Program Evaluation: Evidence for Utilization of AAPD Dental Screening Tool by Primary Care Providers in the Promotion of Better Dental Health in Children

The primary purpose of this project is to improve the oral health status of children 6 months to 13 years of age by integrating the use of the Carries Risk Assessment Tool (CAT) into Primary Care Provider (PCP) office visits to ensure early detection, intervention, and referral for children with childhood carries. This evaluation will seek to provide insight on whether the program is being implemented as planned, how many patients are being referred for dental services, how many and who is receiving dental services.  It uses a combination of summative and formative evaluation designs to identify needed dental referrals for non-typical patients and patients with increased risk of Early Childhood Caries (ECC). It also helps to compile a community health analysis and promote dental health and regular treatment for children.

Outcome/Summative Evaluation

To determine the status of these objectives, data will be collected through the American Academy of Pediatric Dentistry (AAPD), Caries risk Assessment Tool (CAT). These medical records and patient charts will be randomly selected and reviewed for dental referral opportunities and potential ECC patients. Questionnaires will be administered by mail, telephone, face-to-face interviews, handouts, or electronically, and will be quick, easy, and inexpensive (Burns & Bush, 2010). Surveys and patient data tracking sheets will be utilized to determine the status of the objective for health promotion in parents and children and the establishment of a dental home for regular dental treatment.  

Analytical Techniques

Descriptive analysis will be used to create a frequency distribution answer the ultimate program evaluation questions.  To provide further insight into the populations served and to identify any loopholes of care, a contingency table analysis will be performed to compare patients in different groups based on captured variable data (Andersen, 1980).  To identify any difference in statistically significant distribution between the categories of patients, a chi-square will be performed and any quantitative measurements on any particular variables will be analyzed through the use of a t-test.  

Process/Formative Evaluation

A formative evaluation will be conducted throughout program implementation with an aim of program improvement.  Data will be collected from participating primary care providers (PCP) and their office staff, via feedback forms, and periodically scheduled program evaluations.  These periodic checks will identify any problems in CAT implementation, patient referrals, patient treatment plan documentation, and adequate follow-up.  Audits will be conducted on patient charts, patient referral activity, and proper utilization of the CAT, by PCP’s (Greiver, 2006). Additionally, reviews of patient literature and handouts on dental health and treatment will be reviewed for accuracy and to ensure patient understanding.  This formative evaluation will help to determine the extent to which the project has successfully implemented the inputs and the status towards achieving planned outputs. 

The two part program evaluation plan will produce analytical data with an effort to improve services, obtain additional funding for the use of CAT, support the use of CAT by more PCPs, and promote changes to policy that will allow for insurance carriers, and state health insurance providers to pay and approve CAT exams and additional dental health treatments carried out PCPs that normally are reserved for dental health professionals.  As a result, this plan is realistic and feasible as it incorporates specific and targeted information that will assist in improved decision making by stakeholders and program funders. 

References

Andersen, E. B. (1980). Discrete Statistical Models with Social Science Applications. North Holland, 1980.

Burns, A. C., & Bush, R. F. (2010). Marketing research. Upper Saddle River, NJ: Pearson Education.

Greiver, M. (2006). Chart audits in my practice. Can Family Physician. 52(4): 451–452.