PLANNING FOR Planning for allocation of resources -the planner needs to inquire into the

COMMUNITY PROGRAMS history and current status of dental

-Involves selecting best alternatives services in the community.
to achieve a desired goal when the
amount of resources is limited . To gather information on a
population
- Planner are called on to allocate the A population profile should be
budget labor and facilities in a system obtained :
so that it may meet existing needs and
demand . 1. Number of individuals in the
population
Creation of a plan 2. Geographic distribution of the
population.
-Involves the development of a 3. Rate of growth
Types of health Planning
blueprint or proposal for action 4. Population density and
containing recommendation and degree of urbanization
I. Problem Solving Planning :
supporting data. 5. Ethnic backgrounds
-Involves the identification and
Ex. Health state plan that describe the 6. Diet and nutritional level.
resolution of the problem.
health status and distribution of 7. Standard of living
health services for the population. 8. Types of housing
Ex. Appearance of dental fluorosis
9. Amount and type of public
among residents of a community in
Design of standard operating service utilities
colorado . This enamel disorder was
procedure: 10. Public and private school
identified through a scientific study of
system
possible causative factor.
Requires planner to come forth 11. Patterns and distribution of
with a set of standard practices dental diseased.
Program planning
or criteria for the operation and B.The planner needs to inquire into
evaluation. the history and current status of
Entails designing a course of action
dental programs in the community
for a circumscribed health problem .
Steps in Program Planning ❖ Types of program
Ex. School based fluoride rinse
1.Conducting need assessment : currently existing.
program .
Reason :
- To define the problem and to ❖ Organization
Steps in Program Planning
identify its extent and severity. responsible for the
-Used to obtain a profile of the planning,implementa
Is a decision about a course of action
community to ascertain the cause of tion and
the problem. administration of
Is a systematic approach to defining
-To evaluate the effectiveness of the programs.
the problem , setting priorities
program by:
,developing specific goals
a. obtaining baseline information. ❖ Whether programs are
and objectives determining
preventive.
alternative strategies and a method
b. measuring the amount of progress
of implementation.
achieved in solving the specific C.The planner must learn the way in
problem. which policies are developed and
Coordination of effort and activities
decision are made within the
planning
A.Techniques in obtaining data communities
● Survey questionaire ● Financial leaders
-Aims to increase the availability ,
● Clinical examination ● Policies for the communities
efficiency, productivity, effectiveness,
● Personal communication ● Organizational structure of
and other aspects
community
of activities and programs.
Factors the planner should consider: ● Attitude toward oral health
● Number of individuals and community dental
-It involves an adjustment process
involved program
such as closing of services and
● Extent and degrees of severity
facilities.
of the problem D.Types of resources that are
Ex. closing of obstetric and pediatric
● Attitudes of the individual to available to the community to
ward in hospital located in areas with
be surveyed. successfully implement a program
declining birth rate.
● Funds
 ● Facilities
● Labor
E. Educational status of a community .
Provides two prospective
planning:
● Tells educational level in
years of schooling obtained.
● Indicate community values
toward obtaining an
education.
Median income – indicates the
population’s ability to purchase
health services.
Transportation system- provides
planner with
information regarding a population
ability to get to health care service
Health care facilities –indicates the
types of service being provided,
amount of services , cost of this
services.
Labor data- indicate the number of
dentist providing the care.
II.Determining Priorities
Method of imposing people values
and judgment of what is important
onto the raw data.
Purpose :
1. Setting priorities among
problems elicited through a
need assessment
2. Ranking solution to the
problem
3. Allow the most efficient
allocation of resources.
Factors considered in determining
priorities
Problem that affects a large number
of people
- generally takes priority over a
problem that affects small number of
people.
- serious problems.
- community should be involved.
Target group commonly associated
with high risk dental needs:
➔ Preschool and school
children
➔ Mentally and Physically
handicapped patient
➔ Chronically ill or medically
compromised patient.
➔ Elderly person
for ➔ Expectant mother
➔ Low income minority group
Specific group that are more
susceptible to dental caries :
-Preschool
-School age children
-Low income minority group.
