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BDS3 PMHP > Childsmile > Flashcards

Childsmile Flashcards

1
Q

Give an example of upstream, midstream and downstream interventions

A

Upstream (work done at a national level)
- National/Local Policy Initiatives
- Legislation/Regulation

Midstream (work done at a community level)
- Community Development
- School Dental Health Education

Downstream (one to one interventions)
- clinical prevention
- chairside dental health education

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2
Q

Why are upstream interventions preferable?

A

These measures tend to be further reaching and more cost effective

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3
Q

Describe the theory of proportionate universalism

A

All involved benefit from the measures but those most in need experience the greatest change

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4
Q

What are the components of the Childsmile Logic model?

A
  1. Interventions (levels, settings, workforce, training)
  2. Behaviour change, service access & uptake, intervention reach
  3. Health & social (oral health, inequalities, economic)
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5
Q

What are the community activities used in Childsmile?

A
  • supervised nursery toothbrushing (universal)
  • fluoride varnish application in nurseries and schools (targeted)
  • preventive dental primary care contract (universal)
  • community support for disadvantaged families (targeted)
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6
Q

What is the role of a dental healthcare support worker?

A

They go into family homes to provide support in regards to oral health and link families to dental primary care and community based support

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7
Q

What are the 3 main elements of Childsmile?

A
  1. Childsmile Core Programme
  2. Childsmile Practice
  3. Childsmile Nursery & School
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8
Q

What is involved in the Childsmile Core Programme?

A
  • programme is delivered by health visitors in connection with dental healthcare support workers
  • toothbrushing packs delivered to families
  • free flow cup delivered at 6 months old
  • help provided to register family to dentist
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9
Q

What is involved in Childsmile Practice?

A

-programme is delivered by GDPs in Greater Glasgow & Clyde
- oral hygiene instruction delivered
- fluoride varnish application

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10
Q

What is involved in Childsmile Nursery?

A
  • daily toothbrushing until P2
  • targeted fluoride varnish application until P4
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11
Q

What are some examples of Oral Health Educators?

A
  • providing assistance to establishments to manage core toothbrushing programmes
  • providing staff training
  • providing oral health education to pupils and their families
  • organising national and local oral health campaigns
  • fluoride varnish programme
  • NDIP assistance and acclimatisation sessions
  • caring for smiles programme in care homes
  • working to support local learning disabilities services
  • NHS24 follow up
  • dental practice visits
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12
Q

Describe the Childsmile Toothbrushing Programme

A
  • daily toothbrushing
  • teaches an important life skill
  • offered to all P1s and P2s
  • children toothbrush alongside their peers
  • negative consent letter, 2 week window for opt out
  • supervising adults monitored twice annually by oral health staff
  • children assigned a toothbrush with a symbol that matches a position on the rack
  • P1s receive a toothbrushing pack to take home
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13
Q

What are the direct benefits to schools from toothbrushing programmes?

A
  • promotion of a holistic approach to healthy living
  • teaches children key life skills
  • demonstrates health promotion within the school
  • benefits children, families, school community and society
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14
Q

Describe the Childsmile Fluoride Varnish in Nurseries & Schools

A
  • priority nurseries and schools offered twice yearly FVA within the building
  • Extended Duty Dental Nurses apply fluoride varnish twice a year
  • parental consent required using consent form. Every 6 months an update on changes to personal details or medical history is required
  • be mindful of children with asthma or colophony allergies
  • children can have 4 FVAs annually, 2 by EDDNs and 2 in general practice
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15
Q

What are the benefits of the dental play boxes supplied to nurseries?

A
  • fun activities to promote oral health education
  • resources from the dental surgery alleviate fear
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16
Q

What is promoted in the Starting Solids session?

A
  • importance of toothbrushing
  • dental registration
  • healthy food and drink choices for baby
17
Q

What are the benefits of Childsmile within the nursery?

A
  • life skill of toothbrushing is learned, routine personal care is developed
  • messages are passed onto parents are carers
  • positive peer example (FVA, toothbrushing)
  • children learn about healthy eating
  • reduced need for dental treatment in later life
18
Q

What are barriers to Childsmile interventions in nurseries?

