Kentucky Oral Health Coalitions: Using Community-Based Prevention Marketing to Improve Oral Health

Background:  Oral health is a major health issue for Kentuckians.  The 2001: Kentucky Children’s Oral Health Profile found of Kentucky’s children, ages 24 to 59 months, 42.8% had several early childhood caries and 39.3% had never seen a dentist.  Almost 24% of Kentucky elders have all their teeth extracted in the 2006 Behavioral Risk Factor Surveillance System Survey.  These problems became a national focus when Diane Sawyer did a 20/20 story on “A Hidden America:  Children of the Mountains” in which she highlighted the oral health problems of Appalachia and “Mountain Dew Mouth.”  The Kentucky Oral Health Program received two grants, which funded the creation and development 24 oral health coalitions. This work is part of Governor Steve Beshear’s oral health initiative to improve oral health of Kentucky.

Program background:  Each community conducted an application for funding to start or support an oral health coalition.  Coalition leaders attended a workshop on Community-Based Prevention Marketing (CBPM) by Dr. Carol Bryant, University of South Florida, in which they received a toolkit on the CBPM process.  Coalitions assessed their community’s oral health issues and determined a specific behavior or barrier to address.  Through research, coalitions narrowed their focus to a target audience, developed a program and designed an evaluation plan. Although oral health needs are consistent throughout the state, the method to address the needs varied from coalition to coalition.  Some of the projects that the coalitions selected included the following:

• Franklin County:  The coalition is installing outdoor electrical outlets to support the University of Kentucky mobile dental van.
• Lawrence County: The coalition is working with high school students to have two dental cleanings a year.  If the student completes both cleanings, he/she will receive a tooth whitening kit.
• Madisonville:  Coalition members are working with preschools to promote a new drink pyramid to encourage drinking more water and drinking less sweetened beverages.
• Madison County:  Has a strong dental sealant program for elementary age students but no preventive program for their preschool/kindergarten students.  They developed a fluoride varnish program for preschool students.

Evaluation Methods and Results:  Evaluation is ongoing within each coalition.  The Kentucky Oral Health Program works with each coalition to ensure that the outcome evaluation process is relevant and sustainable.  Process evaluation has been conducted on the relevance of the CBPM process and application.

Conclusions: The Kentucky Oral Health Program would not have been able to reach the vulnerable populations in all of these counties through its limited resources.  Through training of coalition leaders and ongoing technical support, the oral health needs are being met at each location.  The CBPM process provides a tool that local coalitions can use to bring a group of partners together to bring about oral health change in their communities.

Implications for research and/or practice: The model that the Kentucky Oral Health Program and local coalitions are developing will be used by the Appalachian Regional Commission as a resource for other ARC designated states for coalition development.