Test 3 Flashcards
What is included in program planning?
Health promotion principles
Health education and lesson plans
Prevention theories
Development of public health measures
What is defined as a broad concept that refers to the process of enabling people and communities to increase their control over the determinants of health, and, therefore, to improve their own health?
Health Promotion
What does health promotion involve?
Informing and motivating people to adopt health behaviours
Making people aware of health ideas and concepts
Creating environments that enable people to increase control over and improve their current and future health
Is health promotion the same as disease prevention and health education?
No
How is health promotion different from disease prevention and health education?
Different constructs with different goals and strategies
What are the goals of health promotion?
Health and wellness
Is health promotion positively oriented?
Yes
Health promotion involves a ____ approach to achieving health through _____, _______, and _____.
Comprehensive
Education
Health services
Lifestyle
What influences health?
Peace
Shelter
Education
Food
Income
A stable ecosystem
Sustainable resources
Social justice and equity
Health promotion actions intend to alter an individiual’s environment in a way that will
Improve health regardless of individual actions or to enable individuals to take advantage of preventive and treatment procedures by removing barriers
Dental hygiene care can be thought of as a continuum of care that includes
Health protection
Health education
Disease prevention
What are the components of health promotion campaigns?
Health protection
Health education
Disease prevention
What is health protection?
Regulation
Legislation
Policy change
What is health education aimed at?
Influencing individual’s behaviour
What is disease prevention?
Services aimed at reducing risk of disease development
True or False: Disease prevention is negatively oriented.
True
What are the three basic health promotion strategies from WHO?
- Advocating for health
- Enabling people to achieve their health potential
- Mediating different social interests in the persuit of health
What are 5 actions to build the WHO’s health promotion strategies?
- Build healthy public policies
- Create supportive environments for health
- Strengthen community actions for health
- Develop personal skills
- Reorient health services
What are the aspects of health promotion?
Advocacy
Efforts to change organizations, policies, and environments
Political considerations
Ethical responsibilities
What are the outcomes of health promotion?
Reduced incidence and severity of disease
Improved health
Increased demand for care, use of services and preventive self care measures
What are the two theories that support the philosophy of health promotion?
Mandala of Health (Hancock’s)
Health Promotion Framework (Achieving Health for All, 1986)
Who designed Mandala of Health and when?
Trevor Hancock and Fran Perkins in 1985
What is the Mandala of Health?
A framework for understanding health in a holistic way. It redesigns the earlier “Health Field Concept” by recognizing health as influenced by multiple factors, not just medical care or personal behavior
What is Health Promotion Framework aimed at?
Achieving health for all by accepting specific health challenges, identifying health promotion mechanisms, and implementing health promotion strategies to meet these challenges
What are some other supporting documents and philisophies?
Changing Perspectives of Health
Responsibility for health
Determinants of health
Theories of Health Behaviour
What is the Theories of Health Behaviour?
That behaviour leading to improved (oral) health can be affected at three levels, intrapersonal, interpersonal and community.
What involves changes withing the individual?
Intrapersonal
What involves changes between people?
Interpersonal
What involves changes in institutional, organizational, and public policy?
Community
What theroies are intrapersonal?
Stages of Change Theory
Health Belief Model
Com-B Model
What theory is interpersonal?
Social Learning Theory
What theories are community?
Community Organization Theory
Diffusion of Innovations Theory
Intrapersonal theories start by:
Increasing patients awareness that there is a problem
Initiating behaviour change
Maintaining behaviour
The Stages of Change (Transtheoretical) Model describes individuals’ motivation and
Readiness to change a behaviour
What are the five stages of change?
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
What is one of the first theories of health behaviour that remains one of the most recognized?
Health Belief Model
The Health Belief Model argues that people are ready to act in what circumstances?
If they believe they are susceptible to the condition
If they believe the condition has serious consequences
If they believe taking action would reduce their susceptibility
The intra-personal level - Health Belief Model allows us to assess perceptions of
How susceptible one is to a health problem and if one believes that preventive behaviours will result in less susceptibility
What theory is new and emerging within the dental community?