A
  • nurseries struggle to find time to perform toothbrushing
  • nurseries don’t always have the space required for FVA
  • concerns about cross infection (measures in place to reduce risk)
  • staff shortages and challenges delivering training
19
Q

What is the role of an oral health educator?

A
  • Delivery of the Childsmile programme in practice.
  • Fluoride varnish application
  • Support families with dental registrations.
  • Use language line or visual aids used where required.
  • Discuss Childsmile programme with parents and carers.
  • Provide tooth brushing demonstrations.
  • Build rapport with families (help overcome finance barriers for transport etc.)
  • Signpost families to other services
  • Be available for families to contact for further support.
20
Q

What 7 components make up the Childsmile Employment Structure

A
  1. Scottish Government
  2. Local Authority Education Services
  3. General Dental Services
  4. Community Services
  5. Special Health Boards
  6. Childsmile Executives
  7. Territorial Health Boards
21
Q

What were some of the challenges faced by Childsmile during the pandemic?

A
  • government policy was to suspend delivery of Childsmile
  • staff were redeployed to focus on COVID related support
  • schools and nurseries closed
  • AGP procedures prohibited
  • care inspectorate focussed on COVID related efforts
22
Q

What does the Outcome Evaluation of Childsmile consider?

A
  • is the programme reaching the children it should?
  • is it improving oral health?
  • what components of Childsmile are working?
  • is it narrowing inequalities?
  • what is the cost benefit and savings as a result of Childsmile
23
Q

What are the targeted components of Childsmile?

A

Access to DHSW and nursery and school FVA

24
Q

What are the universal components of Childsmile?

A

Access to primary dental services and supervised toothbrushing

25
Q

How do targeted and universal components differ when charted on a bar graph?

A

Targeted components should show the greatest engagement in the targeted group (e.g least deprived) creating a gradient. Universal components should have no gradient showing equal access to all groups.

26
Q

From the implementation of Childsmile, what has been the overall trend shown in oral health?

A

Oral health has improved with less children from all socioeconomic backdrops experiencing decay. Still higher levels of decay found in most deprived areas.

27
Q

What is the impact of both referral and intervention by DHSW on the most at risk families?

A

They are more likely to attend practice than families not receiving either or families receiving referral alone.

28
Q

What aspects are involved in process evaluation?

A
  • routine administrative data
  • qualitative studies including interviews and focus groups
  • surveys
29
Q

What are some of the barriers to fissure sealant placement?

A
  • Child and family
    • child doesn’t like taste
    • poor or pre cooperative
    • parent concerns
    • lack of parent understanding
  • Activities & Teamwork
    • moisture control
    • lack of nursing training
    • inadequate materials
    • lack of planning for complications
    • disagreement over benefits
  • Organisational
    • time required
    • complications surrounding payment
    • inability to book appointment with nurse
  • Environmental
    • AGP procedure
    • must consider in regards to covid
30
Q

What are the areas which can be explored surrounding fissure sealant improvement?

A
  • Child & Family
    • videos for children to watch
    • assessment of behaviour
    • automated text reminders
    • appointments at convenient times
  • Activities & Teamwork
    • adequate nurse training
    • moisture control training
    • fissure sealant packs ready to use
  • Organisational
    • ensure supplies are available
    • make prevention a practice goal
    • review appointments to determine what was successful
  • Environmental
    • beneficial to have separate room for child prevention treatments
31
Q

How does the Logic Model work?

A

The logic model tells you how the intervention is supposed to work by looking at inputs, processing and outcomes. It helps with planning, implementing and evaluation.

32
Q

What factors can contribute to the failure of the logic model?

A
  • COVID pandemic
  • staffing issues
  • lack of resources
  • insufficient funding
33
Q

What are the core elements of the MRC framework?

A
  • consider context
  • develop, refine and test programme theory
  • engage stakeholders
  • identify key uncertainties
  • refine intervention
  • economic considerations

BDS3 PMHP (14 decks)

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