#TEAMORALHEALTH NCOHC

[thelizzybetts]

Macro Post #4

That is a wrap from Team Oral Health! This semester has been a great opportunity and I have gained a lot of knowledge that I will take with me in the future. Team Oral Health has accomplished so much about water fluoridation surrounding other states as well in North Carolina. I have learned a lot about water fluoridation and oral health that I did not really know much about at the beginning of the semester. Having fluoride in water is very beneficially to individuals in the community. To dive into the findings of our key informant interviews, we found that in Iowa, fluoridation looks like this; this state notifies its customers of any change of fluoridation through their water bill. In Missouri, customers are notified of any change through radio, television, newspaper, mail, and or electronical. In Alabama, they write out the date and reason for change to fluoride.  Each of these states provided us with information that we can look at doing especially in North Carolina pertaining to regulation of fluoridation

Additionally, we found three key themes from our key informant interviews from the stakeholders of Iowa, Alabama, and Missouri. One of the findings suggested that we should have an appropriate time for notifications. This is proposing that communities should establish some form of the 90-day notice that other states required when communicating about any modification of fluoride supplementation. Another finding is to make sure to have effective language. With this, you want to make sure community members clearly understand what you are suggesting and making sure you are approachable to everyone of different backgrounds. The most important finding that the majority of our interviews concluded with was to establish important relationships. Having these relationships and connections can help to develop an opportunity for change in a community. This ties into our lesson on power mapping with showing how it is important to connect with partnerships that support fluoridation. Something I found interesting is that insurance companies were most influential regarding water fluoridation but there was a little bit of opposition against it. Insurance companies stop paying for fluoride at a certain age which I think they need to rethink this because your oral health is just as important as overall health so if these companies can pay for other procedures, then they can pay for oral health needs.

The recommendations that we found was that proposals needed to be met in response to educating water operators in North Carolina. This could be  very beneficial for them to understand the importance of water fluoridation. Something that was suggested was maybe to incorporate training or webinars about fluoridation. Other recommendations that could be beneficial to North Carolina is to use basic easy language for everyone to understand. Developing relationships with key stakeholders in North Carolina can help to advocate our findings to help create opportunities for fluoride regulations. North Carolina currently does not have a time frame for notifying the community about fluoride addition or discontinuation. Adding the 90-day notice like in other states could help the community understand why fluoride should be in these water systems.

Today, Team Oral Health met with Senator Bergin of Harnett County to talk about the importance of oral health care. This was an amazing opportunity for Team Oral Health to discuss our findings. Senator Bergin made suggestions for us to do within our project like talk to the water plant here in Harnett County as well as go to legislative as well as the house to talk about our report and explain the importance and benefits to why fluoride should be in water systems. Other topics of discussion that we talked about was reverse osmosis. This would give consumers the opportunity to opt out of having fluoride in their water system because of individuals not wanting their children to have fluoride. I gained a lot of information from this meeting, and it is important to have connections and network with others as a way for partnerships to be created.  Team Oral Health will also create another flyer to bring to up to the legislative meeting that we will partake later on in the future.

In conclusion, I want to thank our wonder preceptors of North Carolina Oral Health Collaborative. This practicum was very well organized, and they provided us with the assistance we needed to retain more information about water fluoridation. Having the organization definitely helped to make sure we stayed on top of things and also gave us the flexible to learn a lot more about fluoride. I really liked how our topics of discussion lined up with the course material from our classes to review the material as well as correlate it to our findings with our practicum. This was a wonderful experience, and I am glad that I was able to be apart of team oral health and potentially help make a difference with fluoridation within North Carolina. I gained a lot more knowledge about fluoridation than I knew in the beginning, and I now understand the importance of how oral health is a contributor to an individual’s overall health. By educating the significance of fluoride could help prevent tooth decay and other health complications. I can not wait to see what else is in store for Team Oral Health in the future. This semester has been a blast.