III. Development of program goals
and objectives:
Program Goals -Broad statement on
the overall purpose of a program to
meet a defined problem .
Program Objectives – more specific
- describe in measurable
way the end result of program
activities.
Objectives should be:
S-pecific
M-easurable
A-ttainable
R- esult oriented
T-ime bounded
2 types Objectives :
1.Outcome objectives :
Provides a means by which to
quantitatively measure the outcome
of the specific objective.
2. Process objective :
Specific process by which a public
health problem can be reduced and
prevented .
*Program objective should specify:
What : nature of the situation or
conditioned to be attained .
Extent : the scope and magnitude of
the situation or conditioned to be
attained.
Who : the particular group or portion
of the environment in which
attainment is desired.
Where: the geographic areas of the
program
When: the time at or by which the
desired situation or condition is
age intended to exist.
Ex. Of outcome objective : “ by the
year 2024 more than 90% of the
population aged 6-12 years in
community x will have not lost any
teeth as a result of caries, and at least
40% will be caries free
-It provides a means by which to
quantitatively measure the outcome
of specific objective.
Program Activities:
Described how the objectives
will be accomplished .
3 components.
1. What is going to be done?
2. Who will be doing it?
3. When will it be done?
When planning these type of
program activities, consideration
should be made to the type of
resources available as well as to the
program constraint .
A. Resource Identification:
● Personnel
● Equipment and supply
● Facilities
● Financial resources
*Criteria use to determine what
resources would be utilized:
Appropriateness- the most suitable
resources to get the job done.
Adequacy – the extent or degree to
which the resources would complete
the job.
Effectiveness- how capable the
resources are at completing the job.
Efficiency – the cost and amount of
time expended to complete the job.
B. Identifying constraint
Roadblocks or obstacle to achieving a
certain goal or objectives
- by identifying constraint early in the
planning –can modify the design of
the program creating a more practical
and realistic plan.
Constraint may result from:
1. Organizational policies
Ex attitudes of professional
organization limitation of state dental
practice
2. lack of funds
3. Characteristic of the community
3. Inadequate transportation systems.
Ways to identify constraint- bring
together group of concerned citizens
who might in some capacity be
involved in or affected by the project.
A group that is familiar with the local
politics and community structures
Alternative strategies :
Being aware of the constraint and
given the available resources, the
planner should then consider
alternative courses of action that
might be effective in attaining the
objectives.
It is important to generate a sufficient
number of alternatives so that out of
that number at least one may be
considered to be acceptable.
If the preventive measure was
considered to be cost –effective as
well as practical to implement the
planner would choose that measure as
the best of the alternatives.
Implementation, Supervision,
Evaluation and Revision
Implementation :
-The process of putting the plan into
operation.
- The phase is ongoing in situation
where supervision and evaluation of
the program will ensure effective
operations.
Developing implementation strategy:
An implementation strategy for each
activity is complete when the
following question are answered:
Why : the effect of the objective to be
achieved .
What : the activities required to
achieve the objectives.
Who : individual responsible for each
activity
When : chronological sequence of
activities.
How : materials, media ,methods,
techniques to be used.
How much : a cost estimate of
materials and time
Monitoring , evaluating ,and revising
the program.
Once it has been implemented ,the
program requires continous
surveillance of all activities
Monitoring:
how well individual are doing their job
. someone’s action .
How well equipment functions.
How approriate and adequate
facilities .
- are fundamental to the program’s
success.
Evaluation – allows us to:
1. Measure the progress of each
activity.
2. Measure the effectiveness of
each activity.
3. Identify problems in carrying
out the activities.
4. Plan revision and modification.
5. Justify cost of administering the
program as well as to justify seeking
additional funds.
Program evaluation in health care:
Program evaluation is concerned with
finding out how well program works.
Fundamental purpose: provide
information for decision making .
It is a judgement of merit or worth
about a particular person ,place or
thing .
Basic research- abstract and general.
Applied research- highly concrete and
specific.
Evaluation vs. Research
Researcher and evaluator possess
many
similarities:
Both engage in scientific inquiry.
