Community Oral Health Chapter 8

Community Oral Health Practice for the Dental Hygienist

• This is a 5th edition textbook by Christine French Beatty
• Copyright 2022, Elsevier Inc.

Health Promotion and Health Communication (Chapter 8)

• This chapter covers health promotion and health communication
• It discusses the scope of health promotion and related activities
• It covers application of health promotion strategies, theories, and models to oral health situations
• It helps students understand steps in the health communication process for developing, implementing, or evaluating health communication plans or projects
• It teaches techniques for assessing needs of diverse populations before designing health promotion and health communication strategies

Lesson 8.1: Health Promotion

• Part 1 (1 of 2): Discusses scope of health promotion and range of related activities; applies health promotion strategies, theories, and models to oral health; follows the health communication process in developing, implementing, or evaluating plans/projects
• Part 2 (2 of 2): Discusses how to assess needs of diverse populations to design health promotion and health communication strategies

Health Promotion (General)

• Introduces the role of behaviors (not just attitudes and knowledge) in health, expanding beyond individual behavior to social and environmental interventions
• Moves beyond health education, linking oral health to broader health issues
• The Ottawa Charter defines three health promotion strategies: advocacy for health, enabling people to reach their full health potential, and mediating societal interests in pursuit of health
• Oral health promotion improves use of oral health and wellness services and preventive self-care measures; outcomes include reduced oral diseases and improved overall health

Health Promotion Theories (Intrapersonal, Interpersonal, Community)

• A theory is an abstract concept that only takes form when applied to specific topics and problems. Conceptual frameworks and models help in analyzing situations and applying effective solutions from similar circumstances
• Traditionally, dental hygienists often view oral health issues as solely the patient's problem, providing education without assessing the individual's background, environment, literacy, or cultural sensitivities
• Behavioral change can be impacted at different levels: intrapersonal (individual), interpersonal (between people), and community levels (including institutional/organizational and policy changes)

Interpersonal: Stages of Change Theory (Transtheoretical Model)

• Views change as a multi-stage process or cycle occurring over time, rather than a single event
• Assumes individuals are at different stages of readiness for lifestyle changes
• People cycle through various stages over time, depending on the behavior and the environment's support

Oral Health Example (Stage of Change)

• Cycle starts with awareness of a problem (e.g., gingivitis)
• Moves to behavior change (effective brushing/mouthwash usage)
• Next, preventive actions are maintained and reinforced (follow-up visits).
• Health promotion should match resources and messages to the individual's stage of readiness to change.

Interpersonal: Health Belief Model (HBM)

• Allows assessment of perceptions of susceptibility to health risks and whether preventative behaviors will reduce susceptibility.
• The model assumes that increased perceived severity and susceptibility of a disease increases the likelihood of action

Oral Health Example (HBM)

• Example questions based on the Health Belief Model applied to a pipe-smoking father: Does he perceive a risk for oral cancer due to his pipe smoking? Does he believe limiting pipe use will reduce his risk? Does he perceive risks of quitting pipe smoking to be worse than oral cancer risk? Does he think he can quit and how much support does he need

Interpersonal: Social Learning Theory

• People learn through direct experience, observation of others, and the results of their actions.
• Behavioral change results from the interaction of personal factors, environmental influences, and individual behaviors

Oral Health Example (Social Learning)

• Example: Supporting a single mother on improving her child's oral hygiene through demonstrations, video, and ongoing feedback. This feedback loop extends to other childcare workers and parents at the center for improved oral healthcare habits.

Community Level Theories

• Community Organization Theory
• Diffusion of Innovations Theory
• Organizational Change: Stage Theory

Community Organization Theory

• Encompasses the process of involving and activating community members for addressing a common problem or goal; mobilizing resources and evaluating outcomes for community improvement

Oral Health Example (Community Organization)

• Example: A church pastor and congregation noticing decline in elderly attendance at church suppers due to tooth loss. Dental professionals collaborate to address the needs and provide dentures, enabling elderly attendees to feel comfortable returning to church suppers.

Diffusion of Innovations theory

• This theory assesses how new ideas, products, or services spread through a society or other groups. Analysis considers innovation characteristics, communication channels, and social systems.

Oral Health Example (Diffusion of Innovations)

• Example: The adoption of dental sealants, proceeded more rapidly in public health clinics (urgent need for change, strong advocacy) versus private offices (lower caries rates, payer issues, procedural adherence).

Organizational Change: Stage Theory

• Organizations evolve through discrete stages of change. Specific strategies are needed at every stage

Oral Health Example (Organizational Change)

• Example: Health educators implementing changes to the cafeteria food to promote healthier worker lunches. Note the multiple stages of change in the hospital process.

