PHE 425 Module 6 Milestone Three Example

From Signed Form to Sealed Molar: Theory, Strategies and the First-Year Plan for the County School Sealant Program

[Student Name]

Southern New Hampshire University

PHE 425: Programming Planning in Public Health

Final Project Milestone Three

[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.

From Signed Form to Sealed Molar: Theory, Strategies and the First-Year Plan for the County School Sealant Program

Milestone Two found that most parents want sealants for their children but that consent forms fail to reach them or ask for details they hesitate to give, and that children found with decay need a route to treatment. This milestone sets out the theory behind the program's response, the strategies that follow from it and a practical plan for the first school year.

Theoretical Framework

Two frameworks work together. The health belief model explains the single decision the program depends on, a parent saying yes, by asking whether parents see the risk as real and serious, judge the gains worth the trouble, meet a prompt at the right moment and feel able to act (Janz & Becker, 1984). The ecological model reminds planners that this decision sits inside a school, a community and a set of policies that can make it easier or harder (McLeroy et al., 1988). The first framework shapes what the program says to parents; the second shapes where and how the program works.

Strategies Mapped to Theory

Every strategy in the plan answers a construct or a level of influence identified in the assessment, as Table 1 shows.

Table 1. Strategies, constructs and levels

Note. Each strategy links to a finding from Milestone Two.

Staffing and Capacity

The program will be run by the health department's hygienist, a second hygienist at half time and a full-time dental assistant, with the school nurse as the link to families. Working in two teams, the staff can seal about 25 children a day per team. At the target consent rate of 65%, about 390 of the 604 second and sixth graders will take part, which means roughly eight team-days per round. Hygienists will check teeth visually, clean surfaces with a toothbrush and seal sound molars and those with early, noncavitated lesions, without requiring x-rays, as Gooch et al. (2009) recommended for school programs. Children with cavities will receive a referral.

Schedule

The schedule serves the two outlying schools first, where decay was highest, and avoids state testing weeks, as principals asked.

Table 2. First-year schedule

Note. Dates avoid testing windows at all six schools.

Partners and Roles

The school district provides space, the text system and nurse time. The Medicaid dentist reserves two half-days a month for referred children. The pastor and two other churches announce consent dates and host one evening session for questions. The county commission funds equipment. The regional nonprofit's dental van, which serves mainly adults, agreed to take referred children on its spring visit. Each partner's role is written into a one-page agreement so that commitments survive staff changes.

First-Year Budget

Table 3 sets out the year-one budget.

Table 3. Year-one budget

Note. The first hygienist is already funded; Medicaid billing will offset part of the cost.

Fitting the Program to Families

The assessment showed that trust runs through people families already know, so the program's messages will come from the school nurse, teachers and pastors rather than from the health department alone. The form will use short words and short sentences, tested with five parents before it goes out and printed with the school's logo, not the health department's. Children will bring home a sticker and a short note after sealing, so parents see that the visit happened. The program will never ask families for immigration or income details, and the insurance question will be optional, with the health department billing Medicaid only when a number is given.

Sustaining the Program

The grant covers two years, so sustainability is planned from the start. Medicaid billing for sealants placed at school is expected to cover a growing share of staff costs as consent rises. The county commission has been asked to fold the equipment into the health department's capital plan, and the school district will include the program in its annual health services agreement. If the year-two results meet the impact objective, the department will seek to add first and fifth graders who missed earlier rounds.

Obstacles and Fallback Steps

Three obstacles are likely. If consent stays below 50% after the second wave, the nurse will phone families who have not answered, starting with the outlying schools. If staff illness cancels a school day, the schedule holds two open days in December. If the dentist's referral slots fill, children will be referred to the nonprofit van and to the nearest pediatric practice, with the nurse helping families arrange transportation.

Measuring the Objectives

Each objective from Milestone Two has a source. Consent rates will come from returned forms by school and grade. Referral follow-up will come from the nurse's log. Sealant prevalence and untreated decay will come from the spring third-grade screening, compared with last year's baseline. Process data will be reviewed in December so the spring round can be adjusted, in keeping with the PROCEED phases' emphasis on judging implementation as well as results (Green & Kreuter, 2005).

Conclusion

The plan is modest by design: one consent process that reaches parents, sealing at school, a route to treatment and a budget the county can sustain with Medicaid billing. The final presentation will bring these pieces together for the county commission and the school board.

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.

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

McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4), 351-377. https://doi.org/10.1177/109019818801500401