Signing Off,

Lizzy :) 

[aassante]

Group meeting with Team Oral Health today! Drafts of my info graphic and our group blog post were presented to our preceptors, and their suggested revisions will be incorporated into our final products. If all goes according to plan, the blog post will be published on the NCOHC website. #TeamOralHealth

[kdlamberth0110-blog]

F7:

       This semester, Team Oral Health has collaborated with North Carolina Oral Health Collaborative (NCOHC) to assess population needs, assets and capacities that affect communities health. The NCOHC’s goal is to connect underrepresented populations with both traditional and nontraditional stakeholders to facilitate integrative collaboration, increase access to oral health care, and advance equity. Oral Health is important because "Poor oral health can have a detrimental effect on children's quality of life, their performance at school, and their success later in life." (The Center for Disease Control & Prevention). Poor oral health affects eating, talking, socializing, sleeping, and learning which affects the quality of life. To promote equity by providing access to dental care to everyone is a need that affects the community's health.

       In my previous post, I touched on the dental health provider shortage in Rural Areas. It creates an access barrier to receiving health care that is needed. 43% of Rural America lack access to dental care. Looking more into North Carolina there are 5,110 dentists as of December 2018. 74 counties in North Carolina are considered to have a dental care shortage. Harnett County is one of those counties. Furthermore, in Harnett County there are currently 22 dentists. Those 22 dentists are serving a population of 132,754, that creates a 3,724:1 ratio of dentist to person. This data analysis shows there is a significant need for more dentists in Harnett County to improve the dentist to person ratio. Whenever there is a barrier for a population or community to get the health care they need, then an intervention needs to be implemented to ensure equity for everyone.

       Another population need that needs to be addressed is the language barrier in Harnett County. 10.8% (12,359) of Harnett County population is made up of Hispanic or Latino origin. That is higher than the North Carolina percentage of 8.4% of the population being Hispanic or Latino origin. Through individual and group research with the collaborative, I have found that the Hispanic population is higher in Harnett County (Rural) than North Carolina because of the job opportunities in agriculture. In Harnett County there is 10 dentist that speak spanish. That creates a 1235.9:1 ratio of dentist that speak spanish to spanish speakers. The dentist that speak spanish are not in every town which creates a distance and traveling barrier for spanish speakers to go to the dentist. Quality of life is defined as the standard of health, comfort, and happiness experienced by an individual or group. Creating this barrier for the Hispanic population to go to dental care providers nearby that do not speak spanish creates a level of uncomfort that affects them from getting the standard care of health which affects their quality of life. When someone feels uncomfortable receiving service then they are likely to stop going which creates a health issue. This is not only a public health issue but a community issue that needs to be addressed. 

       To begin the process of identifying community assets that can help increase access to dental care, Our Preceptor Dr.Brian, helped us create an asset map to identify the resources in North Carolina that can be used to improve the quality of dental care in North Carolina. We used the NCOHC as the main connection to identify and connect with other assets.  Through discussion and mapping, we identified assets such as NCChild, BCBSNC Foundation, and ECU School of Dentistry. ECU School of Dentistry is an important asset because they are located locally in Lillington. ECU Dentistry is a FCCHC (First Choice Community Health Center) which is a full service family practice that offers primary care services at an affordable price by using a sliding fee. They accept medicaid and speak spanish. This helps provide services for low-come populations that might be able to get dental care and provide comfortable services for individuals that need a spanish speaking provider. However, through asset mapping, I also learned the challenges and limited assets the community had for dental care. 

       To maximize the community's assets, we need to strengthen the capacity of the community to identify and work to find solutions. Community capacity is communities that function well and has the ability to achieve goals. In order to make dental access a goal the community wants to fix, the community needs to be educated on the issue. HealthyPeople 2020 has started the platform to educate others. One of the goals for HP2020 is to “prevent and control oral and craniofacial diseases, conditions, and injuries, and improve access to preventive services and dental care (ODPHP). It states the health of the teeth and mouth is central to a person’s overall health and well-being. Preventative measures for oral health has been a huge success for public health, however, there is still a major issue that some Americans do not have access to dental care. It says there is a need to bring awareness to the importance of oral health. Therefore, by collaborating with NCOHC, we created brochures to educate the community. We shared the brochures with Team Farmworker while they passed out toothbrushes and toothpaste and also worked with Team Medfest so we could share them with families in the community specifically with disabilities. Working with these groups helped educate others and help create assets with the Team Farmworker and Team Medfest organizations.

