Re: Health Through Oral Health : Guidelines For Planning And Monitoring For Oral Health Care By C Ross;
Toccara Delacerda
The challenges to the dental profession include the unemployed dentists, the radical changes to the numbers of dental schools and their intake of new students; and the imbalance which exists on a global scale between oral health personnel and service need and demand. Workforce planning needs clearly defined goals which relate to the nature of disease, the shift from treatment to prevention and consumer expectations. A wide variety of information is required to facilitate communication and co-operation with elements of the political system, the educational system, professional bodies, health service agencies and consumers. It is essential that national planning and monitoring groups be established with membership from dental associations, educational institutions and government. In workforce planning there must be the ability to accept change, to be creative, to be positive, and to be decisive.
Health through oral health : guidelines for planning and monitoring for oral health care by C Ross;
Download Zip https://miimms.com/2yUGwW
Increasing disease rates, limited funding, and the ever-growing scientific basis for intervention demand the use of proven strategies to improve population health. Public health practitioners must be ready to implement an evidence-based approach in their work to meet health goals and sustain necessary resources. We researched easily accessible and time-efficient tools for implementing an evidence-based public health (EBPH) approach to improve population health. Several tools have been developed to meet EBPH needs, including free online resources in the following topic areas: training and planning tools, US health surveillance, policy tracking and surveillance, systematic reviews and evidence-based guidelines, economic evaluation, and gray literature. Key elements of EBPH are engaging the community in assessment and decision making; using data and information systems systematically; making decisions on the basis of the best available peer-reviewed evidence (both quantitative and qualitative); applying program-planning frameworks (often based in health-behavior theory); conducting sound evaluation; and disseminating what is learned.
The formal training of the public health workforce varies more than training in medicine or other clinical disciplines (6). Fewer than half of public health workers have formal training in a public health discipline such as epidemiology or health education (7). No single credential or license certifies a public health practitioner, although voluntary credentialing has begun through the National Board of Public Health Examiners (6). The multidisciplinary approach of public health is often a critical aspect of its successes, but this high level of heterogeneity also means that multiple perspectives must be considered in the decision-making process.
Federal funding in states, cities, and tribes, and in both urban and rural areas, creates an expectation for EBPH at all levels of practice. Because formal public health training in the workforce is lacking (7), on-the-job training and skills development are needed. The need may be even greater in local health departments, where practitioners may be less aware of and slower to adopt evidence-based guidelines than state practitioners (16) and where training resources may be more limited.
Community Health Assessment and Group Evaluation (CHANGE) Tool and Action Guide (www.cdc.gov/healthycommunitiesprogram/ tools/change.htm). Developed by the Centers for Disease Control and Prevention (CDC), this tool focuses on assessment and planning. It provides Microsoft Excel (Microsoft, Redmond, Washington) templates for collecting data in 5 sectors: community-at-large, community institutions/organizations, health care, school, and worksite. It is recommended for prioritizing action planning and tracking annual progress in key policy and environmental strategies.
YMCA Community Healthy Living Index (www.ymca.net/communityhealthylivingindeX). This site provides assessment tools and planning guides for 6 key community settings: after-school child care sites, early childhood programs, neighborhoods, schools, worksites, and the community at large.
Behavioral Risk Factor Surveillance System (BRFSS) (www.cdc.gov/brfss). BRFSS tracks health conditions and risk behaviors annually, using a standard core questionnaire that allows state-specific data to be compared across strata. An interactive menu generates prevalence and trend data by age, sex, race/ethnicity, education, and income level. The SMART (Selected Metropolitan/Micropolitan Area Risk Trends) project provides local data for selected cities and counties.
CDC WONDER ( ). CDC WONDER (Wide-ranging Online Data for Epidemiologic Research) provides a single point of access to public health surveillance data and a wide variety of CDC reports, guidelines, and reference materials. Data sets available for query include mortality, natality, cancer incidence, HIV/AIDS, and more.
Guide to Community Preventive Services (the Community Guide) (www.thecommunityguide.org). The Task Force on Community Preventive Services has systematically reviewed more than 200 interventions to produce evidence-based recommendations on population-level interventions. Topics currently include adolescent health, alcohol, asthma, birth defects, cancer, diabetes, health communication, health equity, HIV/AIDS, sexually transmitted infections and pregnancy, mental health, motor vehicle injury, nutrition, obesity, oral health, physical activity, the social environment, tobacco use, vaccines, violence, and worksite health.
