MUST KNOW
What is this?
-Survey and Needs assessment
-Data analysis
-Program planning
-Program Operation
-Funding
-Appraisal or Evaluation
Community Health Practice
MUST KNOW
What is this?
-Health History and Examination
-Diagnosis
-Treatment Planning
-Treatment
-Payment
-Evaluation
Private Practice
What is an example of international government levels of community dental health?
World Health Organization (WHO)
What level of government acts on oral health problems of national significance?
Federal
What level of government is primarily within the jurisdiction of the deparment of health and human services?
Federal
DHHS published what?
Healthy People 2010
Centers for disease control and prevention (CDC) is located where?
Atlanta, Georgia
What is the CDC an example of? (level of government)
Federal
What level of govt is Health resources and services administration?
federal
What level of govt is the national institute of health
federal
What level of govt provides consultation services to local health departments?
State
What level of govt directly administers some programs, esp statewide programs
state
what level of govt directly administers county and city programs
Local
What level of govt initiates dental health legislative measures, such as fluoridation
local
The estimated population of people who are managing a disease at any given time.
Prevalence
Refers to the annual diagnosis rate or the number of new cases of a particular disease diagnosed each year
Incidence
-Collecting data to describe normal biological processes
-Understanding the natural history of a disease process
-measuring the distribution of a disease in a given population
-identifying determinants of disease
-testing hypotheses for prevention and con
Uses for epidemiology
An unexpectedly large number of cases of disease in a particular population at a particular place and time
Epidemic
A disease that occurs regularly in a population as a matter of course.
Endemic
An outbreak of disease over a wide geographical area; often worldwide
Pandemic
Designed to describe the extent of a disease or condition within a population and its relationship with other variables. Determines who is geting the disease and where and when the disease is occurring.
Descriptive studies
Tests hypotheses to establish cause.
experimental studies
Suggested explanation of a phenomenon
hypothesis
A hypothesis which a researcher tries to disprove or nullify.
null hypothesis
An alternate way to explain the phenomenon.
alternate hypothesis
Experimental treatment is withheld; test subjects receive placebo
control group
what is another name for null hypothesis
H0
What is another name for alternate hypothesis?
H1
Receives experimental treatment
treatment group
Researcher is unaware of whether test subject is in the control or treatment group during the study; helps prevent bias.
blind study
Neither the researcher nor subject knows who is receiving experimental treatment; best way to prevent bias
double blind study
Examines whether a past association exists between an exposure of interest and development of a present condition
retrospective (Case control) study
Study in which subjects are observed and data is collected over time to determine if a disease or condition develops.
prospective study
Group is studied over an extended period of time
longitudinal study
Every element in the population has an equal chance of being selected; reduces the chance of bias
random sample
Selecting an element according to certain subgroups; accomplished by selecting a proportionate number of participants from each subgroup for the sample
stratified sample
Select every nth to participate
judgement sample
Sample group is chosen based solely on convenience
convenience sample
The outcome of interest. Should change in response to some intervention. The dependent variable depends on the independent variable
dependent variable
Manipulated to produce a response to the dependent variable
independent variable
Used to describe, summarize, and organize numerical data. Measures of central tendency
descriptive statistics
Measures how often each score occurs.
frequency of distribution
Data is presented in ascending or descending order along with the frequency of each score. (ex: hatch marks)
ungrouped scores
Frequency of occurrence of scores up to and including any given value in the data set.
cumulative scores
Grouping variables into consecutive intervals
grouped scores
Frequency of distribution is plotted out an x-y graph resulting in a pictorial representation of the data. Mean, median, and mode. When data is plotted using a normal curve: the mean, median, and mode are equal.
measures of central tendency
The arithmetic average of scores. Most common measure of central tendency. To calculate: add all the scores together and divide by the number of scores.
mean
Divides the distribution of scores into two equal parts. To calculate: place scores in a data matrix and locate midpoint
median
The most frequently occurring score within the data matrix. To calculate: using an ungrouped tally system, identify the score that occurs most often.
mode
Describes how wide the scores are around a central point (in a normal curve, the central point would be the mean, median, and mode.
measures of dispersion
The difference between the high and low scores of a data matrix; affected by extremely high or low scores.
range
Represents the square root of the sample variance. The most commonly used method of dispersion in oral hygiene research and reflects the range within the data matrix; the bigger the range or 'standard deviation', the wider the distribution curve.
standard deviation
This is a board alert: When data is plotted using a NORMAL curve, the mean... median.. and mode are all...
EQUAL!!!!!!!!!!!
When more scores fall in the lower range
positive skew
When more scores fall in the higher range
negative skew
Allows one to generalize findings from the sample study to a larger population.
inferential studies
Degree that a study or procedure can be conclusive yet sufficiently realistic. 'Does the test measure what it claims to be measuring?'
Validity
The extent to which the method of measurement CONSISTENTLY performs
Reliability
Consistent performance by the same evaluator
INTRAexaminer reliability
Consistent performance between different examiners; is increased by calibration
INTERexaminer reliability
The ability of a test to correctly identify the presence of a disease
sensitivity
The ability of a test to identify the absence of a disease
specificity
Determines the strength of relationship between two variables. Shows probable cause and effect. Given as a number between +1 and -1. The closer the correlation is to either +1 or -1 te stronger the correlation
Correlation co-efficient
As the value of x increases, the value of y increases. As the value of x decreases, the value of y decreases. Reflects a direct association between the variables.
Positive correlation
As the value of x increases, the value of y decreases; as the value of x decreases, the value of y increases. The score on one scale's predicts an opposite score on the other scale.
