142nd APHA Annual Meeting and Exposition

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303187
Strengthening Early Childhood Systems by Integrating Community Oral Health Coordination (COHC) Competencies into Home Visitation (HV) Curriculum in South Carolina

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 12:30 PM - 12:50 PM

Amy B. Martin, DrPH , Division of Population Health, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC
Mary Kenyon Jones , SC Dental Association and SC Department of Health and Environmental Control, Columbia, SC
Christine Veschusio , SC Rural Health Research Center, University of South Carolina, Arnold School of Public Health, Columbia, SC
Joni Nelson , SC Rural Health Research Center, University of South Carolina, Arnold School of Public Health, Columbia, SC
Background: The Maternal, Infant, and Early Childhood Home Visitation (MIECHV) program, authorized in the Social Security Act (Title V) and amended in healthcare reform, calls for improved care coordination and outcomes for high-risk families. Oral health is not addressed, despite detrimental evidence of early childhood caries. Many states espouse a COHC workforce model whereby an individual provides dental-related case management services. We are testing an alternative model, integrating COHC competencies into job descriptions of home visitors (HVs), rather than creating new workforce models. 

Study Purpose: Examine the degree to which integrating COHC competencies into HV curricula improve preventive dental service utilization and parents’ efficacy with infant and toddler mouth care.

Methods: We used the Institute for Healthcare Improvement’s Breakthrough Series to facilitate integration of COHC competencies and activities into HV curricula. We piloted the enhanced curricula with 12 HVs and 250 cases in a rural community health center. Outcomes include receipt of risk-based fluoride varnish, preventive dental visits by first birthday, parent-reported self-efficacy improvements with daily infant/toddler oral hygiene and oral literacy.  We are using Medicaid claims data and program data to assess outcomes; and Photovoice to assess HVs’ and parents’ experiences with coordinating/accessing preventive oral health services, and how the COHC approach has impacted parental efficacy.

Significance: Data will be analyzed by August 2014.  We will expand the COHC model statewide and demonstrate how COHC competencies be adopted among MIECHV grantees nationally. This approach may alleviate some workforce sustainability concerns and facilitate medical-dental integration for early childhood systems.

Learning Areas:

Other professions or practice related to public health
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe how one state strengthened early childhood systems by integrating community oral health coordination competencies into national maternal, infant, and early childhood home visitation curricula used by existing care coordinators in a community health center. Discuss the impact the approach has had on families, existing care coordinators, and the early childhood system. Discuss opportunities for replication among maternal, infant, and early childhood home visitor programs nationally.

Keyword(s): Child Health, Oral Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Martin is Deputy Director of SC Rural Health Research Center, Arnold School of Public Health at the University of South Carolina. Her research foci are vulnerable populations, access to care, and oral health with an emphasis on rural healthcare and public health systems. Dr. Martin holds Doctor and Masters of Science in Public Health degrees. She was a recipient of the National Institutes of Health Loan Repayment Award for her health disparities research.
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.