The Mississippi State Department of Health (MSDH) sponsored an EBPH course, led by faculty from the Prevention Research Center in St. Louis (PRC-StL), for state leaders in July 2010. In April 2011, the course was expanded to local public health districts. At a pre-course workshop, the Southwest District health officer explained the importance of evidence-based community interventions and the role of the health department in community assessment, interventions, and policy. The course itself was taught to 26 local practitioners by instructors from MSDH and PRC-StL. In May 2011, MSDH repeated the course, taught entirely by MSDH staff, in McComb, Mississippi. MSDH included the EBPH model in grant applications to the Coordinated Chronic Disease Program and the Community Transformation Grants program, both initiated by the Centers for Disease Control and Prevention. MSDH offered $15,000 to $26,000 mini-grants to support the development of evidence-based action planning in such areas as physical activity, joint-use agreements, smoke-free municipalities, and healthy corner stores.
In 2006, with support from National Institutes of Health, experts from the fields of medicine, nursing, public health, social work, psychology, and library sciences formed the Council for Training in Evidence-Based Behavioral Practice. This group produced a transdisciplinary model of evidence-based practice that facilitates communication and collaboration (Figure) (2,4,5,24) and launched an interactive website to provide web-based training materials and resources to practitioners, researchers, and educators. The EBBP Training Portal, available free with registration, offers 9 modules on both individual and population-based approaches. Users learn how to choose effective interventions, evaluate interventions that are not yet proven, engage in decision making with others, and balance the 3 domains of evidence-based decision making (Figure).
Other data collection methods can be tailored to describe the particular needs of a community, creating new sources of data rather than relying on existing data. Telephone, mail, online, or face-to-face surveys collect self-reported data from community members. Community audits involve detailed counting of factors such as the number of supermarkets, sidewalks, cigarette butts, or health care facilities. For example, the Active Living Research website (www.activelivingresearch.org) provides a collection of community audit tools designed to assess how built and social environments support physical activity.
Once health needs are identified through a community assessment, the scientific literature can identify programs and policies that have been effective in addressing those needs. The amount of available evidence can be overwhelming; practitioners can identify the best available evidence by using tools that synthesize, interpret, and evaluate the literature.
Systematic reviews (Box 1) use explicit methods to locate and critically appraise published literature in a specific field or topic area. The products are reports and recommendations that synthesize and summarize the effectiveness of particular interventions, treatments, or services and often include information about their applicability, costs, and implementation barriers. Evidence-based practice guidelines are based on systematic reviews of research-tested interventions and can help practitioners select interventions for implementation. The Guide to Community Preventive Services (the Community Guide), conducted by the Task Force on Community Preventive Services, is one of the most useful sets of reviews for public health interventions (27,28). The Community Guide evaluates evidence related to community or population-based interventions and is intended to complement the Guide to Clinical Preventive Services (systematic reviews of clinical preventive services) (29).
Not all populations, settings, and health issues are represented in evidence-based guidelines and systematic reviews. Furthermore, there are many types of evidence (eg, randomized controlled trials, cohort studies, qualitative research), and the best type of evidence depends on the question being asked. Not all types of evidence (eg, qualitative research) are equally represented in reviews and guidelines. To find evidence tailored to their own context, practitioners may need to search resources that contain original data and analysis. Peer-reviewed research articles, conference proceedings, and technical reports can be found in PubMed (www.ncbi.nlm.nih.gov/pubmed). Maintained by the National Library of Medicine, PubMed is the largest and most widely available bibliographic database; it covers more than 21 million citations in the biomedical literature. This user-friendly site provides tutorials on topics such as the use of Medical Subject Heading (MeSH) terms. Practitioners can freely access abstracts and some full-text articles; practitioners who do not have journal subscriptions can request reprints from authors directly. Economic evaluations provide powerful evidence for weighing the costs and benefits of an intervention, and the Cost-Effectiveness Analysis Registry tool (Box 1) offers a searchable database and links to PubMed abstracts.
aa06259810