Capstone Report

An Oral Health Promotion Program for a

Pregnancy Counseling Center

Amber Fredericks, RDH

University of Michigan, HYGDCE 491

2

Table of Contents

Project Statement/Description 3

Review of Literature 3

Rationale and Objectives 8

Design 10

Methods 11

Evaluation 11

Results 12

Discussion/Impact 16

Conclusion 18

Timeline 10

References 22

Appendices

Appendix A 24

Appendix B 26

Appendix C 27

Appendix D 29

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Project Statement/Description

The purpose of this capstone project was to develop an oral health education program for The

Lennon Pregnancy Center (LPC). Pregnant women can experience negative changes in their oral health

status due to associated changes in hormone levels. Research suggests a link between preterm, low-

birth weight babies and periodontal disease. The goal of this capstone project was to increase the oral

health knowledge of the pregnant women who receive services from the LPC.

This project continued a partnership between the LPC and the University of Michigan Dental

Hygiene (U-MDH) Program. Working with the center’s clients, the U-MDH student provided oral health

information to increase awareness of the oral-systemic link as it relates to pregnancy. In order to

identify oral health topics of interest to the clients at the center, a survey was disseminated prior to

project implementation. Possible topics included fluoride and maternal/child dental health, pregnancy

and x-rays, mouth pain, bleeding gums, and dental treatment during pregnancy.

This project benefited the LPC by expanding on the center’s health related education resources

for pregnant women. From this project, participants at the counseling center gained oral health

knowledge which can improve oral health and general health outcomes. U-MDH benefited from this

project by improving campus-community efforts.

Literature examined for this project included primary and secondary research from peer-

reviewed scholarly journals, evidenced-based databases such as PubMed and Google Scholar, and

credible web-based resources such as government, academic and industry web-sites. The Faculty

Advisor of this Capstone Project was Jennifer Cullen RDH, BSDH, Adjunct Clinical Lecturer at the

University of Michigan, Dental Hygiene program. The Project Advisor was Elizabeth Schultz, Executive

Director of The Lennon Pregnancy Center.

Review of Literature

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General Health/Oral Health

When it comes to oral health, many people are not aware of the relationship it has with general

health. The mouth is often thought of as an entry way to the body, reflecting and influencing general

health and wellbeing.1 Poor oral health can negatively affect chronic diseases such as diabetes and heart

disease.2 Understanding the oral/systemic link, health professionals can greatly enhance patient

wellbeing for both oral and general health.2Oral diseases include dental caries, periodontal disease, and

oropharyngeal cancers, with oropharyngeal cancer.3 One important health condition that is thought to

be negatively affected by poor oral health is pregnancy.

Pregnancy/Oral Health

Oral health changes occur during pregnancy that effect the hard and soft tissues of the mouth.4

One of these changes is pregnancy gingivitis, caused by hormonal changes along with poor oral hygiene

during pregnancy.4 When gingivitis is left untreated, it can progress into periodontal disease (PD). PD is a

chronic, destructive, inflammatory condition, located in the gingiva and bone that support the teeth.1,4,5

It is the inflammatory response created by PD that has been associated with pre-term and low birth

weight deliveries.1,4 It has been suggested that the effect of PD on low birth weight could result from

the stimulation of fetal membranes with products derived from the inflamed periodontal tissues.4

Pre -term birth (PTB) is defined as delivery at less than 37 weeks of gestational age. This occurs

in approximately 12% of all births.1 Low birth weight (LBW) is defined as having a birth weight of less

than 5.51 pounds (2500g).5 About 6-7% of all births are low birth weight babies and data suggests that

18% of pre-term and low birth weight babies born are attributed to periodontal disease.1,5

Pregnant women who deliver preterm and low birth weight babies have more gingival

inflammation than do women with normal weight babies.4 A 2011 study focused on the oral health

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status of 142 Caucasian women with normal and high risk pregnancies.4 The pregnant women were

divided into two groups; the research group (high risk pregnancy) and the control group (normal

pregnancy).4 The high risk pregnancy group had serious health conditions including gestational diabetes,

pre-gestational diabetes, and high blood pressure.4 Clinical dental examinations in this study included

Decayed, Missing and Filled Index (DMF), Papilla Bleeding Index (PBI) along with Community Periodontal

Index of Treatment Needs (CPITN).4 The results showed that 77% of the women with high risk

pregnancies had dental treatment needs compared with 32% of the women with normal pregnancies.4

