February 2020
Best Practice Approach Example Oral Health Coalitions: Connecting People and Systems to Influence Oral Health Outcomes
 

State oral health coalitions can be powerful influencers of system and structural change to improve oral health outcomes.  Partnerships with diverse stakeholders drive this influence.   Many of our partners include agencies, organizations and other coalitions that have broad membership and constituent reach.  For example, 12 health centers in Ohio were awarded HRSA dental expansion grants.  Oral Health Ohio sent this information out to partners such as Ohio Head Start, Ohio Association of Community Action Agencies, Charitable Healthcare Network, Ohio Department of Aging and Ohio Association of Health Commissioners to push out to their members/constituents to inform them of expansion of dental care in their communities.  Another example is that the Ohio Department of Medicaid recently made policy changes around reimbursement of age one dental visits.  We pushed this information out to the American Academy of Pediatrics, Ohio Chapter and Ohio Head Start, Early Head Start program.  Another example is that OHO developed a section on its website for school nurses .  Our partners at the Ohio Department of Health, School Nurse Program and Ohio Association of School Nurses pushed this information out statewide in their newsletters.  Our work consists of:

  • Building relationships with communities to identify their unique challenges and resources around oral/health.
  • Facilitating broad community engagement to address complex issues that lead to system action
  • Connecting people and systems to influence oral health outcomes
  • Messaging that oral health is overall health
  • Ensuring that professionals in a wide variety of disciplines have access to oral health training and resources
  • Identify opportunities to institutionalize equity in the oral/health system. 

OHO’s Oral Health Ohio’s strategic plan drives the work we do in Ohio.  Diverse stakeholders at the grassroots and state level helped develop this plan by attending a yearlong strategic planning process held by a professional facilitator paid for by HealthPath Foundation, OHOs fiscal agency.   The strategic planning meetings were held in Columbus, Ohio which is a central location to the different regions of Ohio.  It is through diverse relationships and partnerships that OHO is able to frame the narrative around oral health as being much more than access to a dentist. Our impact comes from ensuring that oral health is part of the conversation around overall health, social determinants of health, mental health, workforce, and the economy.

Pilot study partnerships provide opportunities to raise issues through data to the forefront of policymakers. For example, data from Ohio Head Start Program Information Report (PIR) showed that the number one reason that children did not receive needed follow-up dental care was due to a lack of caregiver follow-up.  Oral Health Ohio partnered with the Ohio Head Start Association, Inc., (OHSAI) to better understand the reason for this data point through a statewide survey with HS programs.  From this survey we were able to capture the number of children who were identified as needing follow-up dental care and did not receive it.  Oral Health Ohio presented the data to the monthly provider meeting at the Ohio Department of Medicaid (ODM).  Included in this presentation were the survey results by county, need for greater engagement from the managed care organizations (MCOs) and upstream prevention strategies to connecting HS children to care.  Three things came from this meeting:  1) The Ohio Department of Medicaid requested that OHO present the data to the dental directors of all the managed care plans.  This meeting is being scheduled for March 2020.  Oral Health Ohio has invited OHSAI, a local HS program and the Ohio Department of Health (ODH), Oral Health Program to co-present at this meeting.  2) This data was presented to the top leadership at ODM including the Medical Director and Assistant Medical Director so this is now on their radar and 3) Oral Health Ohio,  ODH  Oral Health Program and OHSAI are working together to develop a consent process within the HS program to get caregiver consent for programs to contact the MCO when follow-up treatment is needed.   

Another pilot was born out of the Ohio PIR data/statewide survey.   Head Start programs provided feedback to OHO that oral health literature provided by insurance companies showed pictures of white children with “perfect, shiny” white teeth and that these pictures did not reflect the demographics of the children in their programs.  The HS programs also believed that caregivers needed to see what severe tooth decay looks like and that caregivers did not understand the importance of primary teeth due to low health literacy.   As a result, OHO partnered with Alta Head Start in Youngstown, OH in the spring of 2019 to develop a flyer to attach to dental exams where children need follow-up care.  The flyer includes pictures of children from minority groups with tooth decay and bullet points about the importance of primary teeth.  Alta Head Start saw a 14% increase in follow-up treatment among caregivers the first few weeks of using the flyer.  The Ohio Head Start Association, Inc., recently scaled the one-page flyer statewide and will follow-up to determine how many programs are using the flyer and outcomes.  

OHO’s partnership with Head Start (HS) to collect data on untreated caries among the HS population has enabled OHO to engage Medicaid Managed Care Organizations (MCOs) and the Ohio Department of Medicaid (ODM) on the state of oral health for these children in a specific and meaningful way.  With MCO, ODM and HS engagement, we are working toward creative solutions and outcomes for these children including upstream prevention by MCOs.

OHO has taken the lead on work that the state oral health program (SOHP) does not currently have capacity to do including Basic Screening Survey BSS of Older Adults, developing a State Oral Health Plan  and advocating for a Dental Director.  OHO took a leadership role in the development of the State Oral Health Plan by convening stakeholders on its own strategic process then writing a draft Plan which was shared with stakeholders for comment.  OHO presented a  “preview” of the State Oral Health Plan at a legislative breakfast at the statehouse for Children’s Dental Health month in February.  The preview Plan was also shared widely.  The full Plan will be released in late Spring 2020. OHO has a close working relationship with the Ohio Department of Health, Oral Health Program and relies on their expertise and input on all of these activities and many of the coalition’s other activities.

Finally, OHO seeks grant opportunities to improve oral health in Ohio and is currently waiting to hear from two grant proposals for funding in 2020 totaling $433,000.  Both proposals will allow OHO to build new and diverse relationships and partnerships throughout Ohio and work with national l organizations and partners in other states. 

Lessons Learned:

  • SHOW UP, SPEAK UP and FRAME THE NARRATIVE!!!
  • We need advocates across disciplines to advocate for oral and overall health.  It is not enough to hear from the state oral health coalition and oral health providers.  We need these other voices to be part of work and advisory groups. 
  • To influence systems, you must understand the system and leverage points that can be catalysts for change.

Contact Person(s) for Inquiries:

Marla Morse, Program Director, Oral Health Ohio, 720 E. Pete Rose Way, Cincinnati, OH 45202, Phone: 513-768-6137, Email: marla.morse@oralhealthohio.org

Eric DeWald, President, HealthPath Foundation, 720 E. Pete Rose Way, Cincinnati, OH 45202, Phone:513-768-6128, Email: eric.dewald@healthpathohio.org

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