Survey Logistics for Data Collection
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1 Healthy Smiles Healthy Bodies Survey Logistics for Data Collection Health and Wellness for all Arizonans 1
2 Healthy Smiles Healthy Bodies Survey Logistics for Data Collection Margaret Perry, BSDH, MBA, AP HSHB Clinical Trainer Connie Baine, RDH, AP, BS HSHB Administrative Trainer Health and Wellness for all Arizonans 2
3 Survey Logistics for Data Collection Events, processes, procedures & policies for: Sample Recruitment & Replacement County Contractors & Survey Teams School Scheduling Survey Participation / Consent Equipment and Supplies Survey Screening Days at Schools Survey Forms Invoicing Health and Wellness for all Arizonans 3
4 Healthy Smiles Healthy Bodies Survey Logistics Setting up the Survey Sample Health and Wellness for all Arizonans 4
5 Survey Logistics Survey Sample & Replacements Radom sample: recruit 99 schools (5 feeders) Statistical replacement: non-participating schools One screening day per school: up to 5.5 hours for screenings Randomly selected K & 3rd Grade classes: ask parents to participate (consent) Number to screen per school: at least 50 total students but may be up to 100 (will weigh data for reporting) Health and Wellness for all Arizonans 5
6 Survey Logistics Scheduling Schools HSHB Survey s Field Coordinator Connie Baine Screening Day Schedule, remind & confirm screening day with school Remind and promote consent/questionnaire responses School Scheduling & Team Assignment Summary School location School contact Consents Randomly selected classes Health and Wellness for all Arizonans 6
7 School Scheduling & Team Assignment Summary Provides Attachment 1 School Screening Scheduling & Team Day Assignment Information Summary 7
8 Healthy Smiles Healthy Bodies Survey Logistics Setting up Screening Team for Data Collection Health and Wellness for all Arizonans 8
9 Survey Logistics Collect Survey Data Utilize national Basic Screening Survey (BSS) Model Collect data through oral, height & weight survey screenings Collect data through questionnaire Determine estimates of oral health and healthy weight status for K & 3 rd grade children in Arizona (assessment & surveillance) Report for the state, counties and FTF Regions Health and Wellness for all Arizonans 9
10 Survey Logistics Screening Teams Collect Data County Contractor collect data in <5 months, one screening day per school Field Coordinator/OOH distributes consent packets to each school Screening Team collects consents/questionnaires, conducts screenings, record data, and processes survey forms (to school nurse/contact, parents/guardians, and ADHS Office of Oral Health) Health and Wellness for all Arizonans 10
11 Survey Logistics Preparing for Screening Day Pack survey equipment, supplies & forms o Make sure that equipment works o Have adequate quantity of supplies & forms o Have all components for the goodie bags to assemble at the school (check # enrolled children in selected classes) Review Training Booklets Health and Wellness for all Arizonans 11
12 Healthy Smiles Healthy Bodies Survey Logistics Setting Up Screening Stations Health and Wellness for all Arizonans 12
13 Survey Logistics Setting Up Screening Stations Transport/unpack equipment & supplies Set up a dental station and a height/weight station Set up a designated student waiting area Organize these areas: o Infection Control Area o Survey Forms Area o Goodie Bags Assembly Area Health and Wellness for all Arizonans 13
14 Survey Equipment & Supplies Equipment - Dental light (with extension cord, bulb & fuse) - Dental Patient Chair - Dental Operator Chair - Stadiometer (measure height to 0.1 cm) - Digital Scale (measure weight to 0.1 kg) Supplies - Infection control - Survey forms - Goodie bags (all components to assemble at school) - Resource materials for school nurse and parents (low cost dental clinics list & height/weight handout) Health and Wellness for all Arizonans 14
15 Portable Dental Light, Operator s Chair and Dental Chair 15
16 Stadiometer and Digital Scale 16
17 Screener s Infection Control Area 17
