Successfully Working with Schools to Improve Oral Health Consent Rates July 17, 2019

1. Successfully Working with Schools to Improve Oral Health Consent Rates July 17, 2019

2. General Reminders • This webinar will be recorded and archived on the ASTDD website • We would like to hold any audience questions until the end, so if you have questions, please make a note of them. When we are ready for questions, if you wish to ask one, please click on the Set Status icon which is the little man with his arm raised on either the upper left or the top of your screen. Click on “raise hand.” We will then call on you to ask your question over the phone • Please respond to the polling questions during the webcast and the evaluation questions at the conclusion of the webinar

3. Conflict of Interest Funding was made possible (in part) by Cooperative Agreement Number DP16-1601 NU1ADP003090 and NU58DP006573-01-00, from the Centers for Disease Control and Prevention. The views expressed do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

4. Successfully Working with Schools To Improve Oral Health Consent Returns Nichole Bobo, MSN, RN Director of Nursing Education nbobo@nasn.org

5. Learning Outcomes • Describe the benefits of partnering with school nurses to improve the oral health of students. • Identify strategies for effective partnership building with school nurses.

6. Partner with School Nurses

7. Your School Nurse Partner • The school nurse reach • Approximately 17,000 NASN members • NASN’s reach is beyond members • Affiliates in each state • ‘Boundary dweller’ • Focus on prevention • Critical thinking process

8. Your School Nurse Partner https://www.nasn.org/nasn/nasn-resources/professional-topics/framework

9. Your School Nurse Partner

10. Why partner with a school nurse? • Expand the infrastructure • Familiar with the school environment • Positioned to implement evidence-based strategies • Experience with consents • Understands SDoH

11. Why partner with a school nurse? • Knows community resources • Communication with students and families • Support for students and families • Position statement (NASN, 2016) and policy(AAP, 2016) • Program success (Carpino, Walker, Liu, & Simmer-Beck, 2017) • Student-centric

12. Partnership Strategies to Engage School Nurses • Invite to the table • Make a clear and specific ask • Begin with systems thinking • Build trust, mutual understanding, common goals • Inventory resources and opportunities

13. Partnership Strategies to Engage School Nurses • Outline a clear plan – start small • Identify common ground and shared vision • Anticipate co-learning • Share data

14. What question would you like to ask your school nurse partner? Let’s Engage

15. Call to Action • Choose one partnership opportunity • Plan to contribute to the literature

16. Tools for Partnership Building • ASTDD - Improving Children’s Oral Health through the Whole School, Whole Community, Whole Child (WSCC) Model https://www.astdd.org/improving-childrens-oral-health-through-the-whole-school-whole-community-whole-child-(wscc)-model/ • Center for Disease Control & Prevention - Children’s Oral Health https://www.cdc.gov/oralhealth/basics/childrens-oral-health/index.html • Center for Disease Control & Prevention - Parents for Healthy Schools https://www.cdc.gov/healthyschools/parentengagement/parentsforhealthyschools.htm • National Association of County & City Health Officials - Mobilizing Action through Planning & Partnerships (MAPP)https://www.naccho.org/programs/public-health-infrastructure/performance-improvement/community-health-assessment/mapp

17. Tools for Partnership Building • National Association of School Nurses Online CNE Courses https://www.pathlms.com/nasn • Coalition Building (.75 CNE) • Partnership Building to Support Students Manage Chronic Health Conditions (1.0 CNE) • NASN White Paper https://www.nasn.org/nasn/nasn- resources/practice-topics/collaboration-chronic-health • The Center for Health & Healthcare in Schools- Partner Build Grow http://healthinschools.org/partner-build-grow/#sthash.2ABy32Td.dpbs

