PHE 425 Module 5 Milestone Two Example

What 247 Parents Told Us: A Needs Assessment for a School Sealant Program on the Cumberland Plateau

[Student Name]

Southern New Hampshire University

PHE 425: Programming Planning in Public Health

Final Project Milestone Two

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

What 247 Parents Told Us: A Needs Assessment for a School Sealant Program on the Cumberland Plateau

Milestone One named unfilled cavities in the county's grade-school children as the health issue and second and sixth graders as the priority population. This milestone asks what those children and their families need from a program, what stands in the way and what the community already has to build on. It combines existing data with a parent survey and interviews, follows the needs assessment logic of PRECEDE-PROCEED (Green & Kreuter, 2005) and ends with measurable objectives.

Methods

Secondary data came from last spring's school screening, county hospital records of emergency visits for dental pain and the health department's survey of local dentists. Primary data came from two sources. A one-page survey went home with all 604 second and sixth graders, in paper form and as a link in the school's text message system; 247 families returned it, a response of 40.9%. Six key informants were interviewed for about thirty minutes each: the school nurse, two principals, the public health hygienist, the one local dentist who takes Medicaid, and a pastor whose church runs a food pantry. Survey questions were written to capture the health belief model's constructs (Janz & Becker, 1984), such as whether parents think back teeth matter and what makes saying yes hard.

Survey Findings

Table 1 summarizes the parent survey.

Table 1. Parent survey results (n = 247)

Note. Percentages use all 247 returned surveys as the denominator.

The most striking result is the gap between willingness and action. More than three in four parents would agree to school sealants, yet last year's pilot received consent for fewer than four in ten children. Among the 64 survey respondents from the pilot school, 29 (45.3%) said they never saw the form. The barrier is less refusal than a form that does not reach parents, or asks for information they hesitate to give.

Interview Findings

The interviews explained the numbers. The school nurse said forms sent in backpacks often never leave the classroom floor and that parents call her with questions they would not write down. Both principals offered space and class time but asked that visits avoid testing weeks. The hygienist said she could seal about 25 children a day with portable equipment and a dental assistant, and needed a second set of equipment to work two schools at once. The Medicaid dentist said she could reserve two half-days a month for children referred from school, but only if referrals came with screening notes. The pastor said trust is built through people families already know, and offered to announce the program at services.

Community Assets

The county has more to build on than its shortage of dentists suggests. Assets include a nurse whom parents trust, supportive principals, a hygienist already employed by the health department, a school text system that reaches most families, a dentist willing to reserve time, churches that reach families outside school and a county commission interested in children's teeth. Recognizing assets matters because a program built on them is more likely to last.

Ranking the Needs

Needs were ranked by how much they contribute to the problem and how easily a program can change them, as in Table 2.

Table 2. Needs ranked by importance and changeability

Note. Ranks reflect both columns.

The ranking confirms the direction from Milestone One. Gooch et al. (2009) found school programs to be an effective way to deliver sealants to children who might not otherwise receive them, and supported sealing even when follow-up cannot be guaranteed, which suits families who move often. Griffin et al. (2016) estimated millions of low-income children could benefit from such programs; the county's survey suggests most of its families want one.

What the Assessment Changed

Before the assessment, the plan assumed that the main need was parent education about sealants. The data shifted the emphasis. Most parents already value sealants; what they lack is a form that reaches them, asks for little and can be answered from a phone. The interviews also added a need the plan had not considered: children found with decay at school need a path to treatment, or the program will find problems it cannot fix. Education remains, but as a short message on the form and a word from the nurse, not as a separate campaign. The assessment also changed the order of schools. The two outlying schools, with the highest decay and the lowest pilot consent, will be served first, and the pastor's offer gives the program a way to reach their families outside school hours.

SMART Objectives

The needs translate into four objectives, each naming a group, a measure, a realistic target and a deadline.

Table 3. Program objectives

Note. Baselines come from last spring's screening.

Limitations

About six in ten families did not return the survey, and those who did may be more engaged with school than those who did not, so the results may overstate willingness. The next milestone will plan consent outreach that reaches families who did not answer.

Interviews also reflect six voices only, and a later round should include parents who declined last year.

References

Gooch, B. F., Griffin, S. O., Gray, S. K., Kohn, W. G., Rozier, R. G., Siegal, M., Fontana, M., Brunson, D., Carter, N., Curtis, D. K., Donly, K. J., Haering, H., Hill, L. F., Hinson, H. P., Kumar, J., Lampiris, L., Mallatt, M., Meyer, D. M., Miller, W. R., . . . Zero, D. T. (2009). Preventing dental caries through school-based sealant programs: Updated recommendations and reviews of evidence. Journal of the American Dental Association, 140(11), 1356-1365. https://doi.org/10.14219/jada.archive.2009.0070

Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill.

Griffin, S. O., Wei, L., Gooch, B. F., Weno, K., & Espinoza, L. (2016). Vital signs: Dental sealant use and untreated tooth decay among U.S. school-aged children. MMWR Morbidity and Mortality Weekly Report, 65(41), 1141-1145. https://doi.org/10.15585/mmwr.mm6541e1

Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47. https://doi.org/10.1177/109019818401100101