Oral Health strategies Flashcards
What is a strategy? And what is the purpose of planning?
organisational plan for obtaining a specific goal
Planning aims to guide choices
Maximise results with limited resources
Make proactive decisions rather than reactive
Enables priorities to be set
why do we need oral health strategies?
oral diseases are preventable but still common and
- To improve oral health
- To ensure access to high quality NHS dental services
- Can be at an international local and national level
what are the three princples of designing a strategy?
AIM
Objectives
Data collection
What is the purpose of the aim?
Identify what is to be achieved
What is the purpose of the objectives?
steps needed to achieve aim
what is the final stage in writing a strategy and what does this entail?
This is data collection
identifies the problem, understands the problem and considers possible solutions and then evaluate whether the strategu has worked
What does Mc Carthys 1982 rational planning cycle show?
AODAIE
- assessment of need
- options: evaluate interventions available using evidence based and critical analysis and consider the level of evidence eg systematic review
- decisions of policy
- available resources
- implementation
- evaluation: should be built in to the project and not just an afterthought. Ask questions such as: is it working, is it acceptable, is it reaching the people who need it and how are resources being used
What is the purpose of a needs assessment?
this identifies and quantifies the problem by looking at the wants, demands and needs
Wants: individuals subjective analysis
Needs: professional judgement about the capacity to benefit
Demands: willingness to pay
what is a need for medical care?
when an individual has an illness or disability for which there is an effective and acceptable cure for
it is subjective: professional judgment varied
dynamic: new technologies drugs and information.
relative: wealth of the population
not finite
Define needs assessment
evidence based approach to commissioning and planning health care services using objective and valid methods
Why do we need to do a needs assessment?
to facilitate planning and commissioning -Health care inflation -changing demographics -limited resources - inequalities in health -consumerism and accountability Inverse care law Competing priorities
WHat are the three strategies to improving oral health?
Whole population
High risk
Targeted Population
How does the whole population approach work?
aims to lower average level of risk of a population by reducing entire populations exposure to disease
according to the whole population approach, who is affected by risk factors?
the entire population
What are the advantages to whole population strategies?
tackles underlying health determinants
avoids victim blaming
enables healthy choices to be made
benefits the whole society
Give examples of whole population strategies
Fluoridated tooth pastes and water
What are the disadvantages to whole population strategies?
They have long time scales
need to do alot of lobbying and gaining support
adverse effects on companies eg sweet shops
removes individual free choice
prevention paradox
What is the prevention paradox?
Rose 1981
Contradictory situation where for majority of cases come from a population at low risk of disease and a minority come from Hugh risk population because number of people at high risk are small
for a minoroty of people to beneift many people have to change their behavioureven though they will receieve no benefit themselves
What us the high risk strategy?
aims to reduce the risk for individuals that are identified as being at higher risk than the gernal population
What is an example of high risk strategy being implemented?
mammograms in women under 50 wkth a family history of breast cancer
What are the advanatges of a high risk strategy?
cost effective
intervention is apprporate to the individual
What are the disadvanatages of high risk strategies?
medicalises prevention
non selcted indivudals are not at no risk, they are at lower risk
contribution to the overall control of disease maybe small
poor ability to predict future outcome for individuals
What is a targeted population strategy?
A whole population apporach which is then adapted for a local community
Which individuals are targeted in the targeted population approach?
those that are high risk
What are the disadvantages of the targeted population approach?
Not all people at risk will be included in the target group and not everyone in the target group is at high risk
What are the advantages of the targeted population approach?
it places an emphasis on reducing inequalities and a variety of interventions can be used eg clinical intervention, environmental approach, developing community or individual skills
What are the threeWHO oral health action areas?
Diet, nutrition and oral health
Fluorides and oral health
Tobacco and oral health
Give an example of a national dental strategy aimed at improving oral health?
Choosing better oral health 2005 DoH
What were the aims of the choosing better oral health programme?
reduce the prevalence of oral disease
reduce oral heath inequalities across all age groups in England and Wales
How can you tell if the strategy has worked?
measuring level of satisfaction of those individuals that are involved
What did the choosing better oral health national strategy focus on?
Improving diet and reducing sugar Improving OH increase fluoride exposure Tobacco control and sensible alcohol use research and development reducing dento facial injuries
What other types of strategies exist other than whole population, high risk and targeted populations?
Integrated
How do whole population integrated strategies work?
They can be used at in international and national level
How can targeted population strategies be integrated with other strategies?
Integrated with while population eg diet water fluoridation
How can local high risk strategies be integrated?
They can be integrated with targeted strategies
What is the common risk factor approach?
Many diseases share risk factors eg heart disease, stroke, cancer, diabetes therefore action is directed to co,,ok risks and underlying social determinants using partnership working
Give an example of a targeted population strategy at an international level.
WHO oral Health strategy
Aimed at reducing the burden if oral disease In poor populations by rejecting risk factors to oral health that arise from environmental economic social and behavioural causes
