Evaluation of the Smiles across Greater Missouri – 2006-07: Oral Health Education

Objective: To create an evaluation structure for grantees implementing oral health education programs as part of the Smiles across Greater Missouri program, funded by the Missouri Foundation for Health (MFH).

Methods: The program charged grantees to target underserved populations, focusing on children in 3rd and 6th grade, providing dental screenings, education, referrals if needed, and sealants. The evaluation structure used qualitative instruments (open-ended questionnaires, interviews of key stakeholders) and quantitative instruments (minimum data sets, interim reports). Changes in knowledge were assessed using pre-post questionnaires.

Results: There were a total of six grantees, comprised of two County Health Departments, three Community Health Centers, and one Health Agency. A total of 7,027 children participated in the oral health education efforts; the total number of participating adults was difficult to ascertain. The focus of education included dental sealants, brushing techniques, oral hygiene, need for regular preventive care, and reducing soda and sugar consumption.

Discussion: The challenges to evaluation included assessing quality of message delivery and short-term and long-term outcomes. Behavioral change as a result of dental health message was not directly measured. The cost of evaluating the structure, process and outcome of public health education efforts would require a budget greater than the programs themselves. The challenges are compounded as dental caries is multi-factorial in etiology.

Conclusions: There are numerous challenges to measuring outcomes when promoting health education where the relatively slow disease process requires long-term monitoring. New methods need to be explored to monitor oral health education programs.