PHE 425 Module 7 Final Project Presentation Example

Sealed Before They Decay: A School Sealant Program for the County's Second and Sixth Graders

[Student Name]

Southern New Hampshire University

PHE 425: Programming Planning in Public Health

Final Project Presentation

[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.

Slide 1: The Problem in Our Schools

Untreated decay in 76 of 318 third graders screened (23.9%).

Sealants on a permanent molar in only 28.9%.

61 children's emergency visits for dental pain last year.

Speaker notes: Thank you for having me. Last spring the school nurse and the health department screened every third grader in the county. Nearly one in four had a cavity that needed treatment, and fewer than three in ten had a sealant on any permanent molar. Our hospital saw 61 children for dental pain in its emergency department, where a child can get medicine for the pain but rarely gets the tooth fixed. These are our children, in our six schools.

Slide 2: Why Sealants

Thin coating over the grooves of back teeth, where most childhood decay starts.

Proven in randomized trials to prevent decay (Ahovuo-Saloranta et al., 2017).

Unsealed children carry close to triple the first-molar decay (Griffin et al., 2016).

Speaker notes: A sealant is a thin plastic coating painted into the grooves of the back teeth. It takes a few minutes, does not hurt and needs no drilling. A Cochrane review of dozens of trials concluded that resin sealants prevent decay on those surfaces. CDC's national figures show low-income children with no sealant with about three times the decayed or filled first molars that sealed children have, and only 38.7% of those children are sealed. Here, it is fewer than three in ten.

Slide 3: The Children We Reach First

Second graders: first molars just in.

Sixth graders: second molars just in.

About 604 children a year; the two outlying schools first.

Speaker notes: We chose second and sixth graders because those are the ages when the permanent molars come in, and sealants protect best when placed early. That is about 604 children a year. We will start with the two schools farthest from town, which had the most decay, about a third of screened children, and are more than twenty miles from the county's only dentist who accepts Medicaid.

Slide 4: What Parents Told Us

247 families answered our survey.

76.5% would say yes to sealants at school.

45% of pilot-school parents never saw last year's form; a third were uneasy about insurance questions.

Speaker notes: We asked parents before we planned. The answer surprised us. Three in four said yes, they would want sealants at school. But last year's one-school pilot got only 38% of forms back. When we asked why, nearly half of the pilot-school parents said they never saw the form, and a third said they were uneasy about writing down insurance details. Interviews with the nurse, two principals, the hygienist, the dentist and a pastor told the same story. The problem is not that parents say no. It is that the form does not reach them.

Slide 5: The Theory Behind the Plan

Health belief model for the parent's decision (Janz & Becker, 1984).

Ecological model for the school, community and policy around it (McLeroy et al., 1988).

Planned with PRECEDE-PROCEED (Green & Kreuter, 2005).

Speaker notes: Our plan rests on two well-tested frameworks. The health belief model explains why a parent signs or does not: whether they see the risk, believe in the benefit, run into barriers, get a reminder and believe they can manage it. The ecological model adds the setting: the school, our county and the payment rules all bear on that signature. We built the plan using PRECEDE-PROCEED, starting from what families care about, missed school and toothaches, and working back to causes.

Slide 6: What We Will Do

One-page form, sixth-grade reading level, insurance question optional.

Consent by text link or paper, with reminders and the nurse's number.

Sealing at school by two hygienist teams; referrals for children with cavities.

Speaker notes: Each piece answers something parents told us. The form explains in plain words why new molars need protection. Insurance is optional, so no family has to share a number to say yes. Parents can answer by text link or on paper, and they will get reminders from the school and a call from the nurse if needed. Two teams will seal at school, following CDC's recommended school methods: a visual check, a toothbrush cleaning and sealants on sound teeth and early lesions (Gooch et al., 2009). Children found with cavities will be referred, and the nurse will follow up.

Slide 7: Schedule and Partners

August to September: consent outreach, pastor announcements.

October to November: sealing at all six schools.

March to May: return visits, third-grade screening, year-one report.

Speaker notes: Forms go out in August by text and in backpacks, and three churches will announce the program. Sealing happens in October and November, outlying schools first, avoiding testing weeks as the principals asked. In spring we return to check sealants and catch children who missed fall. The school district provides space and the text system, the county's Medicaid dentist holds two half-days a month for referrals, and a regional nonprofit's dental van takes referred children on its spring visit. Each partner has signed a one-page agreement.

Slide 8: First-Year Budget

Staff: half-time hygienist $32,000; dental assistant $36,000.

Equipment $14,000; supplies $6,000; outreach $2,000; mileage $3,000; evaluation $5,000.

Total $98,000, offset in part by Medicaid billing.

Speaker notes: The first hygienist is already on the health department payroll. The new costs are a half-time second hygienist, a full-time dental assistant, a second set of portable equipment, materials, consent outreach, mileage and evaluation, for a total of $98,000 in year one. The equipment is a one-time cost. Medicaid billing for sealants placed at school should pay for more of the staff time each year as more parents say yes, which is our path to sustaining the program after the two-year grant.

Slide 9: What Success Looks Like

Year one: 65% or more of eligible children with signed consent.

Referral and nurse follow-up for 80% of children with cavities within two weeks.

Sealants in 50% of third graders by year two; untreated decay at 18% or lower by year three.

Speaker notes: These are our objectives, each with a baseline and a date. The first two tell us whether the program is running as planned. The third tells us whether more children are protected, and the fourth whether fewer are living with untreated cavities. We will report to you on each one every year.

Slide 10: How We Will Know

Consent and sealing counts by school, reviewed in December.

Nurse's referral log.

Spring third-grade screening compared with last year.

Speaker notes: Evaluation is built into the plan, not added at the end. In December we will review consent and sealing numbers school by school and adjust the spring round if any school falls behind. The nurse's log will tell us whether referred children reach a dentist. The spring screening, done the same way as last year, will show whether sealant rates and decay are moving. If a strategy is not working, we will tell you and change it.

Slide 11: Our Request

Approve $14,000 from the county for portable equipment.

Endorse the program for all six schools this fall.

Hear a progress report in January.

Speaker notes: We are asking for three things tonight. First, $14,000 from the county for the second set of equipment; the grant covers the rest of year one. Second, the school board's endorsement so that forms can go out in August. Third, a place on your January agenda for a progress report. With your support, every second and sixth grader in the county can have their new molars sealed at school this fall. Thank you; I will take your questions now.

References

Ahovuo-Saloranta, A., Forss, H., Walsh, T., Nordblad, A., Mäkelä, M., & Worthington, H. V. (2017). Pit and fissure sealants for preventing dental decay in permanent teeth. Cochrane Database of Systematic Reviews, 2017(7), Article CD001830. https://doi.org/10.1002/14651858.CD001830.pub5

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

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