18 Recorder s Survey Forms Area 18
19 Goodie Bags Assembly Area 19
20 Healthy Smiles Healthy Bodies Survey Logistics Screening Each Child for the Survey Health and Wellness for all Arizonans 20
21 HSHB Screening of Arizona Kindergarten & Third Grade Students 21
22 Conducting Oral/Height/Weight Screenings 1. Recorder & Screener check consent for each child 2. Set up Child Screening Record staple white Screening Recording Form to the positive Active Consent & Questionnaire 3. Screener calls out each of the five oral screening indicators; Recorder fills in the Screening Recording Form 4. Complete purple Screening Findings Form for each child 5. Add every child needing urgent care to pink Nurse Referral List (one list for the screening day) 6. Recorder measures height and weight (do not call out measures); fill in data on Recording Form and Findings Form (use cm & kg) 7. Do counts for each class; fill in green School Summary Form 22
23 Survey Logistics Positive vs. Negative Consent Each school choose: Active or Passive Consents Active & Passive Consent Packets: Packet has Parent Letter/Consent Form + Questionnaire o Positive Consent = Screen Child o Negative Consent = Do Not Screen Child Health and Wellness for all Arizonans 23
24 Survey Logistics Missing Item on Active Consent 1. Yes or No box must be checked AND 2. Parent/guardian signature must be present Questionnaire does not have to be completed Screener/Recorder should not fill in any blanks Option: Ask if school will consider calling parent for clarification (school caller must document/sign/date) Missing required item = Negative Consent by default Encourage school to check for missing item and fix before screening Health and Wellness for all Arizonans 24
25 Survey Logistics Missing Item on Passive Opt-Out Consent 1. No I give consent box must be checked AND 2. Parent/guardian signature must be present Questionnaire does not have to be completed Screener/Recorder should not fill in any blanks on consent form Option: Ask if school will consider calling a parent for clarification (school caller must document/sign/date) Missing required item = Negative Consent by default Health and Wellness for all Arizonans 25
26 Survey Logistics Oral, Height & Weight Screenings Screen only assigned grades & selected classes For a child with consent to screen, first conduct oral screening Finish with height & weight measurements Record screening data and check survey forms Give the child a Goodie Bag Track/record student & consent counts for each class Check & organize forms for accuracy/completeness Health and Wellness for all Arizonans 26
27 Conduct Oral Screening 27
28 Conduct Height Measurement with a Stadiometer Remove shoes, keep socks on Stand straight Lower headrest Measure to nearest 0.1 centimeter (cm) 28
29 Conduct Weight Measurement with a Digital Scale Remove shoes, keep socks on Stand with both feet in the center of the scale Record measure to nearest 0.1 kilogram (kg) 29
30 Healthy Smiles Healthy Bodies Survey Logistics Recording Screening Data for Each Child Health and Wellness for all Arizonans 30
31 Survey Logistics Screening Day s Survey Forms Active or Passive Consent Form (white) that may be stapled to a Questionnaire (yellow or blue) Screening Recording Form (white) Dental Findings Form (light purple) Nurse Referral Form (pink) School Summary Form/Worksheet (green) Health and Wellness for all Arizonans 31
32 Survey Logistics Required Tasks for Survey Forms Confirm that Consent Form matches the child in the chair for screening (both Recorder & Screener should confirm) Set up a Child Screening Record: Staple the Screening Recording Form to the YES Consent Form and Questionnaire o Recording Form in front, Active YES Consent Form in middle, and Questionnaire last have the data sides of the Recording Form & Questionnaire face outward. If only have the Recording Form and Active YES Consent, then staple them back to back. Review forms for completeness & accuracy and sign all forms before leaving the school Health and Wellness for all Arizonans 32
33 33