Both use test questionnaire and other
measurement device .
Both collect and analyze data
systematically using common
statistical procedures.
Both can be found describing their
outcomes in formal reports.
1. Differrences :
Gathering information:
Researcher: want to draw conclusion.
Evaluator: want to make decision.
2. Sole purpose :
Researcher : understanding
phenomena.
Evaluator : want to understand
phenomena to better influence
3. Whether or not results can be
generalized
Researcher: study the relationship
among
activities so that ideally findings can
be
generalized to a wide variety of
similar
situation.
Evaluator : focus is on particular
program .
Ex. Testing of fluoride rinse.
Researcher: concerned with:
Effect of fluoride rinse on teeth.
Strength of solution necessary to
produce a reduction in caries.
Whether his conclusion could be
generalized across the population.
Evaluator :
1. was interested in determining
whether the program initiated to test
the researcher conclusion was run
correctly and followed the objectives
it stated
2. Positive or negative effect of
fluoride rinse.
4.Determining the value of things:
Researcher : only strive to obtain
accurate truthful information.
Evaluator : eventually comes down to
making a decision about what should
be done /which course of action is
best .
Individuals interested in the result of
evaluation :
1. Program Director
- interested in knowing the overall
effectiveness of the basic program.
2. Policy maker
-concern about financial issue.
3. Program developer
Seek all kinds of information about
ways to improve specific parts of the Advantage: Concept of informed consent :
program that affects them directly. 1. do not require large groups of study
4. Epidemiologist subjects * Informed consent is required when
- seek to compare effect of different 2. can be carried out in a relatively a person will receive some treatment
program. short period of time. or be involved in some techniques of
- Deal with applying some behavioral physical or psychological
Research in Community Dentistry: or educational technique to the oral manipulation that is regarded as
5 Aspects : hygiene practices of an individual or experimental in nature.
group.
1.Types of research commonly carried Informed consent may not be
out in the field. Experimental subjects: required if the individual is not
2. Role of federal government in Can be approached on several directly involved in the research. ex.
supporting such research. different levels, which may involve
3.Ethical issues related to research changes in knowledge,attitudes or If patient records , radiograph, or
involving human subject. behavior. previously
4.Techniques for designing research extracted teeth are used in a situation
studies and writing protocol. Administrative and evaluative where
5.Methods for reading and evaluating research : the patient are not directly identified.
published dental research literature. It deals with the way in which a
program operates and how it can be If the records ,or radiographs were
Types of research in community improved. collected
dentistry: for the purpose of research ,then
3 different areas: Questionnaire survey: informed
an important tool of administrative consent – required .
1. Clinical trials and evaluative research .
- test of techniques and of therapeutic In general if a patient or experimental
agents. - Effective in securing information subject
2. Research in educational technique from a population under study. is manipulated in any way for
and the behavioral sciences. experimental
3.Research related to the Government role in Community purposes –manipulation and risk is
administration and evaluation of Dentistry Research: minimal-
community dental programs. Intramural Research informed consent is required .
Extramural research
Clinical trials of techniques and of Placebo
therapeutic agent: Funding 2types:
Usually follow as the practical Is an agent that is known to have no
application of laboratory research, a. Grants- awarded either to an physiological effect on the patient .
epidemiological observation or both. institution or individual for the
purpose of attaining some research Extremely beneficial effect with a
Ex. Is the observation during 1900’s of goal that has been defined by the patient
severe staining and mottling of tooth individual or institution whose problem is basically
in colorado u.s.a. but this psychological
disfigurement was accompanied by a b. Contracts- evolves from a research rather than organic.
relatively low dental caries protocol that has been designed and
prevalence. stipulated in detail by the federal
agency.
- It was not until 1930s that the
observational technique of Request for proposal (RFP)
epidemiology and analytical - Is a device used when contract
technique in chemistry were able to research is anticipated.
establish connection between
mottling of teeth and high fluoride Request for Application ( RFA)
content in the drinking water. - Suggest general area where the
government places high research
Educational and behavioral research: priority.
Frequently carried out by
undergraduate dental students. Ethics of Dental Research