In addition, high CPITN index values were detected in 6 women (9.8%) in the normal pregnancy group

and 18 women (22.1%) in the high risk pregnancy group.4

Many times pregnant women state they have heard that they cannot visit a dentist while

pregnant. Oral health care is not only encouraged throughout pregnancy, but recommended. Pregnancy

by itself is not a reason to defer routine dental care and necessary treatment for oral health problems.6

Diagnosis and treatment during the first trimester, including dental X-rays, can be safely undertaken.6 If

additional treatment is needed, it is best that it is provided throughout the pregnancy. However, the

time period that is thought to be the safest is between the 14th and 20th week of pregnancy.6

Pregnancy in the United States

In 2012, a total of 3,952,841 births were registered in the United States.8 The births declined by

1% for the non-Hispanic white and Hispanic women from 2011-2012 and were unchanged among non-

Hispanic black women.8 The number of preterm births in 2012 was 11.55% of all births, down 2% from

2011 and down 10% from the peak in 2006.8 The rate of low birth weight was 7.99% in 2012, which is

slightly down from 8.10% in 2011 and 8.26% in 2006.8 Between 2008 and 2012, 85.7% of the population

age 25 and older had an education level of high school or higher and 28.5% of the population had a

bachelor’s degree or higher.7

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Pregnancy in Wayne County

According to the United States Census Bureau, Michigan’s population estimate in 2012 was

9,882,519. The population of Michigan’s largest county, Wayne County was 1,792,496.9 Six and a half

percent of the population in Wayne County was under 5 years of age.9 According to the Michigan

Department of Community Health, between 2008 and 2012 there were 5,312 teen (ages 15-19)

pregnancies in Wayne County.10 Approximately 84% of the state’s population age 25 and older had an

education level of high school or higher and 20.8% of the population had a bachelor’s degree or higher.9

Michigan Health Resources

The Michigan Department of Community Health (MDCH) promotes the health and safety of

people in Michigan. MDCH is one of the largest of the executive branch departments serving residents

with the Women, Infant and Children (WIC) program. WIC is a health and nutritional program that has

demonstrated a positive effect on pregnancy outcomes, child growth and development.11 Each month

more than 200,000 mothers, babies, and children (under age 5) receive nutritious foods from the

Michigan WIC program.11 WIC participants also receive nutrition and breastfeeding education as well as

referrals to other health services.11 A local community center that also provides education and support

services to new moms and their babies in need is the Lennon Pregnancy Center (LPC).

The Lennon Pregnancy Center

The LPC, located in Wayne County, Michigan, was created in 1984 under the name of Metro Life

Choices by committee members Joe and Marybeth Lennon.12 At first, the center was only open one hour

per week due to lack of volunteers.12 In 1996, the center grew its hours of operation to thirty hours per

week and in 1997 the center changed their name to The Metro Crisis Pregnancy Center.12 In 2003, the

Board of Directors decided to once again change the name of the center, since the center’s name

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involved ‘crisis’, causing it to be perceived as an abortion clinic.12 The new name became the Lennon

Pregnancy Center, attributing the name to Joe and Marybeth Lennon.12

The LPC currently has thirty-five clients enrolled in its program. One of the main focuses of the

LPC is their free health education classes. The classes cover topics such as pregnancy, childbirth and

newborn parenting, and mom and baby care.12 The students range in age from fourteen to twenty-six

years of age and are from the surrounding metro Detroit area; Detroit, Westland, Redford Township,

Southfield, Taylor, Dearborn Heights, Belleville, Dearborn, Livonia and Inkster.12 Of these clients as of

late 2013, 11 are Caucasian, 20 are African American, 2 are Hispanic, and three have chosen not to

identify their race.12

Health Education and Promotion

Health education programs are important for the wellbeing of all communities. Healthy People

2020’s oral health goal is to prevent and control oral and craniofacial diseases, conditions and injuries,

and improve access to preventive services and dental care.13 One of the Healthy People 2020 oral health

objectives includes reducing dental decay in children, adolescents and adults.13 Another is to increase

the proportion of those who received any preventive dental service within the last year.13 The goal of

Healthy People 2020 for maternal, infant and child health is to improve the health and wellbeing of

women, infants, children and families.14Healthy People 2020 Maternal, Infant and Child Health

objectives include; reduce low birth weight, very low birth weight and reduce preterm births.14 This

project supported Healthy People 2020 goals and objectives by educating pregnant women about the

benefits of good oral health as it relates to maternal and child health.

