Motivating Public Housing Residents to Prioritize Children s Dental Health

Transcription

1 Motivating Public Housing Residents to Prioritize Children s Dental Health Barbara Springer Executive Director Delta Dental of Colorado Foundation

2 WELCOME

3 DELTA DENTAL OF COLORADO FOUNDATION MISSION: Improving Colorado s oral health by eradicating childhood tooth decay

4 DELTA DENTAL OF COLORADO FOUNDATION Founded 1997 as 501(c)(3) Receive 55% of company s net gain Programs: Brush with Me Public Will Building Campaign Delta Dental Frontier Center at the School of Dental Medicine Hygienist Co-Location Program Cavity Free at Three The Cavity Free at Three Clinic Happy Teeth Healthy Babies

5 DENTAL 101

6 THREATS TO MOUTH HEALTH Children Tooth decay Infection from tooth decay Adults Tooth decay Gum disease Infections from tooth decay and gum disease Oral cancer

7 EARLY CHILDHOOD CAVITIES Severe decay in children and infants Common bacterial infection Rate highest in minority and rural populations

8 HOW DOES A CAVITY FORM Bacteria + Sugar = Acid + Tooth = Cavity + = Cavities can spread to nearby teeth

9 TOOTH ANATOMY: CAVITIES Can have a cavity without it hurting Go to the dentist If you wait, will likely need bigger filling, root canal, crown, etc.

10 DIET AND TOOTH DECAY Not just WHAT we eat, but how OFTEN, too Acid exposure leads to demineralization which leads to cavities Bacteria feeds off food in our mouths frequent snacking leads to more acid exposure

11 TOOTH DECAY: A BALANCING ACT Disease Indicators White spots Restorations < 3 years Enamel Lesions Cavities/Dentin Risk Factors Bad bacteria Absence of saliva Dietary Habits Protective Factors Saliva Fluoride Effective diet Sealants Anti-bacterial NO DECAY TOOTH DECAY Featherstone et al, J Calif Dent Assoc.2007

12 THE PUBLIC HEALTH PROBLEM

13 MOST COMMON, CHRONIC CHILDHOOD DISEASE

14 OVERWHELMINGLY A DISEASE OF POVERTY

15 UNTREATED DENTAL DISEASE LEADS TO ORAL SURGERY 3,300 children visited the OR at Children s Hospital Colorado for dental surgery last year 70% of 3-year-olds seen at Denver Health have dental disease

16 DENTAL PROBLEMS IMPACT CHILDREN S FUTURES children with toothaches are 4x more likely to have a low GPA 2.5 days of work missed by parents per year because of their children s dental problems For every 100 disadvantaged elementary school children, 58 hours are missed each year due to dental disease.

17 PUBLIC WILL BUILDING

18 building Public FRAMING THE PROBLEM BUILDING AWARENESS Will BECOMING KNOWLEDGEABLE/TR ANSMITTING INFORMATION CREATING A PERSONAL CONVICTION EVALUATING WHILE REINFORCING PHAS E 1 PHAS E 2 PHAS E 3 PHAS E 4 PHAS E 5 Integrates grassroots outreach + mass media Connects to existing, closely held values Respects cultural context Includes target audiences in development and testing Results in long-term shifts in behavior, attitude, policy, practice, norms

19 OUR GOAL Eliminate early childhood caries Desired outcome: Families prioritize dental health The community prioritizes dental health

20 OUR PROCESS Research Plan Implement Evaluate

21 RESEARCH FINDINGS

22 RESEARCH METHODOLOGY Need to better understand how families view dental health Baseline telephone survey Expert interviews Observations at safetynet clinics One-on-one in-home or in-clinic visits Review of existing data

23 LIKE ALL PARENTS, THEY LOVE THEIR KIDS There is no having a You Day. It is a 24-hours thing. But I love it. I love to watch them grow and become their own person. It s the best thing that ever happened to me. The most important part of my life is my children. I love them. I am with them all the time and it is about them. My life is about filling their needs. I d like to work, but I think the best thing I can do for them is be here. It s the one thing I ve always wanted to do.