Negative correlation
Statistical measure used to test the hypothetical difference between two mean scores
T-test
Used when comparing the statistical difference between three or more mean scores.
ANOVA (analysis of variance)
Used when testing hypothesis. Refers to the probability that a condition or circumstance would happen just by chance without experimental intervention. Standard acceptability is 1 out of 20 or a p-value of ?0.05; a p-value greater than 0.05 will affect st
p-value (probability value)
Involves preventive therapies. Techniques are designed to prevent, reverse, or arrest a disease process. Common examples include mechanical plaque removal, dietary restriction of sucrose, and fluoride treatments.
primary services
Treating or controlling a disease or condition after it occurs. Examples include periodontal therapy and restorative procedures.
secondary services
Involves replacing lost tissues in order to rehabilitate oral structures. Examples include implants and bridges.
tertiary services
Simple, valid, reliable, clear, sensitive, quantifiable, objective, accepted
Characteristics of an ideal index
What general category of indices measures conditions that can be resolved or reversed?
Reversible
What general category of indices.... gingivitis indices are example
reversible
What general category of indices measures cumulative conditions that CANNOT be resolved. Caries and periodontal disease indices are examples
Irreversible
What general category of indices measures the presence or absence of a disease?
Simple
What general category of indices measures all the evidence of a condtion (both past and present)
Cumulative
Decayed, missing, filled teeth/decayed, missing filled surfaces. --Irreversible
-Measures past and present caries experience in populations with adult dentitions
DMFT/DMFS
Decayed, need for extraction, filled teeth.
-Irreversible
-Measures observable caries experience in deciduous teeth
-Does not take into account teeth that have been extracted or exfoliated due to past caries experience
deft
Decayed, filled teeth/decayed, filled surfaces
-Irreversible
-Measures observable caries experience in deciduous teeth
dft/dfs
Root caries index
-Irreversible
-Requires recession. Only takes into consideration areas of root exposure
RCI
Caries management by risk assessment encompasses a methodology of identifying the cause of disease through assessment of risk factors for each individual patient and then managing those risk factors through behavioral, chemical, and minimally invasive pro
CAMBRA
Gingival index
-Reversible
-Based on severity versus extent of inflammation
-Can be used in individuals or study participants
GI
Sulcular bleeding index
-Reversible
-Detects early signs of gingivitis
-Useful in short-term trials
SBI
Periodontal Disease Index
-Both irreversible and reversible because if measures gingivitis and periodontitis separately
PDI
Periodontal Index
-Irreversible
-Looks at surrounding tissue
-Questionable for validity (no CAL)
PI
Periodontal Screening and Recording
-Rapidly assesses periodontal health
-Requires a special probe
-Useful as a preliminary screening technique and for use in large populations
PSR
Community Periodontal Index of Treatment Needs
-Determines periodontal needs versus periodontal status
-Requires special probe
CPITN
Simplifies Oral Hygiene Index
-Reversible
-Measures oral hygiene status by assessing sub- and supragingival plaque and calculus
-better for group versus individual assessment
OHI-S
Plaque Index
-Reversible
-Used in conjunction with the Gingival Index
-Scores plaque according to its thickness at the gingival margin
PlI
Patient Hygiene Performance
-Reversible
-Measures plaque after toothbrushing
PHP
Volpe-Manhold Index
-Reversible
-Used to test agents for plaque control and calculus inhibition
-Measures supragingival calculus formation following prophylaxis
VMI
What is the first step in planning a program?
Needs assessment
What is the reason for a needs assessment?
Collects baseline data
What way of conducting needs assessment is ... time consuming, not cost effective, and not recommended for large groups
direct observation
What way of conducting needs assessment is ... not time or cost effective, not recommended for large groups
interview
What way of conducting needs assessment is ... a good choice for large groups, and must be well written and understandable
questionnaire
What way of conducting needs assessment is ... the best choice for large groups and must be well written and understandable
survey
What way of conducting needs assessment is ... research based
epidemiological survey
What way of conducting needs assessment is ... time consuming and access dependent
records, documents, charts
Comprehensive examination using mouth mirror, explorer, lighting, radiographs, study models, and any other diagnostic tests that may be warranted; not practical for most community programs due to cost, time constraints, and equipment needs.
Type I examination method
Limited examination including mouth mirror, explorer, lighting, and limited radiographs; access to radiology equipment limits use in community programs.
Type II examination method
Examination using mouth mirror and lighting only
Type III examination method
Examination using tongue depressor and lighting only
Type IV examination method
The Consolidated Omnibus Budget Reconciliation Act of 1985 requires most employers with group health plans to offer employees the opportunity to continue temporarily their group health care coverage under their employer's plan if their coverage otherwise
COBRA
Health insurance for elderly and disabled
Medicare
Health insurance for the poor
Medicaid
Both medicare and medicaid were created by the
social security act of 1965
A lump sum of money given to a group to use at their discretion to meet a need.
block grant
specifies where monies are to go
line item grant
establishment of priorities
rank the problems of the needs of the target population
objectives
Must be measureable
When drafting a plan, you should choose activities that have not been used in the past.
FALSE... use ones that have been successful in the past!
Stages of Learning
Unawareness
Awareness
Self Interest
Involvement
Action
Habit
Evaluation must be continuous from the beginning of the program
TRUE
Outcome evaluation; measure impact of program/teaching
Summative evaluation
Conducted during the program; making sure audience is engaged
Formative
Treatment planning in the dental setting is comparable to
program planning in the community setting
A longitudinal study MAY be considered both
retrospective and prospective
The majority of scores (68%) on a NORMAL curve will fall between
+1 and -1 standard deviation
Any index that examines surfaces instead of affected teeth is more
sensitive