Oral health educational sessions at community agencies such as the LPC, can increase oral

health awareness and promote overall health. Oral health education programs aim to promote oral

health by providing information to improve awareness which can lead to a healthier lifestyle, positive

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attitude and good oral health behaviors.15 The potential for adverse pregnancy outcomes related to poor

oral health should be addressed with at-risk populations. Gaining insight on the knowledge and attitudes

toward oral health among LPC clients can set the tone for successful oral health education sessions.

Conclusion

With research on the connection between general health and oral health advancing, the general

population may not know what the recent literature states. In addition, individuals may not be aware of

evidence that demonstrates the importance of maintaining good oral health throughout pregnancy.

This shows a need for oral health education programs in at-risk communities. It is in the hands of oral

health professionals to educate the public on the ways to improve oral health and general health

outcomes.

Research has suggested a correlation between periodontal disease and low birth weight and

pre-term babies. In order to reduce the incidence of low birth weight and pre-term babies, preventative

oral healthcare and appropriate treatment must be provided throughout pregnancy. Access to dental

care among the low income pregnancy community may be challenging, but community-based oral

health education efforts can inform women’s choices for improving their oral health status and in turn

reduce pregnancy risks.

Project Rationale

The LPC is a counseling center offering instructional classes on pregnancy, childbirth and

newborn parenting, and new mom and baby care. This project was selected for the LPC after identifying

a need to increase awareness of the relationship between poor oral health and adverse pregnancy

outcomes, such as pre-term and low birth weight babies. The project was selected with the professional

goal of contributing to the role of dental hygiene in public health by educating an at-risk population of

pregnant women on relevant oral health topics.

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Delivering an educational program for the clients at the LPC was significant because two

important health topics, oral health and pregnancy and fluoride and maternal/child oral health, were

addressed. Health education plays an important role in communication between providers and patients

and improving health outcomes. Evidence suggests the need for community health programs for long

term retention of information.12 This project increased the oral health knowledge of the clients at the

LPC through educational programming developed specifically for their needs and interests.

The LPC and its clients benefited from this project by having access to oral health education

resources. U-M Dental Hygiene benefited from this project by fostering campus-community

partnerships. The U-M Dental Hygiene student benefited from this project by gaining a deeper

understanding of the complex socioeconomic influences on health literacy and behavior and the

relationship between oral health and pregnancy.

Project Objectives/Evaluation Measures

Program Objectives Evaluation Measures Outcome Indicators

1. Disseminate a needs

assessment survey to the clients at the Lennon Pregnancy Center.

A ten question survey will be disseminated to assess client interest on selected oral health topics.

Twenty surveys will be completed by clients and returned.

2. Provide six oral health

educational sessions for clients at a pregnancy counseling center.

A sign-in sheet will be used at each session to collect attendance rate data.

A total of fifteen clients will participate in the six educational sessions.

3. Increase oral health

knowledge of the clients at the Lennon Pregnancy Center.

A pre and post-test will be provided to all clients at the beginning and end of each educational session.

Clients will score 100% on post-tests.

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Design

The purpose of this capstone project was to develop an oral health education program for the

LPC. This project was selected based on a previous collaboration between the LPC and U-MDH.

Developing a project that supports this purpose required many design components. These included:

Identification of the LPC as a potential oral health education partner

Assessment of the LPC client’s interest level on oral health related topics

Collaboration between the LPC administration, LPC clients, and U-MDH

Selection of oral health topics for education sessions

Marketing of oral health education sessions to center clientele

Evaluation of the LPC client’s post-session oral health knowledge

Two different oral health educational sessions were developed for the clients of the Lennon

Pregnancy Center. Two session topics were selected based on responses to a, needs assessment survey

previously disseminated to the clients. The first oral health educational session were use a PowerPoint

presentation and related handouts to demonstrate the connection of bleeding gums and mouth pain to

pregnancy. The PowerPoint was designed for a 3rd/4th grade reading level and clients had a printed

handout with 3 slides per page and available space to take notes. A projector was provided from The

University of Michigan for the PowerPoint presentations.

