Oral Health Promotion Flashcards
Population with unmet dental needs are known as what?
Vulnerable Populations
T/F: Increased health spending is correlates with improved health outcomes
True to a point, but only has a limited effect on population health
Gaps in health in rich and poor remain large
What is the 1948 WHO definition of health?
Complete state of physical, mental, social well-being, not just the absence of disease and infirmity
What is health promotion?
Process of enabling people to increase control over and to improve their health
What are the principles of Health Promotion according to WHO 1984
- Viewing population as a whole in context of their lives/communities
- Requires action on Health Determinants
- Combination of Approaches
- Public Participation
- Role of Health Professionals in Education + Advocacy
What are 4 aims of health promotion according to WHO 1984?
- Increase access to health for all
- Reduce Inequalities in health
- Maximise Opportunities for individuals to improve health status
- Developing conducive environments for health
What are 5 aims of health promotion according to the Ottowa Charter?
- Create Supportive Environments
- Build Healthy Public Policy
- Strengthen Community Action
- Develop Personal Skills
- Re-orient Health Services
What are 3 goals of social justice?
- Individual living free from discrimination
- Individuals have means to make choices about how they live
- Individuals having opportunity to gain employment and good health
What are 3 principles of social justice?
- Equity
- Diversity
- Supportive Environments
What are some examples of health promotion activities?
Water Fluoridation Food Labelling Vaccination Screening for High Risk Diseases Banning Smoking in public domains Car Seat Belts Bicycle Helmets Occupational Health and Safety Building Standards Anti-Bullying Anti-Discrimination Policies Parks + Trees Initiatives Community Garden Projects Alcohol Sales limitations
What are the Australian Dental Council Competencies aimed at dental professionals around health promotion?
- Service of Community
- Appreciate the determinants of health
- Promote + Improve Oral Health in Individuals + Communities
- Recognise + Appreciate need to contribute to improvement of oral health outside practice settings
- Thorough Knowledge of complex health interactions
- Maintain own health
- Promote Health Maintenance of Colleagues
- Encourage/Support patients to take interest + responsibility for management of health
- Education Patients
- Apply Principles of Prevention for inducing behavioural changes that benefit oral/general health
How might dental health be a social responsibility?
- Water Fluoridation
- Public Dental for those who can’t afford private dental
- Affordability of care
How might dental health be a individual responsibility?
- Dietary Choices
2. Individual buy and use dental products
What does the Ottawa Charter mean by creating supporting environments?
Making healthy choices easy choices
Changing Physical + Social Environments to maximise the possibility of leading healthy lives
Examples
- Banning smoking in workspaces
- Safe and Accessible public parks and recreation areas
- Mandatory Seat Belts
What does the Ottawa Charter mean by building Healthy Public Policy?
Ensuring organisations take account of health effects of implemented policies
What does the Ottawa Charter mean by Strengthen Community Action?
Increase abilities for communities to change aspects of physical/social environments
Example: Water Fluoridation required community support to persuade governments to implement
What does the Ottawa Charter mean by developing personal skills?
Information + Education needed for individuals to make choices to improve health
What does the Ottawa Charter mean by re-orient health services?
Move from curing disease to promoting health by extension of formal health care system beyond clinical services
Issue: Health Promotion is hard to bill, hard for policy makers to justify politically as results are long term
How do you define primary prevention?
Action to eliminate/reduce the onset, causes, complications or recurrence of disease
What are examples of primary prevention that are a universal approach to primary prevention
Fluoridated Water, Childhood Immunisation, Healthy Food Policies, School Dental Program
What are the benefits of a targeted primary prevention?
Address those with greater needs.
Examples:
- Different recall frequencies based on need
- Additional support for high risk communities - higher recall / skip fees / skip waitlist for indigenous groups
What are 6 challenges to primary prevention?
- Social Determinants of health/disease
- Inequality in health outcomes
- Priority Populations
- Burden of Disease
- Health Illiteracy
- Life Course Approach
Why are social determinants problematic for the health sector
Social + Cultural Factors lie outside the direct responsibility of health sector
Things such as housing, education and employment
How do primary, secondary and tertiary prevention differ?
