Step 5: Program Evaluation

Step 5: Program Evaluation

Step 5 helps programs determine whether the school-linked dental program is reaching students, connecting families to care, meeting its objectives, and improving over time. Programs should plan for data collection and measurement so they can assess the impact of screening, education, referral, care coordination, and linkage to care activities.

Performance management: Results-Based Accountability (RBA)

RBA is a useful framework to measure and improve the performance of a program. LOHPs can use the RBA framework as a step-by-step guide to using data to engage and collaborate with stakeholders to create an action plan and move into actionable steps that are continuously evaluated.

The RBA can be tied back to the LOHP by tracking the performance on:

  1. How much did we do?
  2. How well did we do?
  3. How are we better off?

Below are some examples of RBA indicators for school dental programs that can also be used for measuring the program's success within other frameworks (such as evaluation and QI). Learn more about RBA at the COHTAC RBA webpage. 

Click to view RBA indicator table

 

Continuous quality improvement

The continuous quality improvement model is a philosophy and attitude for analyzing capabilities and processes and improving them repeatedly to achieve customer satisfaction. Continuous improvement is a core methodology of all quality improvement tools and techniques that will elevate all process improvement initiatives to create a workplace that better serves the customers and the employees.

After the Quality Improvement Team implements and achieves their SMART+C goals, completes a PDSA cycle, or implements Lean and process mapping, it is imperative to start identifying other areas to be improved and focusing on other quality issues to make incremental changes. Updating goals, refining processes, and eliminating forms of waste will help promote success for future generations of Californians.

To give some ideas on what changes can be implemented to improve performance measures and improve processes, the following is a list of available quality improvement tools from the most effective to the least effective:

Once your Quality Improvement Team has finished a cycle of improvement and have demonstrated improvement, submit to your supervisor:

  • Overview of the problem and how it was identified
  • What improvement tools and techniques were used
  • What process changes or standard work was created and implemented
  • Baseline performance compared to current performance

Programs should document lessons learned, process improvements, and successful strategies so they can be shared with partners and used to strengthen future implementation.

These links provide some additional detail on quality improvement and continuous improvement:

Data reporting

In addition to reporting KOHA data to SCOHR and using your data in your QI plan, LOHPs are responsible for sharing their progress and data with the California Department of Public Health, Office of Oral Health. These will be tracked with the LOHP Annual Data Form, within your bi-annual progress reports, and in your summative evaluation report. 

LOHPs should follow current CDPH Office of Oral Health guidance for required data reporting, including KOHA reporting and other applicable program reporting processes.

Resources:

 

 

References

  1. Darsie B, Conroy S, Kumar J. Oral health status of children: Results of the 2018–2019 California Third Grade Smile Survey. J Calif Dent Assoc. 2021;49(5):331–6. 

  2. Dudovitz RN, Valiente JE, Espinosa G, Yepes C, Padilla C, Puffer M, et al. A school-based public health model to reduce oral health disparities. J Public Health Dent. 2018;78(1):9–16. 

  3. Kumar J, Jackson R. California Department of Public Health Oral Health Program: California Oral Health Plan 2018-2028. Available from: https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDCB/CDPH%20Document%20Library/Oral%20Health%20Program/FINAL%20REDESIGNED%20COHP-Oral-Health-Plan-ADA.pdf 

  4. Gooch BF, Griffin SO, Gray SK, Kohn WG, Rozier RG, Siegal M, et al. Preventing dental caries through school-based sealant programs. J Am Dent Assoc. 2009;140(11):1356–65. 

  5. Cavities: School-based dental sealant delivery | The Community Guide [Internet]. 2023 [cited 2024 Jun 14]. Available from: https://www.thecommunityguide.org/findings/dental-caries-cavities-school-based-dental-sealant-delivery-programs.html 

  6. Centers for Disease Control and Prevention (CDC). 2019 Oral Health Surveillance Report. Oral Health [Internet]. 2024 [cited 2024 Jun 14]. Available from: https://www.cdc.gov/oral-health/php/data-research/2019-oral-health-surveillance-report/index.html 

  7. Marinho VC, Worthington H, Walsh T, Clarkson J. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2013;(7):CD002279. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002279.pub2/full 

  8. U.S. Preventive Services Task Force. Dental caries in children from birth through age 5 years: Screening [Internet]. [cited 2024 Jun 14]. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/dental-caries-in-children-from-birth-through-age-5-years-screening-2014 

  9. Weyant RJ, Tracy SL, Anselmo T, Beltrán-Aguilar ED, Donly KJ, Frese WA, et al. Topical fluoride for caries prevention. J Am Dent Assoc. 2013;144(11):1279–91. 

  10. Professionally applied topical fluoride: Evidence-based clinical recommendations. J Am Dent Assoc. [Internet]. [cited 2024 Jun 14]. Available from: https://www.sciencedirect.com/science/article/pii/S0002817714649618?via%3Dihub 

  11. Ignelzi MA Jr, Brickhouse T, Caffrey E, Amini H, Stanislaus D, Wedeward R, et al. Hidden Crisis: Pediatric Oral Health in Rural America [Internet]. American Academy of Pediatric Dentistry. Available from: https://www.aapd.org/globalassets/ruralpediatricoralhealth_aapd_rpc.pdf 

  12. Martin AB, Probst JC, Jones KM. Chartbook: Trends in Rural Children's Oral Health and Access to Care. Columbia, SC: South Carolina Rural Health Research Center; 2017 Aug. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8457889 

  13. Phipps K. The New & Improved Children's Basic Screening Survey [Internet]. Association of State & Territorial Dental Directors; 2017 Oct 12 [cited 2024 Jun 14]. Available from: https://www.astdd.org/docs/childrens-bss-webinar-ppt-10-12-2017.pdf 

  14. Jürgensen N, Petersen PE. Promoting oral health of children through schools—results from a WHO global survey 2012. Community Dent Health. 2013;30(4):204–18.