The second oral health educational session was selected based on responses to the needs

assessment survey and focused on fluoride and maternal/child health. A PowerPoint was created for the

session designed for a 3rd/4th grade reading level and clients had a printed handout with 3 slides per

page and available space to take notes. The reading level of both presentations was assessed using the

Flesch Reading Ease. Information included in the session’s PowerPoint and handouts were obtained

from the Centers for Disease Control and Prevention (CDC) and the National Institute of Dental and

Craniofacial Research (NIH).

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In order to promote client attendance at each educational session, six sessions were offered for

the clients. One month before implementation, a flyer advertising each oral health education session’s

date and time was presented to the LPC. A sign in sheet was be used during the sessions to document

rate of client attendance.

Methods

A Review of Literature was conducted to support the link between oral health and pregnancy

outcomes and provide evidence to support the need for community health educational efforts for at risk

populations. A needs assessment survey was distributed to the Lennon Pregnancy Center to assess client

interest in specific oral health topics. The two topics identified by the survey were bleeding

gums/mouth pain and pregnancy, and fluoride and maternal/child health. Literature was also collected

on the topics selected for the education sessions. Six education sessions were given, two topics per

session.

Oral Health Education Session Topic: Bleeding Gums/Mouth Pain and Pregnancy. A PowerPoint

presentation and handouts were developed. Session topics included were:

A picture of a body showing how the mouth is connected to the systemic components of the

body.

Poor oral health and periodontal disease.

The relationship between periodontal disease and adverse pregnancy outcomes.

Risks of pre-term and low birth weight babies.

Dental treatment and its potential to decrease risk of pre-term and low birth weight babies.

Oral Health Education Session Topic: Fluoride and Maternal/Child Health. A PowerPoint presentation

and handouts were developed and presented. Session topics to be included were:

Background on what is fluoride and where it was found.

Why fluoride is important.

Where it can be found (water, food, formula).

How maternal ingestion of fluoride can positively affect the fetus

Evaluation

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The Capstone Project Proposal and all educational materials were shared with project advisor Liz

Schultz, Executive director of the Lennon Pregnancy Center and staff members prior to implementation.

A project advisor feedback form accompanied the proposal. Client attendance at the education sessions

was evaluated with the use of sign-in sheets for each class. A pre-session survey was given to the clients

to establish base-line oral health knowledge. To measure increase in client oral health knowledge, a

post-session survey was given following the presentation. Surveys consisted of multiple choice and open

ended questions. These surveys were pilot tested by Kathy Yee, BSDH, MPH a U-M Dental Hygiene

instructor who has experience and expertise in designing effective evaluation tools. The results of the

client post-test surveys were reviewed by the U-MDH student and Liz Schultz, Executive Director of the

Lennon Pregnancy Center to evaluate the knowledge gained by the clients.

Results

The first objective was to disseminate a needs assessment survey (Appendix A) twelve weeks

before program implementation. The needs assessment survey was used to assess client interest level

on a variety of oral health related topics. Possible topics included fluoride and my child’s dental health,

pregnancy and x-rays, mouth pain, bleeding gums, and dental treatment during pregnancy. The survey

used a Likert scale to measure client interest level for each topic. Eleven surveys were completed and

returned. The needs assessment survey was extended a week to increase client participation. The

outcome indicator was the return of 20 surveys thus only 51% of this objective was achieved. Seven out

of the eleven client’s selected “very interested” in fluoride and my child’s dental health. Five out of

eleven clients selected “very interested” in dental treatment and pregnancy (Figure 1). Based on the

results from this survey, content for the education sessions was developed and two lecture supported

PowerPoint presentations were delivered.

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Figure 1. Client Responses to Needs Assessment Survey

The second objective was to deliver six oral health education sessions at the LPC. To promote

client attendance, a flyer was provided to the LPC with the dates and times of the oral health promotion

sessions. The flyer was displayed on the information desk and a copy was made to hang on the wall

where educational classes are held. Six oral health education sessions, three sessions per week, were

offered at the LPC during a two week period. A sign-in sheet was used at each session that collected

attendance rate data (Appendix B). Each client was asked to sign-in upon arrival for the educational

session. During each session both Oral Health and Pregnancy and Fluoride and Maternal/Child Oral

Health programs were delivered. A total of nine clients participated in all of the oral health educational

sessions (Table 1). The outcome indicator for this objective was to have a total of 15 clients participate.

This objective fell short by 60%. The highest class attendance rates took place on Tuesday, May 27, 2014

at 11 a.m. and Thursday, June 5, 2014 at 10:30 a.m. The lowest attendance rate for class took place

during the Tuesday, May 27, 2014 at 12:15 p.m. session with zero clients attending. The other three

classes each had one attendee per class.