COM-B
COM-B describes the three iterrelated factors that are needed for behaviours to happen. What are they?
Capability
Opportunity
Motivation
How does the COM-B theory work?
A person would need to have all three factors, capability, opportunity and motivation (COM)
to change the behaviour (B).
What theory belives that individuals are influenced by a social environment?
Interpersonal Theories
What theory suggests that people learn in four ways?
Social Learning Theory
What four ways does Social Learning Theory state people learn?
Direct experience
Vicarious experience
Expert testimony
Inferred knowledge
True or False: in Social Learning Theory self-efficacy and self confidence are not critical factors.
False. They are.
What does grassroots mean in Community Organization Theory?
That changes come from within the community itself rather than being imposed by outside experts
What does empowerment mean in Community Organization Theory?
It involves empowering community members to take the lead in identifying and addressing problems that are important to them.
What theory assesses how new ideas, products and services spread within a society or to other groups?
Diffusion of Innovations Theory
True or False: Despite years of research, very little knowledge exists about how best to promote oral health.
True
True or False: Most behaviour change that occurs after oral health education or promotion is short term and is not sustained without periodic reinforcement.
True
What knowledge is needed to assess and change people’s behaviours?
Factors that are considered a risk for development of oral disease and those factors that can be modified through preventive effots at the primary, secondary and tertiary levels
What factors are needed to assess and change people’s behaviours?
How to assess a person’s risk for development of disease
The level of scientific evidence for and the extent of certainty of the effectiveness of various preventive measures
Which categories of interventions yield the desired impact
Effective oral and written communication skills
Ways in which innovations are diffused and ways of bringing about organizational change
Ways to encourage people to access services and return for contiuing care
The structure of various health care systems and community-based organizations
How to deliver effective services and education
How to evaluate efforts
What is step one of planning public health programs?
Reflect on core functions of publich health. You must develop a community profile.
What is step two in planning public health programs?
Understanding the guiding documents used in health planning
What are the guiding documents used in health planning?
Achieving Health for All
Health People 2030
CHMS
What is step three in planning public health programs?
Know the indicators of oral health and how to measure them in a community
What is step four in planning public health programs?
Be familiar with the current status and trends related to the burden of oral diseases
What provides good benchmarks for assessing trends?
Healthy People 2010
Health People 2020
What is defined as the inclination or direction on a particular course over a period of time?
Trend
What is defined as the state of condition of disease?
Status
According to the Canadian Community Health survey 2022, how many Canadians reported seeing a dental professional in the last 12 months?
2/3
According to the Canadian Community Health survey 2022, Canadians do not have dental insurance?
1/3
How many Canadians are covered for dental by Government funded plans?
4%
According to the Canadian Community Health survey 2022, how many Canadians avoid getting dental care due to cost?
1/4
What is the most commonly chronic disease of childhood?
Caries
True or False: 80% of caries is experienced by approximately 25% of the population.
True
How many adults have gingivitis?
50%
How many adults have severe periodontal disease?
6%
What percentage of the population is edentulous?
6%
Does ethnicity increase the rates of edentulism?
Yes
How many children aged 6-11 have sealants?
32%
What is the 13th most common cancer in Canada?
Oral cancer
Oral cancer is the __th most common cancer worldwide.
6th
Nationally, what percentage of communities have fluoridated water?
37%
What is the term used to describe a group of Indengous individuals?
Aboriginal
What is the collective name for the original people of North America and their descendants?
Indigenous
There are three distinct groups of aboriginals in Canada, who are they?
Frist Nations
Metis
Inuit
Where can the highest concentration of Aboriginal populations can be found?
- Nunavut
- Northwst Territories
- Yukon Territory
- Manitoba
- Saskatchewan
By 2040, how many Indigenous people will be in Canada?
2.5 million
Is there one culture for all First Nations?
No
Aboriginal culture is based on what three principles?
Responsibility
Reprocity
Respect
When was the Indian Act enacted?