34 Screening Recording Form - Top Healthy Smiles Healthy Bodies Screening Recording Form Survey ID# (for office use only) 1. Survey Information School Name: First Elementary School Grade: K Child Name: Adam Smith 34
35 Screening Recording Form - Middle 1. Untreated Decay 2. Oral Health Survey Information 0-No 1-Yes 4 # teeth 1-Yes= At least one tooth with loss of at least ½ mm of tooth structure at the enamel surface 2. Treated Decay 3. Sealants Present 4. Sealants Needed 5. Treatment Urgency 0-No 1-Yes 2 # teeth 0-No 1-Yes 0-No 1-Yes 0-None 1-Early 2-Urgent 1-Yes= At least one tooth: - has fillings, crowns or other restoration due to decay OR - is missing due to decay. 1-Yes= At least one permanent molar tooth has a dental sealant OR part of a dental sealant. 1-Yes= At least one permanent molar tooth needs a dental sealant on a fully erupted, virgin AND sound occlusal surface. 0-None= Routine dental care 1-Early= Dental visit within next several weeks 2-Urgent= Dental visit within 24 hours Height in cm s 3. Height/Weight Weight in kg s
36 Screening Recording Form - Bottom 4. Signature Provider ID # Signature Date RDH 4444 Mary Jones 9/1/2014 ASST 2222 Nora Smith 9/1/2014 ASST Comments: Swelling and pain in the mouth (upper right). Summary of Findings Form 36
37 37
38 Screening Findings Form - Top Student: Adam Smith Date: 9/1/2014 Teacher: Mrs. Cook Dental Screening This was only a screening. Your child should still have a regular dental check-up. Urgent! A problem has been found and your child needs to go to the dentist within the next 24 hours! Your child has signs and symptoms that include pain, swelling or infection (abscess). Possible Problems Found: Your child should see a dentist as soon as an appointment can be made. No Visible Problems: Not all visible problems can be seen by a dental screening. Your child should have a regular dental check-up at least once a year. Sealants Needed: Sealants help to prevent cavities on the chewing surfaces of back teeth. A dentist can tell you if sealants would be helpful for your child. Clean teeth and gums are important. Your child did a good job today. If your child has AHCCCS or KidsCare insurance, dental care is covered. 38
39 Screening Findings Form - Bottom Height and Weight Screening Your child s Height: cm Weight: 19.1 kg Please contact your School Health Office for more information. Comments: Swelling and pain in the upper right part of the mouth. 39
40 40
41 Date: 9/19/2014 Nurse Referral Form School: City: First Elementary School Ace City The following is a list of children with urgent dental treatment needs. These children have an urgent need for a dental visit within the next 24 to 48 hours. Grade Student Name Concern K Betty Howard Abscess near lower left back tooth K Adam Smith Swelling and pain in upper right part of mouth 3 Jenny Garcia Painful infected teeth 41
42 Over-ride Reporting in Findings Form What is over-ride reporting for the survey? Adjust reporting to parents on the child s conditions or issues only in the Screening Findings Form Treatment urgency could be changed, comments added, and printed text in the Screening Findings Form edited. Edits may result in a change from what is recorded in the Screening Recording Form (be sure to add notation to the Screening Recording Form s Comments section) Health and Wellness for all Arizonans 42
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44 School Summary Form/Worksheet - Top Healthy Smiles and Healthy Bodies School Summary Form/Worksheet School Name: School Contact: Ms. Jenny Jones, School Nurse Screening Date: 9/1/2014 Screening Team: First Elementary School Screener (ID & Name) 4444 Joyce Benson Active Consent Passive Consent Recorder Assistant (ID & Name) 6666 Jane Jackson School ID: (Nine-digit CTDS #) Phone Number: (602) Height & Weight Assistant (ID & Name) 4444 Joyce Benson 6666 Jane Jackson 44