       Increasing dental care access is not a job that will be done overnight. There is a lot that goes into it, especially in a Rural area. The next step for us is to continue educating others on the importance of dental care, advocating to legislatures, and finding ways to get dental care into rural areas. Future interventions such as getting dental clinics in schools is ways to improve oral health access. Oral health affects your overall health and so it is important to be educated on the need for it and educate others

       The map above with the dots shows where the dentist are located in Harnett County, the red dots are dentists that speak spanish and the black dots are dentists that do not. The next map shows the hispanic populations. These maps show a visual of the dentist shortage in harnett county. The list is showing dentists that speak spanish and that do not.

 #TEAMORALHEALTH

[thelizzybetts]

Macro Post #2

Over the last couple of weeks, Teams Oral Health has been preparing for the interviews that we would be  conducting to the stakeholders in Alabama, Iowa, and Missouri via Zoom. These interviews were to help us find information regarding how each state differs with their regulations pertaining to water fluoridation. Before our interviews took place, we met at our regularly schedule time on Fridays at 10am to go over the expectations of how the interviews were going to be conducted as well as go over the rest of our schedule for the semester. We were also given some information on how our final report should be written. In preparation to the interviews, we created an outline with the questions so that each person could reference them when talking with the stakeholders. We also went over each of the state’s regulations and statues to be prepared and knowledgeable to help our interview questions flow into conversation. Since there were only three people we were interviewing, we each decided to be the head interviewee by volunteer base. One of our preceptors was also in all our interviews which was very helpful because she also asked questions that would help us in our final report. In addition to preparing for our interviews, we also created a marketing flyer that could educate legislation about the importance and benefits to have fluoridation in water systems.

  Last week, team oral health conducted interviews. These interviews were with three key stakeholders from the states of Alabama, Iowa, and Missouri to discuss their state’s regulations and statues to water fluoridation. On Monday, Amber, Francisco, and I interviewed Dr. Guy Deyton and Julie Boeckman from the Missouri Department of Public Health. On Wednesday, Muaz and I interviewed Bob Russel the dental director and Sarah Petersen, the water fluoridation coordinator for the Division of Health Promotion and Chronic Disease Prevention  as well as the Iowa Department of Public Health. On Friday, all of team oral health was present to interview Tommy Johnson, who works with Alabama Department of Public Health and is the state dental director.

  In conclusion to finishing these interviews, each of these stakeholders provided very important information to assist the community on the importance of water fluoridation. In our interviews we found an overarching theme that each of these key informants put inferences on the 90-days notification. Dr. Deyton, Dr. Russel, and Dr. Johnson provided very informative information to this notification. I think this could be extremely useful in North Carolina because if someone wants to either have or not have water fluoridation in their water systems, this notification could help individuals know when the water operators were going to do this to the community water. These individuals underlined different educational strategies to help the community be knowledgeable about water fluoridation. Dr. Tommy Johnson, the dental director from Alabama, had a unique campaign and promotion to get the community involve with fluoride. In Alabama, every year they get children to be the face of showing their smile to help dentistry in that state. These campaigns are enlightening to support the community with the benefits of fluoride.

Another interesting thing that I found to be very informational during our interviews was that Dr. Tommy Johnson, over the course of five years wanted to go to every water system plant in the county. I think by doing this in North Carolina, we can see what counties need more educational assistance with water fluoridation. He also mentioned that the water operators take CE courses up to 20 hours per year through Alabama’s Department of Education Management. Having these courses for the water operators in North Carolina, could help to advocate how important fluoride is in water systems. 

The competency that goes along within our practicum is that these stakeholders provided us with strategies that we could use to promote partnerships within North Carolina regarding water fluoridation. The key informants told us to be patient as well as educate to community. They also said that there would be opposition by the anti-flourdationist and how we just need to be prepared to educate people. I think that this was a good opportunity for North Carolina to make connections with other states that could help us with our regulations and to promote ways to demonstrate how important fluoride is not just to oral health but overall health. For our final report, we will transcribe each of the interviews to find an overarching comparison between each key stakeholder as well as differences to see how we can use this in North Carolina.

