Program Implementation and Evaluation: Part II

Dates:

 Session One: 3/14 & 3/15

 Session Two: 3/21 & 3/22
 Session Three: 3/28 & 3/29
 Session Four: 4/4 & 4/5

Program Design:

 How was the program initiated? Was this program advertised?

Due to our personal relationship with one of the staff members of DeVita Dialysis
Center, Kathleen Selfridge RD, we were informed of an oral health knowledge deficit
in the patients receiving dialysis treatment and were able to provide educational
guidance for these patients. Since we were not allowed to visit the site, the entire
program was rum by Mrs. Selfridge. We provided all the needed paperwork and DVD
lesson plan recordings. The program was initiated by providing information to all the
patients receiving treatment at the two facilities Mrs. Selfridge worked at. Each patient
would receive a written description of the program provided by us, as well as verbal
description by Mrs. Selfridge. For all who wanted to participate, she would have them
sign the consent form we provided. This was not advertised to anyone outside of
these two facilities.

Session One: “Introduction to Oral Health”

 Written pre-test & patient background taken

 Video presentation delivered via DVD and monitors attached to each chair as patients
are receiving dialysis treatment.
1. Disclosure statement delivered before lesson began
2. Video description: “A brief overview of the periodontium in health and disease.
We discussed periodontal health, gingivitis and periodontitis along with risk
factors and additional conditions seen with each.”
 Written post-test taken

Session Two: “Home Care Products”

 Written pre-test taken

 Video presentation delivered via DVD and monitors attached to each chair as patients
are receiving dialysis treatment.
1. Disclosure statement delivered before lesson began
2. Video description: “A general overview of oral products these patients can use,
mainly focused on reducing their xerostomia. These products included lubricating
gels and sprays, oral rises, gum/lozenges, toothpastes, and denture adhesives
and cleaning tablets.”
 Written post-test taken
Session Three: “Oral Health Instructions”

 Written pre-test & use history survey taken

 Video presentation delivered via DVD and monitors attached to each chair as patients
are receiving dialysis treatment.
 Disclosure statement delivered before lesson began
 Video description: “A medley of video demonstrations on oral homecare to include
tooth brushing with a manual and automatic toothbrush, alternatives to brushing,
interproximal cleaning with string floss, proxabrushes, and water pic, tongue cleaning,
and denture cleaning.”
 Written post-test taken

Session Four: “Oral Screening”

 Written pre-test taken

 Video presentation delivered via DVD and monitors attached to each chair as patients
are receiving dialysis treatment.
 Disclosure statement delivered before lesson began
 Video description: “A brief overview of skin and oral cancer including risk factors and
descriptions of disease manifestations. Also, an overview of lesions associated with
dentures to include traumatic lesions, oral candidiasis, angular cheilitis, and papillary
hyperplasia. Finally, a video demonstration on how to do an at-home oral cancer
screening self-examination.”
 Written post-test taken

Program Objectives:

 For each program objective, provide a summary of how the objective will be
achieved.
1. Participants will identify risks associated with periodontal disease and prevention.
a. Achieved through marked improvement on lesson 1 post-test scores after the
video presentation when compared to lesson 1 pretest scores.

2. Participants will recognize oral health products used to target oral manifestations of
patients receiving dialysis treatment. 
a. Achieved through marked improvement on lesson 2 post-test scores after the
video presentation when compared to lesson 2 pretest scores.

3. Participants will determine the proper mechanisms of biofilm removal specific to their
homecare needs.
a. Achieved through marked improvement on lesson 3 post-test scores after the
video presentation when compared to lesson 3 pretest scores.

4. Participants will identify key factors in the prevention of skin and oral cancer and
lesions associated with denture use.
 a. Achieved through marked improvement on lesson 4 post-test scores after the
video presentation when compared to lesson 4 pretest scores.