45 School Summary Form/Worksheet - Bottom # Class / Teacher Grade # Children Enrolled in Selected Classes # Consent YES # Consent NO (or opt out) # Children Screened # Children Absent # Children Urgent Referral 1 Mrs. Cook K Mr. House K K 4 K KINDERGARTEN GRADE TOTAL: K # Class / Teacher Grade # Children Enrolled in Selected Classes # Consent YES # Consent NO (or opt out) # Children Screened # Children Absent # Children Urgent Referral 1 Ms. Jones K rd 3 3rd 3RD GRADE TOTAL: 3rd * SCHOOL TOTAL K+3 rd Nurse Received Copy of Urgent Referrals Signature: (Screener) Suzie Day 45
46 Healthy Smiles Healthy Bodies Survey Logistics Processing Survey Forms at the School Health and Wellness for all Arizonans 46
47 On the Screening Day Wrap-Up Tasks for the End of Screening Day 1. Record travel hours & screening hours for invoicing 2. Re-pack tubs & fill out order form to replace supplies/forms 3. Clean up areas used for screening and bag/dispose all trash 4. Go to school office to copy pink Nurse Referral Form 5. Organize & keep completed survey forms to be mailed to OOH 6. Deliver to school nurse: Screening Findings Forms, Nurse Referral Form, resource information, and extra goodie bags 7. Thank the principal, school nurse, teachers & school office staff 8. Inform school office staff that you are finished. 47
48 Survey Logistics Processing Survey Paperwork Leave these items with School Nurse/Contact: Completed Original Nurse Referral Form (pink form) o Be sure to make & keep a copy to mail to OOH Low Cost Dental Clinic List Height & Weight Handout (same one place in Goodie Bag) One AzSmiles canvas bag 48
49 Processing Survey Paperwork Mail these forms to Office of Oral Health: Checklist on Submitting Survey Forms to OOH (orange) School Summary Form/Worksheet (green) Copy of Nurse Referral Form (white copy of pink original) School Scheduling & Team Assignment Summary (white) School Enrollment Information Sheets (e.g., Class Rosters) Child Screening Records bundle by class (Screening Recording Form / Consent / Questionnaire stapled packets) Negative Consent Forms bundle by class Consent Forms for absent students bundle by class 49
50 Mail Survey Forms to OOH (Follow Checklist to Bundle & Mail) 50
51 Healthy Smiles Healthy Bodies Survey Logistics Re-Stock for Future Screening Days Health and Wellness for all Arizonans 51
52 Survey Logistics Pack & Re-Stock Survey Supplies/Forms Survey Supplies/Forms Packing List o Tape Packing List to the inside of each tub s lid Survey Supplies/Forms Order Form o Instructions provided on the form o Allow at least 7 days for pickup or shipping 52
53 Survey Logistics Re-Stock for Next Screening Day After every screening day, inventory your supplies/forms for the tubs & central stock; identify ordering needs for OOH Complete a Supplies/Forms Order Form when central stock is low or Fax completed Order Form to OOH 53
54 Healthy Smiles Healthy Bodies Survey Logistics Invoicing Health and Wellness for all Arizonans 54
55 County Contractors: Survey Logistics Invoicing Use your existing procedure to invoice ADHS Office of Oral Health Consult Field Coordinator (Connie Baine) or OOH Chief (Julia Wacloff) as needed Screeners and Recorders: Use existing procedures to invoice 55
56 Survey Logistics Compliance to Policies & Procedures You are representatives of ADHS and the County Contractor in conducting this survey Read & comply with policies & procedures for the HSHB Survey Will ask Screeners and Recorders to complete/sign forms during Calibration Workshop 56
57 Healthy Smiles Healthy Bodies Survey Logistics Policies & Procedures Health and Wellness for all Arizonans 57
58 Survey Logistics ADHS Policies & Procedures HSHB Administrator & Provider Scheduling Information Reporting Suspected Cases of Child Abuse Incident Report Infection Control Policy and Procedures Immunization Policy and MMWR Report Professionalism and Sensitivity Data Confidentiality Agreement (Pledge To Protect Confidential Information) 58
59 Healthy Smiles Healthy Bodies To our partners We look forward to working with you! Health and Wellness for all Arizonans 59
60 Healthy Smiles Healthy Bodies Self-Study Assignments Preparing for Calibration Workshop and Survey Screening Days Health and Wellness for all Arizonans 60
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