An Innovative Multi-Strategy Children's Oral Health Community Program in Ontario: A Program Planning and Evaluation Framework

Background: Oral health is associated with physical, psycho-social and economic outcomes across the lifespan and plays a key role in oral-systematic health (i.e. low birth weight, maternal transmissibility, chronic diseases). The provincially-funded Healthy Smiles Ontario program, part of the Ontario Poverty Reduction Strategy, aims to increase access to oral health care (0-17 years) and reduce inequities and economic burden. Purpose: To describe the development of a community-orientated children's oral health program and its evaluation framework. Methods: A modified situational analysis examined need, impact, assets and barriers to delivering oral health care among children. A population health approach guided program planning activities. Results: Strategies include health promotion; outreach/marketing; professional development; clinical services; and community engagement. A logic model connected strategies, target populations, activities, outcomes and goals. Key activities include outreach/referral networks with agencies; a mail-out promotion campaign to identified high-risk neighbourhoods; collaborations with key community partners (i.e. Food Bank; Library; Women's Shelter); skill-building and training among providers; and dental assessments/referrals/treatment services. The evaluation design utilizes quantitative and qualitative methodologies and various sources of data, including program documentation, surveys, key informant interviews, focus groups, and re-imbursement claims. Conclusion: Strategies employed facilitate the infrastructure and supportive environments needed to empower parents/caregivers to make informed oral health decisions. Evaluative feedback loops will inform the implementation phase and provide accountability to activities and outcomes. Continuing community engagement efforts will ensure the program is accepted, tailored and meets community needs. Effective public health efforts are imperative in improving oral health and reducing associated morbidity.