Childsmile Flashcards
Give an example of upstream, midstream and downstream interventions
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
Why are upstream interventions preferable?
These measures tend to be further reaching and more cost effective
Describe the theory of proportionate universalism
All involved benefit from the measures but those most in need experience the greatest change
What are the components of the Childsmile Logic model?
- Interventions (levels, settings, workforce, training)
- Behaviour change, service access & uptake, intervention reach
- Health & social (oral health, inequalities, economic)
What are the community activities used in Childsmile?
- supervised nursery toothbrushing (universal)
- fluoride varnish application in nurseries and schools (targeted)
- preventive dental primary care contract (universal)
- community support for disadvantaged families (targeted)
What is the role of a dental healthcare support worker?
They go into family homes to provide support in regards to oral health and link families to dental primary care and community based support
What are the 3 main elements of Childsmile?
- Childsmile Core Programme
- Childsmile Practice
- Childsmile Nursery & School
What is involved in the Childsmile Core Programme?
- 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
What is involved in Childsmile Practice?
-programme is delivered by GDPs in Greater Glasgow & Clyde
- oral hygiene instruction delivered
- fluoride varnish application
What is involved in Childsmile Nursery?
- daily toothbrushing until P2
- targeted fluoride varnish application until P4
What are some examples of Oral Health Educators?
- 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
Describe the Childsmile Toothbrushing Programme
- 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
What are the direct benefits to schools from toothbrushing programmes?
- 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
Describe the Childsmile Fluoride Varnish in Nurseries & Schools
- 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
What are the benefits of the dental play boxes supplied to nurseries?
- fun activities to promote oral health education
- resources from the dental surgery alleviate fear
What is promoted in the Starting Solids session?
- importance of toothbrushing
- dental registration
- healthy food and drink choices for baby
What are the benefits of Childsmile within the nursery?
- 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
What are barriers to Childsmile interventions in nurseries?
- 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
What is the role of an oral health educator?
- 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.
What 7 components make up the Childsmile Employment Structure
- Scottish Government
- Local Authority Education Services
- General Dental Services
- Community Services
- Special Health Boards
- Childsmile Executives
- Territorial Health Boards
What were some of the challenges faced by Childsmile during the pandemic?
- 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
What does the Outcome Evaluation of Childsmile consider?
- 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
What are the targeted components of Childsmile?
Access to DHSW and nursery and school FVA
What are the universal components of Childsmile?
Access to primary dental services and supervised toothbrushing
How do targeted and universal components differ when charted on a bar graph?
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.
From the implementation of Childsmile, what has been the overall trend shown in oral health?
Oral health has improved with less children from all socioeconomic backdrops experiencing decay. Still higher levels of decay found in most deprived areas.
What is the impact of both referral and intervention by DHSW on the most at risk families?
They are more likely to attend practice than families not receiving either or families receiving referral alone.
What aspects are involved in process evaluation?
- routine administrative data
- qualitative studies including interviews and focus groups
- surveys
What are some of the barriers to fissure sealant placement?
- 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
What are the areas which can be explored surrounding fissure sealant improvement?
- 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
How does the Logic Model work?
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.
What factors can contribute to the failure of the logic model?
- COVID pandemic
- staffing issues
- lack of resources
- insufficient funding
What are the core elements of the MRC framework?
- consider context
- develop, refine and test programme theory
- engage stakeholders
- identify key uncertainties
- refine intervention
- economic considerations