0

1

2

3

4

5

6

7

8

Very Interested

Somewhat Interested

Nuetral

Not Very Interested

Not Interested At All

N=11

Nu

mb

er o

f R

esp

on

dan

ts

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Table 1. Attendance Rates of Clients

Session Attendees

Tuesday, May 27, 2014 11 a.m. 3

Tuesday, May 27, 2014 12:15 p.m. 0

Thursday, May 29, 2014 10:30 a.m. 1

Tuesday, June 3, 2014 11 a.m. 1

Tuesday, June 3, 2014 12:15 p.m. 1

Thursday, June 5, 2014 10:30 a.m. 3

Total Attendees: 9

The third objective of this project was to assess if there was an increase in clients’ knowledge as

a result of participating in these sessions. A total of six oral health promotion sessions were delivered at

the LPC. The clients participated in a pre-session survey to establish base-line oral health knowledge. All

nine clients completed a pre-session survey consisting of ten multiple choice questions; six questions

related to oral health and pregnancy and four questions related to fluoride (Appendix C). After the oral

health education sessions, the nine clients participated in a post-session survey consisting of the same

10 multiple choice questions. The post-session survey also included four open ended questions related

to the client’s participation experience (Appendix D).

On the pre-session survey, the nine clients’ scores ranged from 9/10 to 5/10 (Figure 2). On the

post-session survey, the nine clients’ scores ranged from 10/10 to 8/10. Six clients scored 10/10, one

client scored 9/10 and two clients scored 8/10 (Figure 3). These results demonstrated a statistically

significant difference between pre-session survey scores and post-session survey scores, indicating an

increase in client oral health knowledge. The feedback provided from the open ended questions

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included, three participants stating they did not know x-rays and dental work could be performed

throughout pregnancy. Four participants did not know that infants could receive fluoride through breast

milk, and three participants also stated they did not know some communities do not have municipal

water fluoridation.

Table 2. Pre Session Survey Results

Table 3. Post Session Survey Results

0

1

2

3

4

5

6

7

8

9

10

Pre-Session Survey Results

Number of QuestionsAnswered Correctly

Nu

mb

er o

f P

arti

cip

ants

N=9

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Discussion/Impact

The needs assessment survey was critical to the project’s success by assessing client

interest level on a variety of oral health related topics. In this project it was sought to increase the oral

health knowledge of at risk pregnant women. Based on the data collected through eleven needs

assessment surveys, education sessions discussing Fluoride and Maternal/Child Oral health and

Pregnancy and Oral Health were implemented. Creating an educational program based on data from the

needs assessment surveys assured that the project met the expectations of the stakeholders. Even

though only 11 out of 20 surveys were collected the results were significant to planning and delivering a

meaningful program. Rationale for the topics suggested on the survey came from previous

conversations with staff and clients at the LPC during an oral health promotion program implementation

in fall 2013. To increase the response rate to a needs assessment survey in the future, it is

recommended that the survey be delivered father in advance, allowing four weeks, for clients to

participate.

0

1

2

3

4

5

6

7

8

9

10

Post-Session Survey Results

Number of QuestionsAnswered Correctly

Nu

mb

er o

f P

arti

cip

ants

N=9

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The attendance rates for the oral health educational session partially met the project objective.

Sixty percent of the anticipated clients participated in the oral health educational sessions through the

six classes that were held. Some factors influencing rates of client attendance were limited

transportation services for clients because most do not have their own care. Client’s work schedules

may have conflicted with session times. If the oral health education sessions ran for a longer period of

time, four weeks vs two weeks, the rate of attendance, may have increased.

The participation and results of surveys were surprising. The participants’ scores were higher

than anticipated on the pre-session surveys with three questions answered correct by all participants’.

The most commonly missed question with no participants answering the question correctly, was “which

dental treatments are safe during pregnancy.” The goal of the oral health promotion program was to

increase the oral health knowledge of pregnant women and to encourage dental cleanings and checkups

throughout pregnancy. After the oral health education sessions concluded, six clients who participated

in post-session survey answered all ten questions correctly, receiving 100%. Two questions were missed

on oral health and pregnancy and one on fluoride and maternal/child oral health. Questions that were

missed by other clients, for example, included choices such as “all of the above” and “both A and B”

answers. For four of those questions, the clients should have chosen “all of the above” or “both A and B”

but instead chose only one of the other responses provided.

