Research Methods
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FinalILEpaperKSWedits.docxORAL HEALTH IN SOUTHSIDE OF CHICAGO 1
Oral Health Education and Intervention in The Southside of Chicago
Executive summary
In this paper, it is evident that Ooral health plays a vital role in an individual's general health. It needs excellent awareness and educational knowledge for one to maintain excellent oral health. Every person should seek medical intervention when developing a type of oral health disorder. Most oral health disorders are curable. Based on the research done in this article, it is evident that the most vulnerable community members are the most affected by oral health disorders: women and children. Women are more prone to oral health disorders due to their hormonal changes, while children are more prone to infections due to their carelessness and lack of knowledge. Comment by Watson, Karriem: Consider re-writing Comment by Watson, Karriem [2]: What about racial/ethnic minorities? Prior to this sentence, consider providing one summary sentence on statistics that highlight what the disparities in oral health are and who is impacted Comment by Watson, Karriem [3]: Avoid statements that can be regarded as judgmental
Based on the research in this article concerning the vulnerable community in Southside Chicago, it is evident that oral health is the most neglected healthcare. The best way of preventing oral health disorders and infections through understanding oral hygiene and general mouth cleanliness. Creating awareness amongst the vulnerable in the community is another way of reducing people suffering from oral health disorders. There is a various intervention that the health care providers initiate in areas that are believed to be underserved, and they should choose the most effective and efficient measures. After the intervention, the health providers should start follow-up procedures. Comment by Watson, Karriem [4]: Needs grammar check Comment by Watson, Karriem [5]: grammar
Background and Rationale
Oral health is essential to every individual globally. Oral health is the strength of one’s mouth with the inclusiveness of the gums, teeth, bones around the mouth, and the throat. Having good oral health helps people to go about their daily activities without experiencing discomfort or pain that may hinder them from their lives to the fullest. However, it should be understood having good oral health does not mean that one is free from some oral disorders such as tooth decay, periodontal disease, gingivitis, or oral cancer(Azami-Aghdash et al., 2021). There are standard and natural ways of maintaining good oral health in an individual, one of the best ways is to ensure you brush your teeth daily, which helps keep the bacteria under control. When one does not observe oral hygiene, there are very high chances that the bacteria in their mouth might get into levels that could lead to some oral infections such as gum disease and tooth decay.
Based on research done in the United States Department of Health and Human Services, it is evident that oral health is essential to the general health of an individual for it gives and an indication of the nutritional deficiencies and infections that may affect the entire body. In the United States, more than 33% of the total population have no access to community water fluoridation; hence on taking the water end up developing some tooth disorders such as tooth decay (U.S. Department of Health and Human Services, 2017). It is also necessary for every person to have dental insurance, just as it is for medical insurances. In the United States, many of the vulnerable population lack dental insurance that amounts to 108 million children and adults. This number is 2.5 times the number of individuals without medical insurance. Comment by Watson, Karriem [6]: Was it done in or supported by US DHHS? Comment by Watson, Karriem [7]: Needs citation
Oral health affects the personal health of an individual and their mental and psychological health. In most cases, the impacts brought by poor oral health may taint one image towards others, and in most instances, it lowers their self-esteem. If low self-esteem is not managed with a lot of care, it can lead to depression(Azami-Aghdash et al., 2021). Most Americans in the United States are suffering from dental care, and a permanent solution for the issue is yet to be found. It is evident that in the United States, the cost of dental services continues to rise daily hence making it for people from vulnerable backgrounds to access dental care services when need be, and they end up suffering in silence. There are also some unethical preferences for most dental clinics for self-pay or the private patients hence alienating the patients with dental needs. They're some of the health care premises in the United States that are selective of the dental coverage. This dramatically affects those individuals who depend on government insurance due to their low-income status, so they cannot get the dental care they need due to their insurance plan. Based on research done in the United States, it is evident that African Americans are more prone to experiencing a disproportionate level of oral health problems than white individuals. Comment by Watson, Karriem [8]: Needs a re-write and
Target Audience
In our discussion about oral health, our target population is children and women. Based on a report by CDC, it is evident that most individuals in the United States suffer from cavities during their childhood, which is considered the most common chronic disease among children. When this chronic disease attacks one, it should be treated immediately and fail to develop long-term disorders such as speaking, eating, learning, and playing. Research done in the United States proves that children with poor oral health are more likely to miss more classes; hence, in the long run, they end up scoring poor grades compared to those with good oral health(Baiju et al., 2017). Children between the age of 5 to 19 years who come from families of a low-income status have double the chances of getting cavities than those who come from a family of high-income status. The oral health concern in women is unique due to the change in hormone levels during the critical times of their life, such as during pregnancy, menstrual cycle, and menopause. The changes in hormones level in women and raise their risk of issues in their teeth, mouth, or even their gums. Based on the statistic taken from the CDC, it is clear that one in four adults in America suffers from untreated tooth decay, which is an equivalent of 2.5 million of the total American population. Half of the individuals who are 11 years and below living in Chicago are believed to have cavities(Baskaradoss, 2018). Based on the University of Illinois College of Dentistry research, about 65% of children in third grade have cavities problems, and half of that number goes untreated. Comment by Watson, Karriem [9]: First time stating it, so needs to be written out
The proposed program intervention will be conducted in the Southside neighbourhoods of Chicago. The reason for choosing this location is that most people living in it are from vulnerable backgrounds and are underserved, hence lack reasonable access to oral health awareness, education, and care. Oral health is one of the most vital and integral parts of people’s overall health; hence it should be given maximum attention(Bersell, 2017). Agreeing to the report by Heartland Alliance, great oral wellbeing needs a comprehensive approach to avoidance where oral health education and mindfulness of care just like the utilization of fluoride toothpaste, get to fluoridated water, regularly seeking dental care, a schedule of domestic dental care, and a nutritious eat less that contains less sugar.
