Charge To Grantee States
Identify prevention opportunities for systemic, socio-political and/or policy change to improve oral health. Conduct a periodic assessment of policy and systems level strategies with potential to reduce oral diseases. The assessment should include identification of opportunities to make changes in policy and health systems to overcome barriers, capitalize on assets, increase capacity, and coordinate prevention interventions.
Performance will be measured by evidence of identification of socio-political and policy changes. Evidence can be shown by periodic assessments consistent with the activities above.
The state oral health program may find it helpful to conduct a periodic assessment (environmental scan) of policy (laws and regulations and administrative policies) and systems-level strategies (system changes) that offer the potential to reduce oral diseases. Several tools are available that can assist a state program to conduct this type of assessment; a state can select the one that best suits their organization. The analysis of policy and systems data can help identify any gaps as well as any strengths that can help the state to achieve the goals and objectives specified by the state oral health plan. The assessment can clearly present those opportunities that exist for overcoming barriers, capitalizing on assets available in the state, increasing capacity, and coordinating prevention interventions. Efforts then can be made to educate policy makers on ways to increase the capacity and effectiveness of the state oral health program. Some examples of such changes in health systems and policies would include increased Medicaid reimbursement for specific services and mandates for fluoridation in communities with water systems that serve a specified number of households.
Policy Framework
The State Based Oral Disease Prevention Program requires states to address 10 "infrastructure development tools" which are listed in order as: (1) leadership capacity (leadership), (2) oral disease burden document (burden document), (3) state oral health plan (plan), (4) statewide oral health coalition (coalition), (5) oral disease surveillance system (surveillance), (6) policy and health systems strategies (policy), (7) partnership development (partnerships), (8) evaluation of oral health programs (evaluation), (9) community water fluoridation program (fluoridation), and (10) school based/school linked dental sealant program (sealants).
Through discussions between CDHP and CDC Division of Oral Health (DOH) leadership (Director, Deputy Director, and Project Officer), CDHP has refined the conceptual framework around policy in a way that may facilitate grantee efforts. This framework suggests that the grantee requirement to educate policy makers on ways to increase the capacity and effectiveness of state oral health program[s] can be accomplished by using an organized approach in which 3 message bearers (leadership, coalition, partners) employ 4 evidentiary inputs (burden document, state plan, surveillance findings, results of evaluation) to promote support for 2 specific outcome goals (fluoridation and sealants). This conceptual framework is represented in the figure below. It helps states understand the potential for the policy element and how their efforts can provide an 'evidentiary' basis for supporting oral disease prevention and health promotion.
During 2005-06, CDHP performed a variety of activities in establishing itself as a policy-related resource for the states in promoting both community water fluoridation (CWF) and sealants:
