Important to the success of community oral health program development, integration, expansion, or enhancement is the identification and mobilization of program resources. These resources may include existing services and equipment as well as financial resources. While the Guide contains a section that specifically addresses funding, it is important to view each step described in the Guide as integral to the funding process. For example, through the mobilization of community support, communities are creating an oral health constituency that can influence the budgeting process and the allocation of funds to support oral health. The development of a program plan driven by an assessment of oral health needs and existing resources and that builds in program evaluation is attractive to funders, who are concerned with accountability. Therefore, each step described in the Guide is intended to help readers identify and mobilize resources.

Step 1. Mobilize Community Support

Mobilizing support for good oral health within the community is essential to ultimate success in improving oral health outcomes. It is often useful to develop a community oral health coalition or to add oral health to the agenda of an existing coalition to obtain this support. To find partners and develop oral health “champions,” it is helpful to look to groups currently concerned with oral health and whose constituents may have extensive oral health needs. These groups could include Head Start programs, child care programs, schools, community action agencies, cultural and linguistic minority programs, and faith-based organizations, among others.

Step 2. Assess Needs and Resources

To determine how to improve oral health within a community, it is important to first obtain a thorough, evidence-based understanding of the community and its current health and oral health needs and existing resources. Certain markers or indicators of community oral health status and need (e.g., rates of tooth decay, untreated tooth decay, oral cancer, oral injury, periodontal disease, number of residents without adequate dental insurance) may be used to help determine the community’s oral health status.

Steps in the assessment process include organizing the assessment of needs and resources, collecting and analyzing data, describing and prioritizing findings, and developing recommendations based on findings. Before initiating the assessment process, it is important to develop the questions that the process will answer. Examples of such questions could include (1) who in the community does not have access to oral health care? and (2) who is available to provide and support oral health care?

To answer assessment questions, it is necessary to understand the community, determine unmet oral health needs, and identify existing and potential oral health resources. Numerous resources are available that can provide useful data. Both primary and secondary data can be analyzed to reveal trends, identify gaps, and describe associations between factors that impact oral health status.

Step 3. Determine Priorities and Plan the Program

Program priorities must be determined to direct resources to areas of most need. Once priorities are established, the next step is to determine program outcomes—that is, what should happen as a result of developing, integrating, expanding, or enhancing community oral health programs. LPHAs should begin by identifying activities that will move the community toward achieving desired outcomes. At this point, it is possible to identify the resources needed to support planned activities. It is essential that cultural competency be woven into program design and planning, given the increasing diversity of the U.S. population and documented evidence of significant oral health disparities for certain population groups.
It is not always necessary to start from scratch with program planning, as it may be possible to tailor or build on others’ evidence-based best-practices experiences.

Step 4. Implement the Program

After assessing needs and resources, establishing priorities, developing a program plan, mobilizing resources, and reviewing best practices, it is time to move to program implementation. Programs comprise specific components or activities, each linked to a particular outcome. It is often helpful to identify the key activities of each component, determine who will take the lead on activities and the resources needed, and set due dates. Keeping new program efforts small scale can allow for working out problems and making changes early on without using resources unnecessarily. Working with a broadly representative group of stakeholders can increase the likelihood of success, as such stakeholders can bring a variety of important insights and resources to the program.

Step 5. Evaluate the Program

Program evaluation is essential. An effective evaluation accomplishes several important tasks, including

• Helping staff understand what is working, what is not working, and why
• Providing managers with information that enables them to make program adjustments
• Permitting periodic evaluations of program activities and progress toward achieving program outcomes
• Helping to document efforts and ensure support from policy and funding entities

Components of the evaluation process include determining evaluation questions and establishing evaluation measures.

Step 6. Participate in Policy Development and Research

Community oral health stakeholders sometimes view policy, laws, regulations, ordinances, rules, and research as being outside the scope of their responsibility or expertise. But, in fact, these stakeholders can play a critical role in policy and research arenas.

The policy process includes several stages: articulating the issue that the proposed policy will address, exploring scientific data relevant to the policy, developing support for the policy, placing the policy on the agenda, formulating the policy, and, finally, implementing and evaluating the policy. Oral health stakeholders can provide expert guidance about the policy process, offering not only scientific expertise but also hands-on community experience.

Community oral health stakeholders are responsible for developing new information and refining existing information. Community oral health professionals are in a unique position to bridge the gap between the development and application of information, and, therefore, they have a special role to play in research. Research activities can generate many benefits for local oral health programs by increasing the visibility of the program and of oral health in general, encouraging collaboration, supporting state and local oral health and public health organizations, and increasing or sustaining support from community organizations, funding sources, governing bodies, and decision-makers.

Conclusion

Good oral health is not only essential to good overall health and freedom from the pain and suffering associated with oral health problems; it also affects self-esteem, quality of life, and performance at school and at work. Therefore, the public health community must view oral health as essential. We hope that the Guide will help LPHAs engaged in efforts to improve community oral health services in the development, integration, expansion, and enhancement of oral health programs.