Primary: Health Promotion +
Specific Prevention
Secondary: Early detection of disease. Prompt, Appropriate treatment
Tertiary: Rehabilitation
Who are some priority populations that more vulnerable to poor health?
Low Income Insecure Employment Disability Mental Illness Homelessness Remote Living Drug Problems
What are 4 stages of life course approach and areas of focus for primary prevention
- Foetal Life: Maternal Nutritional Status
- Infancy + Childhood: Growth Rate, Diet
- Adolescence: Diet, Risk Behaviours - Alcohol + Tobacco
- Adult: Behaviour + Lifestyle, Biological Factors
What are the principles of primary prevention?
Address social determinants Address inequalities Focus on whole populations Use multiple strategies Ensure comprehensive and integrated approaches Use Evidence Develop Partnerships Build Workforce Capacity Support Individual and community Participation
What are the aims of building healthy public policy?
Make Healthy Choices Easy Choices: Implementing policies, legislative changes, taxation and pricing signals
What are examples of primary prevention and oral health programs?
Promote Breastfeeding Promote safe bottle feeding practices Implement Life the Lip Program Work in partnership with other agencies Fluoride Healthy Diet Improve Oral Health Literacy Universal School Dental Program Targeted Health Promotion Programs Explore GA Waiting List Motivational Interviewing Smoking Cessation
What are the 3 types of evaluation when measuring the success of a primary prevention program
- Process Evaluation
- Impact Evaluation- Measures the activities of the program, its quality and who it is reachingMeasures the immediate short term effect of a program
- Outcome Evaluation- Measures the long-term effect of a program (whether it has met its aim)
What are the 2 research methods that can be used to evaluate outcomes?
Quantitative: Numbers to measure things (wait lists, disease rates)
Qualitative: Understanding how/why (surveys, questionnaires, interviews)
What are some examples of impact or outcome indicators?
- Changing in awareness, knowledge, skills
- Increase in people accessing services
- Policy Changes
- Changes in behaviour
- Improved continuity of care
How can evaluation results shape health policy and decision making?
Determines whether a project is reaching its aim/objectives
Identifies if a project merits continued funding
Improves effectiveness
Demonstrates why change has occurred
Ensured the project isn’t having a negative impact
Promotes the value of work to others
Provides learning from results
Informs future planning
Helps with continuous quality improvement
Determines community needs
How can evaluation data and research be shared?
Journal Articles
Conference Presentations
Mass Media
Professional Interpersonal Networks
How would you define a health need?
Condition in the community by it’s presence/absence reduces, limits or prevents achieving the optimum of physical, mental and social well being
How would you define a normative need?
What expert opinion defines as a need based on research
How would you define a expressed need?
A need that can be inferred by observation of the community’s use of services
How would you define a comparative need?
A need created by a discrepancy between what one group has and what another similar group has
How would you define a felt need?
What communities say/feel they need
Why is needs assessment necessarily before embarking on a health promotion initiative?
Provides a comprehensive picture of health problems in a community which then guides the type of health intervention that should be implemented
How can researches identify the priority health problems in a community?
- Consultation: talking to people living/working in the community
2 Data Collection: demographics, social indicator, health status data - Presentation of findings back to community
- Determining priorities
How can priority health issues be determined?
- Prevalence
- Severity
- Selectivity: Population Group
- Amenability to Intervention: has there been previous success
When determining needs analysis, what can be done in analysis of the health problem?
- Literature Review
- Describing the target group
- Exploring the health problem
- Analysing Risk Factors
- Sorting the Risk Factors (Predisposing, Enabling, Reinforcing factors)
- Reassess and Strengthen Community Resources
What are 4 potential issues when doing an needs assessment?
Inadequate Community Consultation
Conflict of Interests
Limited Data
Ethical Responsibilities
What are 3 benefits of applying evidence-based health promotion?
