Program Planning

DH450 : The Class : Program Planning : Overview : Program Planning

Overview on Program Planning

Overview of Public Health Program Planning and Evaluation

When a dental hygienist develops a treatment plan for a patient, various assessments help in identifying the needs of the patient. The patient's priorities, financial ability, health and other factors are considered. From this information, a treatment plan is formulated, the patient is treated and then reevaluated periodically. We develop a program plan for communities or target groups in much the same way, only "the big picture is even bigger" and the process is more complex. We plan to make sure that we are doing the right things, in the right way to make our programs effective in improving the public's health. Community planning may utilize: health planners, advisory boards, committees representing interest groups or the entire community.

Page 218 of Gluck and Morganstein, Box 12-1 gives a comparison of "The Provision of Dental Care for a Private Patient and a Community." It may be more understandable if we make this comparison using dental hygiene care instead.

Comparison of Treatment Planning to Program Planning.

Dental Hygiene Treatment	Planning for a Community
Dental / medical history Intra and extra oral examination perio assessment oral hygiene assessment level radiographs	The planner conducts a needs assessment of the community
Diagnosis of caries, periodontal case type, gingival description, plaque percentage, etc.	The planner analyzes community data
Treatment plan developed based on the patient's conditions, priorities, attitudes and ability to pay for services	A program plan is developed based on the analysis of the needs assessment data, the priorities and alternatives, the communities attitudes and the resources available
Patient's informed consent is obtained	Community buy-in and approval is obtained
Hygienist selects appropriate labor to provide care: i.e., hygienist, perio-specialized hygienist, periodontist, referral to dentist or specialist	The appropriate personnel are selected: i.e., dentists, hygienists, assistants, teachers, nurses, social works, health educators, WIC counselors
Hygienist selects appropriate dental services for the patient: preventive maintenance, periodontal treatment, esthetic, referral for dental	The appropriate activities and interventions are selected: i.e., water fluoridation, fluoride mouth-rinse, dental services, oral cancer screenings, education, media campaign, political lobbying
Hygienist evaluates the treatment rendered, and outcomes acheived compared to initial patient assessment (including patient satisfaction)	The community program is evaluated--comparison of baseline assessment with post information: attainment of goals and objectives, cost-effectiveness of activities, appropriateness of activities, community satisfaction

Criteria for Effective Planning

Programs that are designed to improve the public's health need to meet the following criteria in order to be effective:

Should be designed to meet a real need that is recognized by the community as a priority.
There must be sufficient resources and time to carry out the program.
Influences on the health-related problem need to be identified.
Intervention must address those behavioral, cultural, environmental and political influences which effect the health problem.
Program should have input, ownership and buy-in of the target population.
Program should predict, plan and prevent recurring crises rather than be reactive

Analyzing influences on the problem should include analysis of contributing social factors such as:

predisposing factors
demographics
ex: sex, age
enabling factors
income
dental insurance
transportation
support
need factors
perceptions of ill health

ex: bleeding, white spots, pain

Refer to Figure 12-1 on page 222 in Gluck and Morganstein to view a planning and implementation strategy flow chart.

Example:
Suppose the community has identified a problem with unmet dental decay in children. Sometimes a program may be designed to improve utilization of existing resources. In 1998, Arizona passed legislation for a KIDSCARE program. This program is modeled after AHCCCS (Arizona Health Care Cost Containment System = Arizona's version of Medicaid). KIDSCARE and AHCCCS provide care to qualifying low-income children. AHCCCS provides care to a very low-income group, and KIDSCARE is designed for "notch group" individuals, people who are below federal poverty guidelines but above AHCCCS income guidelines. The numbers of people enrolled KIDSCARE is small.

Without input from the community, a resource assessment, and a look at influences on enrollment, a decision may be made to start a new program to provide dental care to children. Will this program be effective? Probably not. A smart planner would first meet with members from the target community to assess:

How many dental providers are signed up as AHCCCS/KIDSCARE providers?
If the numbers are low, find out what constraints keep providers from signing up.
Is the population aware of the program and how to sign up?
What barriers exist to seeking care?

An effective program may work to improve existing resources and utilization of this existing health resource. Dentists could be recruited to sign up. The KIDSCARE/AHCCCS enrollment process could be simplified. The target group could be educated about how to be good patients. And educational programs could be designed to decrease fear and increase awareness about the benefits of regular dental care for children.

There are five parts of the program plan.

The Needs Assessment
Goals and Objectives
Work Statement
Organization
Evaluation

Each of these steps in planning will be discussed in more detail in the following topics. Evaluation will be discussed in a later module.

Once you have finished the lesson you should:

Go on to Parts of a Plan
or
Go back to Overview

E-mail Tricia Moore at Tricia.Moore@nau.edu
or call (520) 523-4012
or E-mail Ellen Grabarek at Ellen.Grabarek@nau.edu