Combining Health Promotion Theories

• Health promotion theories frequently combine in interventions for a broader ecological understanding.

Expanding Dental Hygiene Knowledge and Strategies

• Dental hygienists must update their knowledge in assessing/changing health behaviors.
• Innovative programs from other fields and countries are helpful to improve dental hygiene practice.

Lesson 8.2: Health Communication and Personal Development

• Part 1 (1 of 3): Describes health communication related to health information technology. Presents strategies for framing health messages for various audiences and types of mobile and social media.
• Part 2 (2 of 3): Identifies uses and limitations of strategies for delivering health information (like materials, activities, communication pathways, & evaluation). Outlines considerations for formats in communicating information effectively to health professionals.
• Part 3 (3 of 3): Identifies opportunities for personal growth in health promotion, health communication, and health information technology.

Health Communication and Health Information Technology

• Health communication involves studies and effective communication strategies that promote health, considering both individual and community decisions and actions within a social context.
• It is important in health communication programs to use appropriate communication channels/contexts/content to capture attention and motivate audiences toward relevant health information.
• Effective use of technology (HIT) in health communication is key to accommodate consumer expectations and accessibility needs.

Social Marketing

• Applying marketing principles to influence human behavior with the aim of improving society.
• The core marketing components (Product, Price, Place, Promotion) all play integral roles.

Framing Health Messages

• Effective message framing is crucial. Gain-framed messages focus on the positive benefits of behavior change, while loss-framed messages highlight the potential downsides of inaction
• A critical error in health promotion is assuming increased knowledge leads to significant behavioral changes.
• "Targeted” health materials help reach specific groups based on demographic characteristics for more personalized impact.
• Personalization can lead to individualizing messages effectively within a health communication strategy

Consumer-Oriented Communication

• Resources are available for dental hygienists for effective message selection, communication format evaluation, and audience evaluation.
• Interactive formats and multimedia strategies are often more effective than basic reading or listening.
• Focus groups are used effectively to assess appropriate language, literacy, and cultural appropriateness of health messages; insights into audience health literacy are also helpful tools.
• Communication should be culturally sensitive and address linguistic competencies; Health promotion interventions that work often are rigorous, theory-based, have a pilot-phase, use skill building principles, and are delivered by skilled professionals.
• The evaluation plan should be in place before implementing health promotion interventions, defining objectives, activities, messages, timelines, resources, responsible parties, methods, measures, and anticipated outcomes in the evaluation plan itself.

The Planning Process

• Begin development of health promotion/communication plan by analyzing the needs assessment; this plan should outline objectives, target audiences, activities, timelines, resources, responsible parties, evaluation methods, measures, and anticipated outcomes.

Evaluation Considerations

• Evaluating the communication channels, methods, and resources is crucial.
• Evaluations can occur throughout/after educational interventions

Guiding Principles (Effectiveness of Interventions & Evaluation)

• Crucial questions for evaluating interventions: did they achieve goals? Why not if not successful? Continue or modify the program? What interventions/messages show the most effectiveness? How can these be expanded to additional settings? Are used resources reasonable/cost-effective?

Presentations to Health Professionals (overview)

• Includes guidelines and considerations for professional presentations across different delivery methods

Presentations to Health Professionals (types)

• Poster Display: The format for a poster presentation includes session time varying (1-2 hours), visual display focus (with discussion time).
• Oral Paper: Shorter presentations (10-15 minutes) using audiovisuals (powerpoint, videos, etc.), may reach larger groups.
• Tips for effective poster- and oral-based presentations to health professionals also include tips.
• Round Table Discussion: Interactive format (30-60 minutes) with small groups (8-10 people) using handouts/materials; discussions are beneficial with conversational topics but audience size limits how broadly information reaches.
• Web-Based Presentation: Typically 30-60 minutes with live audio/slide discussions/video demonstrations; can reach larger audiences; tips include a practice session before the presentation to minimize technical difficulties.

Guiding Principles for Choosing a Presentation Format

• Key questions to consider include target audience, audience size, the audience's knowledge on the topic, the presentation format and its limitations (visual resources, required discussion time).

Resources for Professional Development

• Use of resources pertinent to public health topics like health education, promotion, communications, injury prevention, cancer prevention, maternal/child health, geriatrics, and school health.
• Networking with professional associations (meetings, general healthcare, and specific areas).

Explore the fundamentals of health promotion and communication in dental hygiene. This chapter delves into strategies, theories, and models applicable to oral health. You'll learn about assessing diverse population needs essential for effective health communication planning.