1876
True or False: The overall gap in community wellbeing between Inigenous and non-Indigenous communities has closed over the last 40 years.
False. The overall gap in the community wellbeing between Indigenous and non-indigenous communities remains virtually unchanged for nearly 40 years.
What is the legal rule to ensure all First Nations children living in Canada can access the products, services and supports they need, when they need them?
Jordan’s Principle
The results of the Inuit Oral Health Survey indicated that tooth decay is __x worse than that of the average Canadian.
2-3x
According to the First Nations results from the Oral Health survey 2008-2009 __% of 3-5 year olds have or have had a cavity.
85%
According to the First Nations results from the Oral Health survey 2008-2009, __% of Inuit adults have had severe periodonal disease.
3.9%
According to the First Nations results from the Oral Health survey 2008-2009, almost __% of Inuit adults 20+ are edentulous and __% of adults 40+ are edentulous.
10%
22%
What are some factors influencing the Aboriginal health care experience?
Racism
Culture
Access to health information
Approach of the health care provider
What aims to guarantee all Indigenous Peoples the right to equitable access to social and health services, as well as the right to enjoy the best possible physical, mental, emotional and spiritual health?
Joyce’s Principle
What were the findings of the 2019 dental care study of Ontario’s indigenous people?
Extent of poor dental care
28% visited DDS only in emergency
They don’t know what programs are available
What can we do for the Indigenous people?
Reconcilliation
Indigenization
What is the collaborative process of naturalizing Indigenous intent, interactions, and processes, making them evident to transform spaces, places, and hearts.
Indigenization
What are the three sections programs can be divided into?
Primary
Secondary
Tertiary
What type of prevention is interfering with the onset of the disease? Also the absence of disease and broad based programs.
Primary prevention
What are the requirements for optimal functioning of a primary preventive dental program?
Screening program
DHs and DAs who provide services to the ambulatory and non-ambulatory patients
Regulations - quality assurance
Supplies
Referral base
What are the limitations to the implementation of primary preventive programs?
Funding
Manpower
Supplies
What type of prevention attempts to detect a disease early and intervene early and/or regress before disease is established?
Secondary Prevention
What are examples of secondary prevention targeted programs?
Fluoride rinse programs
Fluoridated school water programs
Dietary fluoride supplement programs
Salt fluoridation programs
Preventive resins
What are the requirements for optimal functioning of a secondary preventive dental program?
Screening program
Dental hygienists and assistants who provide services
Dentists and specialists to provide care beyond the scope of DH and DA
Regulations - quality assurance
Supplies
Referral base
What type of prevention is directed at managing established disease and to avoid further complications?
Tertiary prevention
What are examples of tertiary prevention prgorams?
Sealants
Tobacco cessation
Water fluoridation
Oral health coalitions
Early childhood caries programs
What are the five main challenges to accessing dental care?
Affordability
Availability
Accessibility
Accommodations
Acceptabilty
What are the characteristics of public programs?
Developed to meet the needs of specific groups
Funding from federal provincial and municipal sources
Generally under financial strain now
Can be prevenative and or treatment based
Employ salaried dental personnel
Generally serve those eligible for welfare benefits of some kind
Total public and private dental care in Cnada has increased from $1.3 billion in 1980 to ___ today.
$17.1 billion
The publicly funded share of dental care has decreased from 20% in the early 1980s to __% today.
6%
What areas of concern are being aided by programs that we need to prioritize?
Emergency care
Targeted care
Long term prevention
Who is the Chief Dental Officer of Canada at the Public Health Agency of Canada that was appointed in September 2016?
Dr. James Taylor
What are the four federal programs?
NIHB
Canadian Armed Forces and Veterans Affairs
Citizenship and Immigration
Inmates
RCMP
Federal Dental Care Program (new)
The Canadian Dental Care Plan will cover ___ million Canadians
9 million
What is the cost for the first 5 years of the Canadian Dental Care Plan?
$13 billion
What will the cost of the Canadian Dental Care Plan be annually?
$4.4 billion
What is the criteria for the CDCP?