24 DREAMS FOR YOUR CHILD

25 HOW DO TEETH FIT IN? Play a role, but aren t the only factor Ability to get a job Self-esteem Establishing good habits for life It goes both ways Economic success = dental insurance and care Dental insurance and care = economic success Affects overall health

26 COMPETITION Pressures of daily living Overwhelmed Dealing with urgent stress Own inconsistent brushing Status quo Knowledge Soda, candy = bad Juice and milk = OK Carbs Appeal of junk food Economics

27 CONFUSION/LACK OF KNOWLEDGE Link between milk and juice to cavities Skeptical Link between teeth and GPA Do kids really need to be 6+ before brushing on their own?

28 IMPACT OF PARENTS DENTAL EXPERIENCE Assumption: Disease perpetuates through culture But so does prevention Sometimes a culture of disease sparks a future of prevention

29 GENEALOGY OF CARE Grandparents cared for parent s teeth? Parents care for their own teeth? Parents care for children s teeth? Dental Outcomes? Yes 50% 46% 4% Yes 91% No 9% 46% 0% 2% 2% Yes 100% No 0% Yes 50% No 50% No reports, n=9, 43% Caries +, n=9, 43% Baby state, n=3, 14% No reports Caries +, n=1, 100% No reports Caries +, n=1, 100% No 50% 35% Yes 69% 35% 0% Yes 100% No 0% No reports, n=4, 25% Caries +, n=10, 63% Baby State, n=2, 13% 15% No 31% 7% 9% Yes 9% No 91% No reports, n=0, 0% Caries +, n=3, 100% No reports, n=2, 50% Caries +, n=2, 50%

30 INFLUENCE OF PARENTS BRUSHING HABITS Parents brushing habits are predictive of how often their children brush their teeth* Target parents brushing behaviors as much as the child s brushing behaviors * This finding was statistically significant.

31 BRUSH WITH ME PUBLIC WILL BUILDING CAMPAIGN

32 TWO KEY MESSAGES To keep smiles healthy and prevent painful tooth decay: 1.Make it a habit to brush teeth together as a family, because brushing prevents painful tooth decay. 2.Put only tap water in sippy cups and bottles not juice, Kool-aid or milk between meals and at night.

33 BRUSH TOGETHER WITH YOUR CHILDREN Model good behavior Parents brush young children s teeth and monitor older children s brushing Means parents are brushing, reducing bacteria and transmission

34 ONLY WATER IN SIPPY CUPS Disconnect between knowledge and behavior Sugary drinks Mealtimes Tap water Solution Juice and milk are fine with meals, but not for sipping all day long. Only water in sippy cups and bottles between meals and at night.

35 CAMPAIGN ELEMENTS Ad/public relations campaign Television Radio Mobile-optimized website Partnership with Children s Museum of Denver Weekly story-time Promotores program in partnership with LiveWell Colorado 200 grassroots health education workers Touch 1,000 families

36 CAMPAIGN ELEMENTS Influencers Policy change Campaign advisory committee Outreach to system of care Dentists, pediatricians, WIC offices

37 BRUSH WITH ME CREATIVE

38 TV AD TV AD

39 WEBSITE

40 WEB BANNERS

41 EVENTS/GRASSROOTS OUTREACH One-on-one outreach to target audience Reinforce messages Planned outreach: KidSpree (6/8) Adams County Fair (8/3) Central American Festival (8/30)

42 FACEBOOK TAB

43 PAID MEDIA SCHEDULE MEDIAS April May June July August September October TV RADIO ONLINE EVENTS (TENTATIVE) PUBLIC RELATIONS SOCIAL MEDIA SOCIAL MEDIA

44 2013 A PILOT YEAR Every project evaluated for effectiveness Ongoing market testing Future expansion of successful elements

45 OUTCOME: REDUCING CAVITIES IN CHILDREN Motivate family behaviors that reduce cavities Families prioritize dental health Concrete behaviors to do every day Dentists and pediatricians support these behaviors State oral health survey

46 OUTCOME: COMMUNITY PRIORITIZES DENTAL HEALTH Community leaders know why dental is important Becomes a funding priority Social norm changes from inevitable to preventable Cavity preventing behaviors are the social norm

47 Takeaway Messages Some families reported that they are not consistently brushing even once a day; Brush together because: Evidence is clear that if Mom care for her oral health she Maintains her health Models the behavior Reduces the bacteria transmission Remind families only water in sippy cups because Reduces frequency of sugar exposure Gives teeth a break There is confusion about what is a sugary beverage If you can do one thing get Mom brushing

48 Q & A

49 THANK YOU Barbara Springer Executive Director Delta Dental of Colorado Foundation