Recommendations to improve attendance would be to have a separate routine class on oral

health, provided by a Registered Dental Hygienist, rather than fitting it into already scheduled pregnancy

education classes. This class would offer information related to pregnancy and oral health, eruption of

baby teeth, fluoride, etc. With this class there is still a possibility for client attendance to be low;

however, having a routine class would give clients more opportunities to attend. Clients would be

engaged in asking questions and gaining information on oral health concerns. If this class was offered it

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could also give the clients resources on where to obtain treatment, if needed, and how to access local

oral health services.

It is also important to note that at the conclusion of each session, each client received a “goodie

bag”. Oral health supplies in these bags included, an adult toothbrush, toothpaste and floss as well as a

booklet from the ADA called, Your Child’s Teeth: Helpful Tips for Parents and Caregivers. Information in

this book included, how to brush, how to floss, fluoride, dental visit, tooth eruption, etc. Thirty-six oral

health bags were made. These supplies were funded by the University of Michigan Dental Hygiene

Program. Since nine clients participated, the remaining bags were left at the LPC to be distributed to

other clients. Leaving the bags with the LPC, will promote oral health to these women as well as give

them an insight on where to seek treatment, if needed.

Conclusion

Oral health changes occur during pregnancy that can lead to periodontal disease (PD). The

effects of PD in pregnancy have been associated with pre-term birth and low birth weight. In order to

reduce the risk for oral health changes during pregnancy, good oral hygiene habits need to be developed

and maintained. Oral health programs for at-risk populations should be developed. Oral health

education programs can increase knowledge for pregnant women regarding oral health issues related to

pregnancy. First, the need and stakeholders for such programs need to be identified.

The LPC administration recognized the relationship between good oral health and pregnancy

outcomes and supported the oral health promotion program. With the involvement of the key

stakeholders, an educational program was designed to address the unique interests of the population.

This project successfully addressed the LPC’s needs and also contributed to the role of dental hygiene in

public health through educating an at-risk population of pregnancy women about relevant oral health

topics.

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Project Timeline

Date Activity Significance

January 8th, 2014 Meeting with Capstone Course Instructor to establish capstone project

Establish capstone project topic

January 8th, 2014 Established the LPC’s interest in continuing oral health educational program

Ensure capstone project with agency

February 7th, 2014 Meeting with Capstone course instructor and Faculty Advisor

Establish relationship and meet with faculty advisor to exchange ideas for capstone

March 5th, 2014 Disseminate needs assessment survey

Needs assessment survey disseminated to gain interest for oral health topics

March 5th, 2014 Meeting with LPC’s executive director

Organize program goals and plans

March 12th, 2014 Memorandum of Understanding An agreement with faculty advisor to collaborate with student throughout Capstone Project

March 14th, 2014 Collect needs assessment survey To determine topic of interest for oral health topics

March 14th, 2014 Project Title & Statement Determine direction of project

Increase understanding of project

Develop parameters

Identify beneficiaries

Define goal March 18th, 2014 Literature Review Outline Organize information to be

included in literature review

March 25th, 2014 Literature Review Chart Organize resources related to project

March 25th, 2014 IRB Decision Tree Establish that the IRB did not need to be contacted prior to project

March 25th, 2014 Status Report 1 Shows ongoing progress of project such as reviewing what was done, what needs to be done, and identifying open issues and strategies for addressing them. Summarizes meeting with capstone advisor.

April 1st,2014 Review of the Literature Provide evidence for project topics such as oral/general

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health, pregnancy/oral health, pregnancy rates in the United States, pregnancy in Wayne County, Michigan health resources and oral health promotion.

