Evaluation of a Comprehensive Oral Health Services Program in School-Based Health Centers


Objectives In 2011, the Maternal and Child Health Bureau, within the Health Resources and Services Administration, awarded a 4-year grant to increase access to and assure the delivery of quality oral health preventive and restorative services to children. The grant was awarded to organizations serving high-need communities through school-based health centers (SBHCs). This article describes an independent evaluation investigating program efficacy, integration, and sustainability. Methods Program process and outcomes data were gathered from interim and final reports. Interviews with key informants were conducted by phone, and analyzed in NVivo qualitative software. Results Students had great need for comprehensive services: on average, 45% had dental caries at enrollment. Enrollment increased from 5000 to more than 9700, and the percent receiving preventive services increased from 58 to 88%. Results of the analytically weighted linear regression show statistically significant increases in the proportion of enrollees who had their teeth cleaned in the past year (t(4) = 5.19, β = 8.85, p < 0.05) and those receiving overall preventive services (t(4) = 13.52, β = 10.93, p < 0.01). Grantees integrated into existing programs using clear, consistent, and open communication. Grantees sustained the full suite of services beyond the grant period by increasing billing and insurance claims while still offering free and reduced-cost services to those uninsured or otherwise unable to pay. Conclusions for Practice This project demonstrates that access to comprehensive oral health care for children can be expanded through SBHCs. State Title V Block Grant and other similar federal initiatives can learn from the strategic approaches used to overcome challenges in the school-based environment.

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  1. Bernstein, J., Gebel, C., Vargas, C., Geltman, P., Walter, A., Garcia, R. I., & Tinanoff, N. (2016). Integration of oral health into the well-child visit at federally qualified health centers: Study of 6 clinics, august 2014-march 2015. Preventing Chronic Disease, 13, E58. https://doi.org/10.5888/pcd13.160066.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Blank, M. J. (2015). Building sustainable health and education partnerships: Stories from local communities. The Journal of School Health, 85(11), 810–816. https://doi.org/10.1111/josh.12311.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cappelli, D. P., & Mobley, C. C. (2008). Prevention in clinical oral health care. St. Louis: Mosby.

    Google Scholar 

  4. Colak, H., Dulgergil, C.T., Dalli, M., & Hamidi M. M. (2013). Early childhood caries update: A review of causes, diagnoses, and treatments. The Journal of Natural Science, Biology and Medicine, 4(1): 29–38.

    Article  Google Scholar 

  5. Culyer, L. M., Brown, E. F., & Kelly, K. A. (2014). Oral health care for underserved children in the United States. Journal of Community Health Nursing, 31(1), 1–7. https://doi.org/10.1080/07370016.2014.868729.

    Article  PubMed  Google Scholar 

  6. Keeton, V., Soleimanpour, S., & Brindis, C. D. (2012). School-based health centers in an era of health care reform: Building on history. Current Problems in Pediatric and Adolescent Health Care, 42(6), 132–156. https://doi.org/10.1016/j.cppeds.2012.03.002.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sen, B., Blackburn, J., Morrisey, M., Kilgore, M. L., Becker, D. J., Caldwell, C., & Menachemi, N. (2013). Effectiveness of preventive dental visits in reducing nonpreventive dental visits and expenditures. Pediatrics, 131(6), 1107–1113. https://doi.org/10.1542/peds.2012-2586.

    Article  PubMed  Google Scholar 

  8. Simmer-Beck, M., Walker, M., Gadbury-Amyot, C., Liu, Y., Kelly, P., & Branson, B. (2015). Effectiveness of an alternative dental workforce model on the oral health of low-income children in a school-based setting. American Journal of Public Health, 105(9), 1763–1769. https://doi.org/10.2105/AJPH.2015.302714.

    Article  PubMed  PubMed Central  Google Scholar 

  9. U.S. Department of Health and Human Services. (2000). Oral health in America: A report of the surgeon general. Rockville, MD: Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health.

    Google Scholar 

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Funding was provided by Maternal and Child Health Bureau (Grant No. HHSH250201300007I).

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Correspondence to Tara Trudnak Fowler.

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This document is a deliverable under Contract HHSH250201300007I, Independent Evaluation of the School-Based Comprehensive Oral Health Services (SBCOHS) Grant Program, between the Health Resources and Service Administration, Maternal and Child Health Bureau and Altarum. The goal of this task is to provide a report in the form of a publishable manuscript of the evaluation of SBCOHS grant program findings.

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Trudnak Fowler, T., Matthews, G., Black, C. et al. Evaluation of a Comprehensive Oral Health Services Program in School-Based Health Centers. Matern Child Health J 22, 998–1007 (2018). https://doi.org/10.1007/s10995-018-2478-1

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  • School-based health
  • Oral health
  • Evaluation
  • Program sustainability
  • Program efficacy
  • Program integration