There are some comprehensive approaches for the intervention intended to take place on Chicago’s Southsidein Southside Chicago. Based on research, there are only 66 safety net dental clinics in Southside Chicago that offer care for the underserved and the vulnerable population(Dagon et al., 2019). Another evidence is that around 753 281 people had enrolled for Medicaid in Chicago, and there was only one safety-net clinic intended to serve 11 400 enrollees(Fisher-Owens et al., 2017). The dental care that the 11 400 enrollees were offered was insufficient because most clinics do not give a full range of all the dental services to the underserved population due to inadequate funds and slower technological advancement in the facilities. Comment by Watson, Karriem [11]: Needs to be rewritten
The first intervention is to evaluate the community based on their input concerning their dental needs. After completing the first intervention, the next one will offer an oral health education workshop to parents to enlighten them and create awareness to help them understand the community's needs(Ghaffari et al., 2018). The parents should also be trained on how they can identify the best intervention services that will solve their needs and those living in the Southside of Chicago.
The subsequent intervention that will be implemented is providing access to dental care for the vulnerable populations and those who come from low-income families, more so children and women living in the Southside of Chicago. The above intervention will be made possible by partnering with FQHCs clinics located in the South Side of Chicago. This will offer free dental care to mothers and children in the community aged 18months to -12 years old(Lee, Kim, & Yang, 2021). another group that will partner with the investigators during the above intervention is the Cook County hospital. This is believed to offer sliding scale fees to patients with advanced dental care, for instance, teeth surgery. Another group that will partner with the investigators during the intervention is the hospitals located in Chicago, such as Presence Health Care, known well for having mobile vans that will help provide free dental services every six weeks to the children and women Southside of Chicago.
The Community Health Workers' role will be involved in the intervention process to create organized programs that will help develop awareness and enlighten women and children about dental health. They are considered the vulnerable population in Chicago. For the above exercise to be successful, it should be done in three sections. One of the three sections offers dental health education to all the participants that show up for the dental service outreach(Lee, & Somerman, 2018). The second section of the above intervention is scheduling home visits to the patients to ensure that they are the intervention practices are effective to all the individuals hence there will be no cases of being underserved. The last section of the above intervention is scheduling phone call conversations with the patients, which will help educate the children and women about dental health.
During the dental van service outreach, the trained CHWs are supposed to engage in registering women and children who have shown up seeking to get dental care. The trained CHWs should also offer dental health education and create awareness for women and children. An education section should be created to help create fluoride awareness and education where trained CHWs will give a brief overview of the fluoride effects and the different measures to get fluoride to the teeth(Martin et al., 2020). When women pay a visit to the dentist, a Fluoride varnish should be recommended to them by the dentist. Women should also be educated on different measures of incorporating fluoride in toothpaste and water daily.
It is necessary to permit women to see a dental assistant or a dental hygienist after undergoing dental education and awareness. After every dental care, women and children who are found with critical dental health issues will be sent back to CHWs to schedule a follow-up appointment which should be done by planning a home visit or through a phone conversation.
The home visit intervention will see two home visits scheduled where the medical professionals are supposed to interact with the patient freely. This will enable them to attend to patients in underserved areas. The home visit should be scheduled in two phases. In phase, the individuals of the vulnerable population should be enlightened of a brief overview of their dental health, the effect it has on their health, and create awareness of fluoride to their teeth(Martin et al., 2020). The benefits of brushing one’s teeth and flossing regularly, more so during bedtime, should also be discussed during the home visit. The home visit also gives room for people who had previously been involved in the dental van outreach and were further recommended to seek higher care in dental services. They should be given referrals to hospitals and clinics to get optimum care for their dental needs. Also, during the home visit intervention, individuals who cannot schedule an appointment for themselves receive help from the medical professionals who schedule a date for their appointment and their solutions to their oral health disorders(Office of the Surgeon General, 2019). Some people in a community do not care about their health and wellbeing. Through the home care visits, the medical staff can note them and offer free help where they end up getting solutions to their issues and educated always to be careful with their lives.
