The Association of State & Territorial Dental Directors’ Best Practices Project: Integrating Oral Health into
Coordinated School Health
By ASTDD Best Practices Committee
The steering committee and expert workgroup directing the Best Practices Project administered by the Association of State & Territorial Dental Directors (ASTDD)
The ASTDD Best Practices Project supports state, territorial and community oral health programs to develop best practices that promote optimal oral health for all Americans throughout their lifespan. Programs across the nation participate in this project by sharing their success stories and learning from successes in the field. The ASTDD Best Practices and School & Adolescent Oral Health Committees are currently collecting success stories to help fully integrate oral health into coordinated school health efforts. These stories offer intervention strategies, implementation methods, lessons learned and field contacts that programs can use to promote partnerships between public health and school programs, and the public and private sectors, to assure optimal oral health for all children.
The Tennessee School Based Dental Prevention Program is one of the success stories demonstrating strong partnerships with the state oral health program, Medicaid program, school systems and private sector dentistry:
- Since 2001, the Tennessee Department of Health, Oral Health Services, has administered the Tennessee School Based Dental Prevention Program (SBDPP) for high-risk children. SBDPP has a multi-million dollar annual budget funded by TennCare (the state’s Medicaid program). Schools with at least 50 percent of their students on a free or reduced lunch program qualify for the program; all students (grades K-8) in qualified schools are eligible for SBDPP services. The program includes three service components: screenings and referral for care, oral health education and outreach for TennCare, and dental examinations and dental sealant applications.
- SBDPP is implemented throughout the state (in six metropolitan and seven rural regions) and utilizes 100 dentists/dental hygienists/dental assistants to deliver dental preventive services. A partnership with TENNderCare Outreach provides follow-up care to Medicaid children who need immediate professional dental care. School nurses and health coordinators follow up with families for children with unmet dental care needs. Restorative treatment for referred children is accomplished through partnerships with local health departments and private practitioners.
- SBDPP services are targeted to more than 960 schools using portable equipment. Since 2001, approximately one million children have been served; the children received oral health education, dental screenings, examinations, preventive care (1.8 million teeth sealed), and care coordination for restorative services. More than one-half of Tennessee’s children ages 5 to 17 are cavity free.
A new ASTDD Best Practice Approach Report, Improving Children’s Oral Health through Coordinated School Health Programs, will feature more success stories (to be released in January 2010 and available online). For ASTDD tools to assist integration of oral health into the coordinated school health efforts, visit here.
Indiana Takes a Stand for Adolescent Health
By Stephanie G. Woodcox, MPH, CHES
Adolescent Health Coordinator, Indiana State Department of Health
The Indiana Coalition to Improve Adolescent Health (ICIAH) published the state’s first adolescent health plan, Picturing a Healthier Future: A State Strategic Plan for Indiana’s Adolescents. Indiana is a leader in adolescent health as only a few states have developed such a plan. Picturing a Healthier Future details 10 priority health issues (classified into one of two categories: access to care or prevention) that affect the well-being of Hoosier adolescents (ages 10-24). The framework for the plan is the 21 Critical Health Objectives for Adolescents and Young Adults (from Healthy People 2010) and the concept of positive youth development.
The ICIAH recognizes that all young people must acquire certain strengths, skills and competencies — academic, emotional, social and physical — in order to achieve a happy, healthy and productive adulthood. Strong communities and relationships provide young people with the positive resources and support they need for healthy development. A 17-year-old female ICIAH focus group participant indicated the need for such relationships stating: “If you are talking about being healthy in the future, you are going to be making your own decisions and now is the time to kind of figure out how to do that with somebody to fall back on in case something goes wrong.”
A unique feature of the plan is the introduction to three adolescents — Michelle, Nathan and Carmen — all of whom face multiple challenges and make decisions which affect their health. Their stories are woven throughout, reinforcing and even reminding us of the complexity and pressures experienced during this time of life.
Adolescents comprise a significant segment of Indiana’s population that needs an informed and healthy roadmap for a successful future. It is essential to focus time and resources on adolescents. A 19-year-old male focus group member’s comment emphasized the need for tailored interventions: “We [adolescents] are different people, we have different thoughts, and we are unique in every aspect of everything.”