18. References American Academy of Pediatrics, Council on School Health. (2016). The role of the school nurse in providing school health services. Pediatrics, 137(6). doi: 10.1542/peds.2016-0852 American Nurses Association & NASN. (2017). School nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Authors. Bobo, N. (2014). Increasing immunization rates through the immunization neighborhood recognizing school-located immunization programs. NASN School Nurse, 29(5), 224-228. Brunson, E. (2013). The impact of social networks on parents’ vaccination decisions. Pediatrics, 31, e1297-e1404. Buerlein, J. (2010). Promoting children’s oral health – A role for school nurses in prevention, education, and coordination. NASN School Nurse, 25(1), 27-29. Carpino, R., Walker, M., Liu, Y., &I Simmer-Beck, M. (2017). Assessing the effectiveness of a school-based dental clinic on the oral health of children who lack access to dental care: A program evaluation. The Journal of School Nursing,33(3), 181-188. NASN. (2016). The role of the 21st century school nurse (Position Statement). Silver Spring, MD: Author. Available at https://www.nasn.org/nasn/advocacy/professional-practice-documents/joint-endorsed-statements NASN. (2016). Framework for 21st Century School Nursing PracticeTMRetrieved from https://www.nasn.org/nasn/nasn-resources/professional-topics/framework Nowak, B., Sicilio, L., Kizior, C., Tedder, G., Zimmerman, N, & Bobo, N. (2019). Advocating for oral health through fluoridation. NASN School Nurse. Advance online publication. doi: 10.1177/1942602X19831655 Salmon, D., Moulton, L., Omer, S., Chace, L., Klassen, A., Talebian, P.,….Halsey, N. (2004). Knowledge, attitudes, and beliefs of school nurses and personnel and associations with nonmedical immunization exemptions. Pediatrics, 113, e552-e559.

19. Kimberly Bartolomucci Program Manager of Oral Health Education and Community InitiativesThe Oral Health Forum

20. Presentation Objectives • Objective 1: Participants will be able to explain how the school-based dental sealant program and oral health education functions in Chicago. • Objective 2: Participants will be able to identify specific challenges to increasing utilization of dental services and strategies implemented to remove barriers to accessing care.

21. Program Overview • The Oral Health Forum offers oral health education presentations for students in Chicago public schools • Topics Covered • Tooth brushing and flossing demonstrations • How often to visit the dentist (2x a year) • Etiology and prevention of cavities • Importance of balanced diet • Importance of fluoride (ex. Chicago tap-water) • In 2015 the Oral Health Forum expanded program services to include case management outreach

22. School-Based Oral Health Program, Chicago Illinois • Created in 2000 by the Chicago Department of Public Health • Dental treatments provided: • Dental exams/screenings • Dental cleanings • Fluoride treatments • Dental sealants • 80,000 students served annually • Private dentists go into over 400 schools each year • 20,000 – 30,000 students recommended for follow-up or restorative dental treatment • Oral health score of 2 or 3

23. Increasing Consents • Texting program to all parents • Wrist bands at the time of education • Posters • Meet with principals

24. School Based Health Alliance • 2015 started a learning network • Consensus on raising consents • Shared ideas • Had 1 on 1 calls monthly • Had group calls monthly

25. Lessons from the Field • Innovate – Design – Test – Try it On • School Engagement • Family Engagement • Community Engagement • Oral Health Education • Data Collection and Other Drivers Increase Student Consent and Program Utilization

26. INNOVATIONS: Trying New Things

27. Improvement Plan Process • Introduction letter sent • In-person meeting scheduled with schools • Determine ate of the dental provider school-based sealant visit in before scheduling • Texting program/robo calls • Message on marquees

29. “You Can’t Be On FLEEK With Yellow Teeth” ----- Bringing Oral Health to High School

30. OUR PROCESS Schedule Educate Provider

31. The MIKVA Challenge – Targeting High School Consent Rates • MIKVA – Teen Health Council • High School Program • Helping adolescents learn real-world skills of active citizenship through meaningful and direct experiences in our democracy. • Impacts teens now and also seeds a generation of thoughtful, engaged, ethical citizens and community leaders for the future.

32. Kahoot

35. MIKVA Challenge Wrist Band Slogans • You Can’t Be on FLEEK with Yellow Teeth • Get Rid of Decay, Brush Yo Teeth Dat Way • Don’t Get Played … Brush

36. Urban Prep Academy Team Englewood Curie Metropolitan Little Village Multicultural Lane Tech

37. Success Stories

38. Challenges • Difficulties arranging initial schools in coordination with dental provider schedule • Coordinating Oral Health Education in timely manner (10-14 day window) • High Schools do not have stationary classrooms after 9th grade – difficulty reaching students

39. Considerations • Concentrating on 9th grade students • Utilize Gym & health class to reach students for oral health education • MIKVA students working with peers to educate and “de-mystify” the dental process • Understand the need for “sweat equity” by the oral health providers that provide the in – school services.

40. 1,296 Students educated 100% Total success?...dependent on perspective #86 Students treated by dental provider

42. THANKS!Kim BartolomucciProgram Manager of Oral Health Education and Community InitiativesThe Oral Health Forum Additional Questions? You can find me at: Kbartolomucci@heartlandalliance.org 312.636.3070

43. Questions?