The second home visit should be a follow-up visit where all the participants should be evaluated based on their care during the previous intervention. The health care providers will assess the effectiveness of all the things done in the first home first and evaluate any improvement in the vulnerable population. In the above home visit, the participants will be given room to ask questions concerning their dental health and other issues affecting them(Patil et al., 2020). The health care providers will also take this opportunity of the second home visit to attend to any person that was left out during the first home visit due to whatever reason. The health care providers can also use the second home visit in giving clarity in areas that the patients did not understand during the first visit. The health care providers can use the second home visit in giving hand-outs to the members of the vulnerable population to educate them further on matters concerning their dental health(Reid et al., 2020). In the second home visit, the health care providers will ask questions to the members of the vulnerable population, and those who answer correctly should be given a token of appreciation. In most cases, it should inform of things that boost their oral health, for instance, the toothbrush and the toothpaste. Comment by Watson, Karriem [12]: You need a better transition from the closing paragraph that ends with “toothpaste” to the new paragraph on theory based intervention….
A theory-based intervention to increase dental disadvantage in women and children
Based on Peter Margolis, various theoretical frameworks can increase medical care utilization in dental hospitals in Chicago. The Peter Margolis theory is used in healthcare facilities in Southside Chicago to assist women and children from underserved areas in getting proper dental care(Aliakbari et al., 2021). The intervention occurs by conducting a randomized study amongst a significant number of parents who should volunteer as participants. In the above analysis, the participants are supposed to answer some questions to help in the intervention. One of the questions includes, do contextual variables influence the utilization effects of interventions? In this kind of intervention, dental care utilization is the primary dependent variable while the vulnerable population is the independent variable. The intervention also had some covariates, including psychological and socioeconomic factors affecting people living in the underserved region of Chicago.
Based on the sample of children taken during the intervention, it is evident that a quarter of the children who enrolled on the study was for regular dental utilizers, while the intervention lacked a direct effect on utilization. During the intervention, it is clear that children in the control group are more advantageous than those in the intervention group more than three times; hence, they do not regularly visit the dentist (Aliakbari et al., 2021). It is also clear that women and children from low-income families visit the dentist three times more than those who come from the control group. Only younger children, those who had not previously received regular dental treatment, and families in the lowest income brackets saw an increase in use due to the intervention.
There is another form of intervention which is the use of mobile phones. The mobile forms can be very useful to the participants in the intervention to be educated about their dental health and be enlightened concerning the same through their devices. During the above intervention, the CHWs will briefly explain the dental overview, its effects and create awareness on fluoride to an individual's teeth. The CHWs will also outline the benefits of regular and proper brushing of teeth and the importance of mainly flossing during bedtime. In this intervention, the members of the vulnerable population also give referrals of other individuals that could be suffering from oral health disorder in the community (U.S. Department of Health and Human Services, 2017). On getting the referrals, the health care providers should book an appointment for all the affected people whose condition cannot be intervened at that particular moment. Comment by Watson, Karriem [13]: Forms or phones?
The main aim of the interventions is to ensure that all the individuals from the vulnerable population living in the underserved areas of Southside Chicago. Due to the close access to oral health information, there should be a significant improvement in the number who suffered from poor oral health disorders in the underserved areas of Southside Chicago (Department of Health & Human Services, n.d). The second main objective of the interventions is to reduce the tooth caries and cavities amongst the children aged 18 months to 12 years old who lived in the Southside of Chicago (U.S. Department of Health and Human Services, 2017). Another goal of the interventions above is to ensure that almost every person in the underserved areas of Southside Chicago receives optimum care concerning when in need of their oral health maintenance.
The evaluation research design used for the interventions above is a pre and post-test with a follow-up. The evaluation research design used works by collecting data before starting the program and at the end of the program. The evaluation research design can also assess all the oral health measures in the future(Watt et al., 2019). The above research design is the most appropriate for accessing the targeted group and for intervening. Hence, it is most relevant for the above investigation because it helps the investigators understand the kind of approach to employ to collect data that will be significant in therapy to those suffering from oral health disorders in the Southside of Chicago.
Before the programs start, a pre-test should be conducted on the parents of the children participating in the oral health education workshop. A post-test should also follow and should be done during their routine visit at dental van service outreach(Watt et al., 2019). Various questions will be administered to the parents and them during the pre-test, and they include, do you children complain of pain in their mouth? How many times in a day do your children brush their teeth in a day? How many times do you as parents brush the teeth in a day? What kind of food do you feed your children with? Does your entire family have dental insurance? How often do you visit the dentist for a dental check-up? The above questionnaire helps in the intervention process for the medical professionals can interpret it and know about the health need of the community and the population being addressed. The questions will help healthcare providers create the most suitable intervention program to help solve the people living in the underserved areas of Southside Chicago.
A post-test is then conducted when the participants decide that they no longer want to participate. The post-test does not have a specific time in which it can be performed, and so the investigator can choose to conduct it anytime during the intervention. The investigator will pose the following questions to the parents. One of the questions to parents is finding whether they benefited from the intervention program that has been going on. Another question is finding out whether parents have an area of concern where they need clarity from the investigators.
A follow-up should be conducted six months after the last date of participation with the intervention program. The best way to do the follow up through a phone call where the investigators will find out about the current nature of their patient’s oral health and their oral health habits. The follow-up program helps the investigators know whether the intervention was the most relevant for the oral health disorder.
Intervention strategy
The Community Health Improvement Process
References
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