+ Program Planning for Health Promotion/Disease Prevention Activities Suzanne Marks, Director Albuquerque Area Dental Support Center January 22, 2013

+ After today’s presentation, participants will be able to define the rationale behind planning a comprehensive prevention program at your clinic define the elements of the POARE format of prevention planning with particular emphasis on development of the problem statement and the evaluation describe the components of SMART objectives

+ Program Planning If you don’t know where you are going, how will you know when you have reached your destination? Why is planning important?

+ Program Planning A comprehensive program plan is a foundation of public health Having and following a program plan and then sharing results with administration, tribal leaders, consumers and the community may have other unexpected positive side benefits such as increased patient satisfaction (which could even help decrease broken appointments), confidence in the program and even job satisfaction for you and your staff A program plan will facilitate the targeting of high risk groups such as children, patients with diabetes or pregnant women A program plan increases the chances that prevention efforts will be evaluated Why is planning important?

+ The POARE Model P roblem O bjectives A ctivities R esources E valuation A powerful tool that can help you organize your plan and gives you consistent, systematic steps in to ensure successful outcomes

+ The POARE Model P roblem O bjectives A ctivities R esources E valuation  Helps to focus efforts on one issue at a time  Helps with staff acceptance  Lays the groundwork for future reporting and planning

+ P OARE: identify the P roblem One of the key components to program planning is determining the problem you want to address.

+ P OARE: identify the P roblem Sometimes what we perceive as a problem at the clinic level may NOT be perceived as a problem by your stakeholders.

+ P OARE: identify the P roblem As technical experts, it’s up to us to demonstrate the significance of the identified problem to our stakeholders.

+ P OARE: identify the P roblem Without buy-in and support from your stakeholders, the plan to address the identified problem is likely to fail.

+ P OARE: identify the P roblem “Parents don’t bring their children to the dentist!” “We need a sealant program!” “Decay is rampant in our community!” “The doctors should help apply fluoride!”

+ P OARE: identify the P roblem While these all may be true, as they stand, they don’t necessarily help you determine the extent of the problem determine the severity of the problem identify the factors contributing to the problem garner stakeholder support

+ P OARE: identify the P roblem Determine the extent of the problem Determine the severity of the problem Identify the factors contributing to the problem Garner stakeholder support A problem statement helps you

+ P OARE: identify the P roblem Local demographics The nature and extent of the problem Data Impact of the problem Past approaches tried and what happened Barriers to improving the problem Developing the Problem Statement

+ P OARE: identify the P roblem “You can have data without information, but you cannot have information without data.” Daniel Keys Moran “It is a capital mistake to theorize before one has data.” Sir Arthur Conan Doyle Developing the Problem Statement: Data

+ P OARE: identify the P roblem National or Regional Gathered by experts Usually available over a period of years (measure trends or differences) Usually not specific to your area Developing the Problem Statement: Data Local Specific oral health status may not be available Most powerful for local decision-making

+ P OARE: identify the P roblem Possible sources IHS Oral Health Survey Healthy People CDC National Oral Health Surveillance System GPRA RPMS Chart review Developing the Problem Statement: Data

+ P O ARE: develop the O bjectives Objectives identify what the program will accomplish by when SMART Objectives are S pecific M easureable A ttainable R elevant T ime-based

+ P O ARE: develop the O bjectives Use clear and concise language Avoid vague terms or words S MART Objectives should be Specific

+ P O ARE: develop the O bjectives  Know the material  Help the community  Talk to the doctors  Set up a program  Do more sealants  List 4 reasons  Decrease caries  Give a presentation  Establish a school-based program  Increase sealant applications by 25 percent Specific S MART Vague

+ P O ARE: develop the O bjectives Objectives need to be worded so the desired result can be clearly measured or observed. S M ART Objectives should be Measurable

+ P O ARE: develop the O bjectives Objectives should be challenging but achievable. SM A RT Objectives should be Attainable

+ P O ARE: develop the O bjectives Objectives should be science-based and relevant to your community. SMA R T Objectives should be Relevant

+ P O ARE: develop the O bjectives Objectives should have a time frame in which the desired result is expected to be achieved. SMAR T Objectives should be Time-based

+ PO A RE: plan the A ctivities What actions or activities will you implement to reach your objectives? How will you engage the targeted audience? What things will you change and/or eliminate in order to meet the objectives?

+ POA R E: inventory the R esources What will you need to achieve your plan? Money? Personnel? Materials? Space? Authorization? Outside services?

+ POAR E : conduct Evaluation How will you know if you have met your objectives?

+ POAR E : conduct Evaluation Quantitative Evaluation Uses numerical data to evaluate objectives Using quantitative methods alone may tell you if you met your objectives But it will provide little information about why the intervention did or didn’t work, whether participants were satisfied, etc.

+ POAR E : conduct Evaluation Qualitative Evaluation Collected through  Observations  Satisfaction surveys  Interviews with providers or program participants  And/or other methods to get at the quality of the interventions

+ POAR E : conduct Evaluation Work with medical personnel to develop a policy to include fluoride varnish treatments during immunizations by January Keep lists and notes of all communications and meetings with medical personnel and document all attempts to finalize this policy and whether it was ever finalized or not. If not, document what you think went wrong to assist in any future efforts. Suggested Evaluation Sample Evaluation Strategies Objective

+ POAR E : conduct Evaluation Train 80 percent of the medical staff at X Medical Clinic by January 2010 to apply fluoride varnish during immunization visits. Keep a list of all medical staff trained and compare the number to the total number of medical staff at X Medical Clinic. Suggested Evaluation Sample Evaluation Strategies Objective

+ POAR E : conduct Evaluation Decrease the prevalence of ECC among 3 year olds by 15 percent over the next two years. Survey 3-year old children in a daycare or preschool before and after the interventions and compare DMFT scores to calculate the percentage of decrease or increase in dental caries over the 2-year time period. Suggested Evaluation Sample Evaluation Strategies Objective

+ Program Planning for Health Promotion/Disease Prevention Activities Program planning for oral health promotion/disease prevention activities using the POARE format Defined the elements of the POARE format including the development of the problem statement and the evaluation The rationale behind planning a comprehensive prevention program at your clinic Described the components of SMART objectives

+ Questions?

+ Many thanks to Dr. Tim Ricks and Dr. Cathy Hollister for their leadership in program planning! Much of the content of this presentation was based on examples of their work.

+ Course Number Course Completion Code How to obtain your CDE Visit the Dental Portal at ov/doh/