The coalition’s mission is to promote optimal health and well-being for all Hoosier adolescents with an emphasis on prevention and access to quality, comprehensive health care. To learn more about the coalition and view a copy of the adolescent health plan, visit here.
Collaboration Works in Kansas
By Lori Haskett, BA
Director, Injury Prevention and Disability Programs, Kansas Department of Health & Environment
Jane Stueve, RN, BSN
Adolescent & School Health Consultant, Kansas Department of Health & Environment
Unintentional injury was the leading cause of death for Kansas' adolescents ages 15 to 19 in 2007 with motor vehicle crashes (MVC) causing the majority of deaths. The adolescent death rate due to motor vehicle crashes without using a seatbelt is 42 percent higher for Kansas (13.9 percent) than for the United States (9.8 percent); however, there have been recent decreasing trends. The Kansas 2007 Youth Risk Behavior Survey data showed that 15 percent of high school students never or rarely wore a seatbelt. Kansas Department of Transportation (KDOT) data for 2007 shows that teen drivers account for six percent of all Kansas registered drivers but 18 percent of all crashes. Kansas' higher MVC rate might be attributable to teen drivers’ belief they will not be involved in a MVC and therefore do not need to buckle up. In the rural areas in Kansas, there is a higher fatality rate than in urban areas often times because the MVC occurs far from a high functioning trauma facility.
The Kansas Driving Force Campaign was created to decrease death and injury on Kansas roadways. The first step in the campaign was to raise awareness about the number of people being killed and injured on Kansas roadways. KDOT Secretary Deb Miller, Kansas Highway Patrol (KHP) Col. William Seck, KDHE Secretary Roderick Bremby hosted community forums across the state to start a discussion with citizens, city/county officials, and legislators about their perspective on traffic crashes and the overall impact. The consensus was that this multi-faceted problem would require a strategic plan.
The Kansas Department of Transportation established the Kansas Traffic Safety Resource Office (KTSRO) to assist in reducing drinking drivers, promote prevention of underage alcohol consumption and enhance current safe driving activities. MCH collaborates with KTSRO, KHP, local law enforcement, the Kansas Drivers Safety Education Association, American Automobile Association, Kansas Safe Kids, Students Against Destructive Decisions (SADD) and Family Health Partners to provide traffic safety education and to enhance laws protecting Kansas citizens from MVC injuries. This collaboration promoted legislation that resulted in a primary seatbelt law for those under the age of 18 and an upgraded graduated driver’s license law which included restrictions on wireless devices.
The Maternal and Child Health Program and the Bureau of Health Promotion in Kansas work tirelessly to achieve our mission to protect the health and environment of all Kansans by promoting responsible choices.
Supporting Youth to Achieve High School Graduation
By Christine L. Evans, M.A., CHES
Community Health Educator, Maryland Department of Health & Mental Hygiene Center for Maternal & Child Health
Maryland’s Maternal and Child Health Program supports their adolescent health staff to participate in meaningful collaborations related to performance measure #5 — Percent of Maryland 12th graders who graduate from high school. These collaborations are aimed at helping Maryland youth achieve the goal of graduating from high school.
The Community Health Educator had the opportunity to serve as a planning committee member for the Maryland State Department of Education and America's Promise Dropout Prevention Leadership Summit, “Brighter Futures,” which convened on June 22, 2009. The Community Health Educator served on the family and community engagement subcommittee. The conference brought together professionals from various fields which serve youth throughout the state as well as researchers in the education field. One of the major goals of the summit was to bring together educators, administrators and school staff from around Maryland to develop a strategy which will help all Maryland students successfully complete their education. The other collaborative opportunity was to serve as a member of the planning committee for the 2009 School Health Interdisciplinary Program (SHIP) Conference which was co-sponsored by the Maryland Department of Health & Mental Hygiene and the Maryland State Department of Education. This annual conference has been taking place for nine years and includes workshops on a variety of topics including family trauma, suicide prevention, family violence, HIV/AIDS education, asthma in schools, internet safety, and gangs 101, to name a few. This conference is targeted to school nurses, administrators, health educators, school counselors, social workers and administrators who work in foster care, juvenile justice, education and public health fields. The SHIP conference provides education for professionals who interact with youth in variety of settings to help them be healthy and successful in and out of the school environment.