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UBC Theses and Dissertations

Evaluating the effectiveness of the Healthiest Babies Possible dental program Lin, Diana Louise

Abstract

Objectives: A community dental public health program in Vancouver has been providing clinical hygiene services and oral health counseling to a limited number of high-risk, low income pregnant women for over 20 years. To enable future program decision-making, a program evaluation was undertaken with the following objectives: 1) to describe program, clients, and their oral health needs; 2) to determine whether program activities have been implemented as intended; and 3) to assess program's effectiveness in improving oral health status of clients and in improving their knowledge and behavior in relation to their own health and those of their children. Methods: The evaluation, undertaken by the resident dental hygienist, had two phases. Phase 1: Evaluability assessment, descriptive and process evaluation (retrospective and concurrent chart reviews, semi-structured interviews, appointment monitoring, and field observations). Phase 2: A short- and medium-term outcome evaluation with a convenience sample who attended over a 1-year period. Data, collected by questionnaires, interviews, clinical indices, chart review, field observations, and appointment statistics, was analyzed with a combination of univariate and bivariate analyses. Results: Phase 1: Stakeholders' goals were identified; a logic model and organizational flowchart were developed. Chart review (N=123) revealed mean client age of 27 years; 28% Canadian-born; 48% had other children; 78% were concerned about "bleeding gums"; and 63% had visible tooth decay. 28% of women referred to the program never attended. Unfamiliarity of clients with the dental "experience", language barriers, and clinic operation and time restraints affected implementation of program's activities. Phase 2: Outcomes in clients (N=61) demonstrated significant improvements (P

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