142nd APHA Annual Meeting and Exposition

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300037
Evaluation of a School-Based Solution to Improve Oral Health for High Risk Children

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Rebecca Dudovitz, MD, MSHS , Department of Pediatrics, University of California Los Angeles, Los Angeles, CA
Maryjane Puffer, BSN, MPA , The Los Angeles Trust for Children's Health, Los Angeles, CA
Daniel Romo, DDS , Pediatric Dentistry, Eisner Pediatric & Family Medical Center, Los Angeles, CA
Gloria Espinosa, RN, BSN, MEd , District Nursing Services, Los Angeles Unified School District, Los Angeles, CA
Roberta Villanueva, RN, CPNP, MSN, MAEd , District Nursing CHDP Programs, Los Angeles Unified School District, Los Angeles, CA
Jonathan Valiente, BS , Department of Pediatrics, University of California Los Angeles, Los Angeles, CA
Paul J. Chung, MD, MS , Departments of Pediatrics and Health Policy & Management, UCLA Schools of Medicine and Public Health, Los Angeles, CA
Introduction: Dental caries disproportionately affect low-income minority children, contributing to chronic disease and school absenteeism. To address this disparity, the Los Angeles Trust for Children’s Health piloted a universal school-based oral health screening and fluoride varnishing program in two public elementary schools serving low-income children.

Objectives: To assess program effectiveness and financial sustainability.

Methods: Parent consent was obtained, along with surveys examining demographics, access to dental care, and beverage consumption. Each school hosted a screening event in two successive school years. At each event, students received oral health education, a pediatric dentist screening exam, and fluoride varnishing. Program costs and reimbursements were tracked. We used t-tests to compare means across groups.

Results: Overall, 1,025 students (76%) participated at least once. In year 1, 570 participated; in year 2, 455 newly participated and 289 (51% of year 1 participants) repeated. At their first screening, 75% of students had Medicaid, 9% were uninsured, 62% had seen a dentist in the previous 6 months, 89% had consumed sugar-sweetened beverages in the previous 7 days, and 31% drank fluoridated water. Over 64% had an abnormal screening exam and 6% needed emergent dental care. On average, the year 1 students who participated again in year 2 had improved exams, with 2.2 additional fillings noted (p<.001). Actual costs were $8.22/child. Medicaid reimbursed care for 44% of students, which subsidized the entire program.

Conclusions: Universal school-based screening and varnishing improved oral health for low-income students with high burdens of dental disease and appears financially sustainable.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Identify key components of a public health approach to school based oral health services. Describe the population served by a Los Angeles universal school-based oral health program. Design an oral health program that can be both effective and financially sustainable in a school setting.

Keyword(s): Oral Health, Community-Based Partnership & Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a principal investigator or co-investigator on multiple projects in the areas of school-based health and child health prevention. Among my interests is developing strategies to harness the school environment for child health promotion and the delivery of health services that support school function, including oral health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3100.0: Positive Healthography: Access to Oral Health Care