[thelizzybetts]

On Friday, we discussed what the rest of our practicum would look like and we talked about a flyer we made on water fluoridation. We also had a guest speaker from the CDC talked to us about water fluoridation. It was very informative! He told us about some fluoridation technology that could help get fluoridation in water systems located in rural areas.

[thelizzybetts]

Macro post #1

For the past couple of weeks, Team Oral Health has been diving into the material regarding fluoridation systems. Our overarching picture is Water Fluoridation in Harnett County as well as in surrounding areas. We have been looking at statues and regulations in Alabama, Iowa, Maine, Mississippi, and Missouri to understand their policies with water fluoridation. Fluoridation is extreme important to have in water systems because this can help to prevent tooth decay and bacteria was worsening causing health concerns. Oral Health can also contribute to other health related problems like gastrointestinal and cardiovascular diseases. I found this to be extremely interesting since in undergrad, my degree was in exercise and sport science and that I never really thought much about how in-depth oral health can impact a person’s overall health. Dentists and hygienists are the first ones that could detect these health issues when patients come in for dental examinations. In concerns to fluoride, insurance companies stop paying for it when a child is a certain age. Insurance companies need to rethink their approach to what is exactly important about dental visits. To tie into the social determinants of health, economic stability, social context, and education are important to oral health because it is very beneficial that dentists and hygienists have an adequate educational background so that they can inform patients of health-related issues that may arise. When it comes to the social determinant of health in an economic stability standpoint, oral health should be equal to everyone and allow people to have access to dental examinations. The built environment can also impact oral health. In rural areas, transportation can be a barrier because someone in the community may have to drive a long time to get to their dental visits or may not even have access to go to get there.

We have also talked about two articles within the NC Practice Act for Dental Providers. The two articles included, Article 16, Dental Hygiene Act and Article 2,Dentistry Act. These two articles were very informative as they explained what dentists and hygienists should be doing with their licenses to practice dentistry. We just found out that starting October 1st, 2021, dental hygienists will be allowed to give their patients anesthesia. Dental hygienists would need to make sure they have a certification for it. I think that this gives dental hygienists an opportunity to be able to use what they learned to help their patients with oral procedures.

Within our practicum, we focused on the use Power mapping for two weeks, Power mapping is important because it allows health care providers to be able to see how someone can be opposed within certain policies and legislation as well as people who support it. Some organizations we found that had a strong influence the most support of fluoridation would be the Department of Environmental Quality, NC DHHS-Oral Health Section, and the NC Dental Hygiene Association. These types of organization can help to promote things especially in rural areas that do not have fluoridation in their water systems. Other resources that we read up on to prepare our interview questions were to look on Upstream.com and read articles on how to make interviews productive and in what ways could we analyze the data we will collect. By doing our interview analysis in Community Health Assessment, it gave us a tool to as to how we should approach these stakeholders.

Last Friday, we came up with interview questions to ask the stakeholders from Maine, Iowa, Alabama, Mississippi, and Missouri about statues and regulations with how they have fluoridation in their water systems. With these questions, we will be contacting these stakeholders via a phone call or video meeting. These interviews will provide us with the information we need to help determine ways in which North Carolina especially Harnett County to help with the fluoridation systems. After coming up with the questions, our preceptors took us into a dive with Advocacy 101 training. This type of training is very significant to public health officials as it promotes the importance on how policy should be implemented. Advocacy training should be emphasized in rural areas because this can help these unserved populations be able find ways to make oral health better. Rural areas need to be provided with funding toward oral health practices and education make people in the community be able to get oral health screenings. Having these dental clinics can help be an underlying component to detecting earlier stages of health diseases and illness that a patient may have.  These clinics can also be beneficial to the use of telehealth regarding oral health practices. Underserved communities use telehealth interventions to get up with their patients and to help them with their primary care visits.

By analyzing the key stakeholders in these 5 states and their discussion to how they implement regulation and policy of fluoridation systems, this can help us to figure out an approach to how we want to see where exactly in Harnett County needs these water systems. Oral health should be just as much as a priority as overall health. It will be interesting to see what kinds of answers we get to the interview questions and how we take that information to focus more on fluoridation water systems.