- Demonstrates whether a health promotion active is effective in improving a person’s health and well being
- Reduces resource wastage due to ineffective initiatives
- Identifies the potential benefits, harms, costs of an intervention
What are the 8 points of an evidence checklist?
- Where to source evidence?
- What is the best available evidence?
- How will we collect evidence?
- Understanding the context of the health issue
- What values need to be considered?
- How are we evaluating our program?
- How can we contribute to building an evidence base?
- How can we inform others of what does/doesn’t work?
What are 4 different types of evidence based research that can be used to formulate health promotion policies
Systematic Reviews
Controlled Trials
Economic Evaluations
Contextual Evidence
What is meant by
Contextual Evidence?
Determining if a policy is viable depending on:
- Current Government Priorities, Plans and Budgets
- Data on nature and size of the problem
- Impact on Health Inequalities
- Feasibility and Acceptability to Stakeholders
What are credible resources for evaluating economic evidence?
NHS Economic Evaluation Database
Paediatric Economic Database Evaluation
What are credible resources for evaluating controlled trials?
Cochrane Central Register of Controlled Trials
What are credible resources for evaluating systematic reviews?
Cochrane Collaboration
National Institute for Health and Clinical Excellence (NICE)
Centre for Reviews and Dissemination
Effective Public Health Practice Project
What are some health promotion initiatives that are effective with strong evidence?
Toothbrushing Programs Fluoride Varnish Programs MI Anticipatory Guidance Screen and Referral by non-dental professionals
What are some health promotion initiatives that are ineffective based on the evidence?
Classroom Lessons
Goodie Bags
One off Information Sessions
What are the 1st and 5th largest health issues in Australia?
1st: Dental Caries
5th: Gum Disease
What 4 Oral Health issues are pertinent to Australians?
Dental Caries, Gum Disease, Oral Cancer, Orofacial Injuries (particularly from sports)
What is the aim of Oral Health Promotion?
To ensure all Australians enjoy good oral health that contributes to leading healthy, satisfying lives
How are Oral Health Promotion goals achieved?
Building the knowledge, tools and networks that promote health behaviours and effective public health practices and programs. This includes:
1) Increase knowledge / skills of other health workers
2) Add oral health into public health policy
3) Advocate for government affordability / schemes
Is Oral Health Promotion an upstream, midstream or downstream strategy?
An upstream strategy
What are the 4 key deliverables for an Oral Health Promotion initiative?
- Increase awareness of oral health issues
- Formulation + promotion of sound health policies + programs
- Coordinating development / evaluation of oral health + promotion strategies
- Assist in promotion of initiatives for the prevention + control of oral diseases
What are the upstream strategies that are part of oral health promotion?
Build a fence to stop people falling into via:
- Government Policy
- Structural Change
- Funding
- Healthy Settings
- Inter-sector relationships: other medical health workers
- Mass Media: raising awareness Dental Health Week
What are challenges to Oral Health Promotion?
- Rapid changing nature of oral health knowledge
- Wide range of non/government organisations delivering services/programs
- Different messaging from dental to medical professionals
What are 4 elements in the role of an oral health promoter?
- Collect + Analyse Data to identify Community Needs
- Plan, Implement, Monitor and Evaluate Programs
- Participate in Oral Health Promotion Activities
- Increase Partnerships with appropriate stakeholders
What’s the difference between oral health promotion and oral health education?
OHE: tailored message at individual level to address specific and tailored risk factors
OHP: broader umbrella that involves up/mid/downstream
T/F: Oral Health Promotion is largely focused on whole populations during primary (health) and secondary (at risk) prevention stages
True
Who are some priority groups for Oral Health Promotion?
People who are socially disadvantaged or on low incomes
Aboriginal and Torres Strait Islander people
People living in regional and remote areas
Children
Homeless
Refugees
People with Disabilities
People with Mental Illness
Pregnant Women
Athletes
What is an example of an oral health promotion program aimed at children?
Bright Smiles, Bright Futures Program
Animated dental mascots aiming to engage and inspire children towards prevention and education, viewing dental professionals in positive light and building self-esteem toward oral health. Programs engage both dental professionals and school educators