No access to dental insurance
Annual adjusted family net income below $90,000
Canadian resident
Filed income taxes in previous year
When will all remaining eligible Canadians be able to apply for the CDCP?
2025
Is there an annual maximum for the CDCP?
No, but frequency limitations
When was the CDCP guide presented?
February 2024
What are the general principles of the CDCP?
Plan covers a range of procedures
Determined on an individual basis
Pre-d required for coverage over frequency limits
No maximum
Coverage from July 1-June 30th
Dependant on income
Does client pay copays with CDCP?
Yes
What initative was introduced in 2004, to prevent dental caries and improve oral health among the First Nations and Inuit children living on the reserves?
Children’s Oral Health Initative
Who provides the funding for the Children’s Oral Health Initiative?
Federal government
How many communities across Canada have implemented the Children’s Oral Health Initative?
231
What is the role of the community health worker Children’s Oral Health Initative aide?
3 day training - 5 competencies
Link with community
Home visits
Schedule appointments
Fluoride varnish applications
Oral health education
What is the purpose of the community health worker in Children’s Oral Health Initiative?
Increase reach and productivity of initiative
What is the CDHA involvement with the Children’s Oral Health Initative?
Placement of RDHs for care
Interim stabilization therapy
Collaboration with Inuit Tapiriit Kanatami to develop culturally appropriate resources, oral health promotion materials
What is the PUFA index?
Pulp exposure
Ulceration caused by dislocated tooth fragments
Fistula
Abscess
What is Lift the Lip with Health Smile Happy Child?
A collaborative approach for parents and childcare workers to look in a child’s mouth for any signs of abnormalities
When did the National Oral Health Research Strategy launch?
June 2024
What is the focus of the National Oral Health Research Strategy?
Advancing the health of Canadians through search from 2024-2030
What province has the lowest public funding for dental care per capita?
Ontario
How many Ontarian’s do not have access to oral health services?
23-24%
What are the provincal programs?
Water fluoridation programs
Screenings
Surveys
Cleft lip and palate program
What was the Emergency and Essential Services Stream previously known as?
CINOT
What is the Emergency and Essential Services Stream for?
A child not on HSO but a resident of Ontario whose family declares financial hardship can receive basic treatment to remove pain
When was the Ontario Senior’s Dental Care program established?
2019
Who is the Ontario Senior’s Dental Care Progam focused on?
Low income seniors
How many seniors in Durham region will be eligible for treatment under the Ontario Senior’s Dental Care Program?
9,800 seniors
Who is eligible for the Ontario Seniors Dental Care Plan?
Ontario residents over 65
Annual net income of $22,000 or less for a single person
Combined annual net income of $37,100 or less for a couple
No other dental benefits
What are local oral health programs?
Public health units across the province have launched serveral oral health initiatives that are worthy of mention and commendation.
How many communities are involved in the remote areas program?
30
Where is Greenshield’s One Smile Research program run out of?
U of T
What does the Oral Health Coalition do?
Post card campaign
Bus campaign
Pamphlets
What were DH in Canada celebrating in 2023?
110 years of the funding of the dental hygiene profession and 50 years of our CDHA
DH are expanding outside of the office box, which requires
- Evaluating the needs of a community
- Changes to legislation and public policies
What are the disadvantaged groups in Canada?
Working poor
Youth
Elderly
Physically and/or mentally compromised
First nations
Immigrants
Institutionalized people
Who is the directing and coordinating authority for health within the United Nations system?
WHO
The WHO maintains stats on prevalence of dental diseases in more than ___ countries in its Global Oral Data bank.
170
What are the most widespread of all human diseases?
Caries and periodontal diseases
In Sweden, they saw a lower rate of dental decay in children by __% when implementing a preventative approach.
80-90%
What term is defined as meaning that people and organiziations are expected to behave ethically and with sensitivity to social, cultural, economic and environmental issues?
Social responsibility
What are the 3 P’s of professionalism?
Power
Privilege
Promise
Power and privilege are awarded in exchange for the profession’s promise to
Place the rights of the client over self-interest and the rights of society over the rights of the profession
What is defined as the conduct, aims, or qualities that characterize or mark a profession or professional person?