April 1st, 2014 Project Rationale & Objectives/Evaluation Measures/Outcome Indicator

Describes the reason, significance, and beneficiary of project

Professional goals for this project

April 8th, 2014 Design, Methods, Evaluation and Timeline

Describes project specifics and organization

States materials, resources, and stakeholders required

Identifies how project will be implemented and evaluated with measureable objectives

Describes data collected/evaluation measures

Timeline for project activities

April 8th, 2014 Status Report 2 Shows ongoing progress of project

April 12th, 2014 Ordering toothbrushes, floss, and toothpaste through the U-M School of Dentistry

To provide oral health supplies to the LPC during implementation

April 15th, 2014 Comprehensive Proposal Draft Submitted to the Lennon Pregnancy Center for review

April 22nd, 2014 Status Report 3 Shows ongoing progress of project

April 29th, 2014 Comprehensive Project Proposal Represents completed project proposal

May 2nd/7th, 2014 Project Resources (draft) submitted to Faculty Advisor

Review of all educational materials and surveys to ensure continuity and relevance

May 13th. 2014 Capstone Project Evaluation Instrument-Draft

Submit for evaluation and pilot testing

May 20th, 2014 Obtain overhead projector Obtain overhead projector from the University of Michigan for PowerPoint presentation

May 20th, 2014 Obtain oral health supplies; Obtain supplies to provide to the

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toothbrushes, floss and tooth paste from the U-M School of Dentistry

LPC during implementation

May 20th, 2014 Capstone Project Evaluation Instrument Revisions

Submit for revisions

May 20th, 2014 Project Status Report Shows ongoing progress of project

May 20th, 2014 Project run through Practice hooking up the projector and have a practice run at LPC prior to implementation

May 27th/29th, 2014 June 3rd/5th,2014

Capstone Project Implementation

Oral health education session held to increase knowledge of pregnant women on pregnancy and oral health

June 3rd, 2014 Project Status Report Shows ongoing progress of project

June 10th, 2014 Project Status Report Shows ongoing progress of project

June 10th, 2014 Return projector to U-M School of Dentistry

Concludes implementation phase

June 17th, 2014 Capstone Project Results/Discussion-impact/Conclusions

Shows results of oral health education knowledge of pregnant women

July 1st, 2014 Capstone Project Final Final submission

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9. U.S. Department of Commerce [Internet]. Washington (DC): United States Census Bureau. State and

county quick facts Wayne county Michigan [cited 2014 Mar 29]; [about 1 screen]. Available from:

http://quickfacts.census.gov/qfd/states/26/26163.html

10. Michigan Department of Community Health [Internet]. Lansing (MI): State of Michigan; c2001-2004.

Estimated teen pregnancy rates & population, females ages 15-19 Wayne county residents, 1989-2012;

2012 September [Cited 2014 Arp 5];[about 1 screen]. Available from:

http://www.mdch.state.mi.us/pha/osr/chi/births/teenpreg/PREGCO.asp?DxId=1&CoCode=82&CoName

=Wayne

11. Michigan Department of Community Health [Internet]. Lansing (MI): State of Michigan; c2001-2014.

What is WIC?; 2013 May 24 [cited 2014 Mar 29]; [about 1 screen]. Available from:

https://www.michigan.gov/mdch/0,4612,7-132-2942_4910_6329-12607--,00.html

12. Schultz, Elizabeth (Executive director of The Lennon Center, Dearborn Heights, MI). Conversation

with Amber Fredericks (E-learning degree completion student, University of Michigan, School of

Dentistry, Ann Arbor, MI). 2013 May 21.

23

13. Healthy People [Internet]. Washington (DC): U.S. Department of Health and Human Services; c2013.

Oral health objectives; 2013 Apr 10 [cited 2014 Apr 5]; [about 4 screens]. Available from:

http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=32.

14. Healthy People [Internet]. Washington (DC): U.S. Department of Health and Human Services; c2013.

Maternal, infant and child health; 2013 Apr 10 [cited 2014 Apr 5]; [about 3 screens]. Available from:

http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=26

15. Gauba A, Bal IS, Jain A, Mittal HC. School based oral health promotional intervention: effect on

knowledge, practices and clinical oral health related parameters. Contemp Clin Dent. 2013;4:493-9.

24

APPENDIX A

Oral Health and Pregnancy

Thank you for taking the time to complete the survey below. Your feedback is important. The survey

results will help University of Michigan Dental Hygiene student, Amber, better meet your needs. This

survey should only take about 2 minutes and is completely anonymous. Please return completed surveys

to your instructor when finished and Amber will return Friday, March 14, 2014 to collect the surveys.

What is your age range? (Please circle one)

Under 20

20-25

25-30

30 & up

Do you have a dental office you visit for routine check-ups? (Please circle one)

Yes, How often? __________

No

When was your last dental visit? (Please circle one)

Less than 6 months ago

6 months to 1 year ago

1-2 years ago

2-5 years ago

Greater than five years ago

Don’t know

I have never seen a dentist

Does anyone living with, or caring for, your child smoke? (Please circle one)

Yes

No

**Please complete the back side of this survey.**

25

Please circle your interest level on the following topics related to your pregnancy and oral health.