Results:

 Provide the results for each objective

1. Mean scores of Pretest 1: 5.6 ; Post-test: 6.4 = Objective Met
2. Mean scores of Pretest 1: 4.5 ; Post-test: 5.7 = Objective Met
3. Mean scores of Pretest 1: 5.1 ; Post-test: 6.2 = Objective Met
4. Mean scores of Pretest 1: 5.2 ; Post-test: 6.5 = Objective Met

Evaluation:

 Describe how the program was evaluated (e.g. dental indices, pretest/post test)
Evaluated via pretest/posttest
 Describe how formative evaluation was conducted
After creating the first lesson plan and testing surveys, we quickly learned that
our groups demographic had a wide range of educational levels and the majority
learned at an elementary level. This caused us to take a step back and
reformulate how we ask our questions and how we deliver our presentations. We
re-recorded a couple of the videos before presenting them to better
accommodate the majority of the group.
 Describe how summative evaluation was conducted
After all the lessons were delivered and testing surveys were taken, we collected
all the paper test forms and graded them one by one. We then tallied up all the
correct answers for each question on every test. Also, we calculated the
information in the patient background survey they filled out in the beginning that
described their oral history, age, gender, race, existing health conditions, and any
history of xerostomia. Throughout this process, we plugged in all our data into an
Excel spreadsheet.
 Provide details about three (3) strengths of the program.
1. Ran Smoothly: The program was greatly impacted by the support provided by
the on staff registered dietitian, Kathleen Selfridge. Because of her the program
ran smoothly and due to her relationship with the patients she was able to recruit
and retain a lot more patients for this program.
2. Convenient: The convenience of this program made it easy for people to
participate. The patients receiving dialysis treatment are usually in the chairs for
three hours and have their own personal screens hooked up to their chairs that
they usually watch TV from. Since all the screens can be controlled remotely by
the clinic staff, we were able to record all of our lessons and deliver them without
inconveniencing to the patient.
3. Educational: We had an “additional comments” box at the end of every post-test
were patients could write questions or comment on the program. In this box we
 had numerous patients respond saying the learned a lot and they greatly enjoyed
the presentations.
 Provide details about three (3) weaknesses of the program
1. Virtual Hang-ups: Although we did get a lot of data from the pre-test/post-test
surveys, we could not do in person data collection. This prevented us from
collecting indices and doing hands on training with the patients.
2. Only One Supporting Staff Member: Like mentioned above, this program would
not have been possible without Mrs. Selfridge. No one else delivered the lessons
and collected the paperwork. This could be a problem if they ever wanted to have
another program in the future. Other than this program, the patients don’t receive
regular oral hygiene advisement mainly because the staff doesn’t deliver any.
3. Missed opportunities: I feel because the lessons were all online it was very
impersonal. We did not get a chance to build a relationship with these patients
and I feel any long-lasting changes will not be met because of it.

Future Site for Oral Health Program/ Recommended Changes:

 Describe overall thoughts concerning the program development site

o I had a chance to view one of the site after hours and it look like a very organized
and clean environment. There were educational posters and information all over
the walls with recommendations in regard to their treatment. It looked very
professional and the staff that were still at the site when I visited seemed very
nice. As far as working with us during our research model, we didn’t have any
contact with anyone other than Mrs. Selfridge but she did an amazing job on her
own.
 What changes are recommended based on evaluations
o The staff should be better educated so that they can help educate the patients.
o The resources for oral health education and information in these offices need to
be updated (aka. Pamphlets, contact cards..)
o They should increase interprofessional collaboration with dental personnel
o There were no technical issues with the site though. As a medical facility, with
proper clearance, this facility is suited for oral screening in the future.
 Additional information that was pertinent in this project – N/A

Learning Value:

 Did the group feel that this was a valuable project? Explain.
o Absolutely! Even from just the Pre/Post-test screening we feel we learned a lot
about our participants and this demographic in general. We wish it could have
been in person, but we enjoyed the project regardless. This was a fun project to
participate in and it taught us a lot about public health as a reality. How to teach
and how to collect data, in an alternative setting at that.

Collaboration:

 Describe the duties that each group member was assigned

 o Both: All lesson plan writing and recording, Group Project Part I, Pre/Post-test
grading, Data interpretation, Abstracts, Posterboard presentations
o Bethany: Written lesson plan assignment for lessons 3 & 4, Group Project Part II.
o Maricruz: Written lesson plan assignment for lessons 1 & 2, Imputing data into
Excel spread sheet, Introduction, Conclusion
 How did the group manage to work together?
o Very well. We were able to meet and coordinate our schedules easily for the
most part. We each contributed fairly in general to the project. We both had ideas
and suggestions to bring to the table which benefited the project in the end. And
we both shared a positive attitude throughout.