Professionalism
What are the models of professionalism?
Commerical model
Guild model
Interactive model
WHich model of professionalism has dental care viewed as a commodity sold by the practioner?
Commerical model
Which model of professionalism has dental care as a privilege with the professional owning the dominant role in the practitioner/patient relationship?
Guild model
Which model has dental care as a partnership of equals?
Interactive model
What is the code by which the profession regulates actions and sets standards for its members, with the recognition that professionals are accountable for their actions?
Professional ethics
What are the basic principles in bioethics?
Beneficence (do no harm)
Autonomy (individuality)
Veracity (honesty)
Justice
What is defined as fair and equitable distribution of resources, including health services and other determinants of health among groups in society?
Social justice
How can we achieve social justice?
Advocacy
Policy development
Lobbying
What is defined as an individual who intentionally or unintentionnaly causes social, cultural or behavioural change?
Change agent
What is needed within the dental hygiene profession to eliminate oral health disparities and to ensure access to oral health services for all?
Leadership
DH leadership embraces
Social responsibility
Professionalism
Ethics
Communication
What is defined as the support of social issues, policies and individuals, groups or communities to reduce inequities in oral health status and increase acccess to oral health services?
Advocacy
How is health equity achieved?
When every person had the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances.
How can health equity be achieved?
By discussing problems directly with the policy makers
Delivering messages through the media
Strengthening the ability of local organiziations to advocate
What is defined as the knowledge based action intended to influence system-level decisions for the purpose of improving health?
Health policy advocacy
True or False: healthcare refom and restructuring is having growing impacts on social, economic and other public policies on health.
True
What is the #1 unmet health need?
Dental care
There is debate in the literature whether we are advocating
Change in oral health policy or
Healthy public policy
What is defined as the act of attempting to influence decisions made by oficials in the governement?
Lobbying
What public associations are involved in advocacy for improving oral health?
CDHA
CPHA
OAPHD
CAPHD
OOHA
What do you need in addressing the community assessment?
Population demographics
Determinants of health
Geography
Transportation
Financing
Facilities
Leadership and community partnerships
Manpower
What to use to assess knowledge and community behaviours
Surveys
What to use to assess the dental needs of a population?
Indices
What in involved in planning funding?
Levels of government support
CHMS
Legislation
Advocacy and social justice
What is defined as the application of systematic methods to address questions about program operations and results?
Program evaluation
Why should we evaluate a program?
For learning
For accountability
What are the two stages within evaluation?
- Formative evaluation
- Summative evaluation
Which stage of evaluation refers t the internal evaluation of the program, examination of the process of the program and is conducted in the program planning stage?
Formative evaluation
Which stage of evaluation judges the merit of the program after implementation?
Summative evaluation
What methods are used to evaluate programs
Combination of both qualitative and quantitative methods
What are the non-clinical methods of evaluation?
Interviews
Surveys
Document analysis
What are the clinical methods of evaluation?
Basic screenings
Epidemiological examinations
Indices
Using biostats
What are included in biostatistics?
Null hypothesis
Quantitative/Qualitative
Independent/Dependent variables
Measures of central tendency
Measures of dispersion
Standard deviation
Variance
Correlation
P values
Confidence intervals
What are the 8 steps of the framework for the evaluation program?
- Clarify program
- Engage stakeholders
- Assess resources
- Orangize and select evaluation questions
- Determine methods of measurement and procedures
- Develop work plan, budget and timeline
- Collect data
- Process data and analyze the results
- Interpret and disseminate results
- Take action
What needs to be done in clarifying the program?
Ensure the program has clearly defined goals, populations of interest, outcomes, strategies, activities, outputs, and indicators
What is involved in focusing the evaluation design?
Organize evaluation questions by type - formative, process, outcome. Select your key evaluation questions
What else is process evaluation known as?
Tracking or monitoring
The Canadian Health Measures Survey is currently processing ____ of data collecting.
Cycle 7