X-rays and pregnancy

Very interested Somewhat interested

Neutral Not very interested Not interested at all

Fluoride and pregnancy

Very interested Somewhat interested

Neutral Not very interested Not interested at all

Fluoride and my child's dental health

Very interested Somewhat interested

Neutral Not very interested Not interested at all

Mouth pain and pregnancy

Very interested Somewhat interested

Neutral Not very interested Not interested at all

Bleeding gums and pregnancy

Very interested Somewhat interested

Neutral Not very interested Not interested at all

Dental treatment and pregnancy

Very interested Somewhat interested

Neutral Not very interested Not interested at all

Please feel free to write in your own oral health topic suggestions below:

THANK YOU!

26

APPENDIX B

Attendance

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

Name _____________________________________________________ Date ___________________

27

APPENDIX C

PRE SURVEY

Thank you for taking the time to complete the survey below. Your participation is important.

The survey results will help University of Michigan Dental Hygiene student, Amber, to evaluate

the oral health promotion program. This survey is completely anonymous.

Please select one response for each question

PREGNANCY AND ORAL HEALTH

1. What is gingivitis?

A. Reversible infection in the gums B. Infection in the toe C. Infection in tongue

2. What is periodontal disease? A. Sinus infection B Non-reversible infection in the C. Swelling of the ankles

gums and bone around the teeth

3. What general health problems are affected by periodontal disease?

A. Acne B. Pregnancy C. Teeth staining

4. What does the term “pre-term” mean?

A. A baby delivered after 37 weeks

B. A baby delivered before 37 weeks

C. A puppy delivered after 35 weeks

5. What adverse pregnancy outcomes are affected by periodontal disease?

A. Pre-term birth B. Low birth weight C. Both A and B

6. Which dental treatments are safe to have during pregnancy?

A. X-rays

B. Fillings and Cleanings

C. Both A and B

D. Neither A or B Please turn over and complete back side

28

PRE SURVEY

FLUORIDE

1. What is fluoride?

A. Mineral found in nature B. Toxic material C. Foreign substance

2. Where fluoride is found?

A. Soil and water

B. Toothpaste and mouth rinse

C. Food

D. All of the above

3. Why is fluoride important to your oral health?

A. Reduces risk for cavities B. To be able to eat C. To add flavor to water

more candy

4. Infants can receive fluoride through ___________

A. Formula

B. Breast milk

C. Both A and B

29

APPENDIX D

POST SURVEY

Thank you for taking the time to complete the survey below. Your feedback is important. The

survey results will help University of Michigan Dental Hygiene student, Amber, to evaluate the

oral health promotion program. This survey is completely anonymous.

Please select one response for each question

PREGNANCY AND ORAL HEALTH

1. What is gingivitis?

A. Reversible infection in the gums B. Infection in the toe C. Infection in tongue

2. What is periodontal disease?

A. Sinus infection B. Non-reversible infection in the C. Swelling of the ankles gums and bone around the teeth

3. What general health problems are affected by periodontal disease?

A. Acne B. Pregnancy C. Kidney disease

4. What does the term “pre-term” mean?

A. A baby delivered after 37 weeks

B. A baby delivered before 37 weeks

C. A puppy delivered after 35 weeks

5. What adverse pregnancy outcomes are affected by periodontal disease?

A. Pre-term birth B. Low birth weight C. Both A and B

6. Which dental treatments are safe to have during pregnancy?

A. X-rays

B. Fillings and Cleanings

C. Both A and B

D. Neither A or B Please turn over and complete back side

30

POST SURVEY

FLUORIDE

1. What is fluoride?

A. Mineral found in nature B. Toxic material C. Foreign substance

2. Where fluoride is found?

A. Soil and water

B. Toothpaste and mouth rinse

C. Food

D. All of the above

3. Why is fluoride important to your oral health?

A. Reduces risk for cavities B. To be able to eat C. To add flavor to water

more candy

4. Infants can receive fluoride through ___________

A. Formula

B. Breast milk

C. Both A and B

What did you learn today about oral health and/or pregnancy that you did not know before?

What did you learn today about fluoride that you did not know before?

What did you like about the program (content, schedule, location, format, other)?

What would you like to learn more about?