Train the trainer approach to oral health in early year s settings

Transcription

1 International Journal of Perception in Public Health Volume 2, Issue 1, December 2017 ISSN Short Commentary Train the trainer approach to oral health in early year s settings Samantha Glover Dental Public Health Program Manager, Public Health England, UK. Abstract Aim: Improve knowledge and confidence of children s centre staff in oral health Method: Multi disciplinary team training of those who work with children under 5 to promote Oral health. Results: The importance and awareness of Oral health and hygiene for under 5s was raised. Knowledge and confidence in discussing oral health was raised. Conclusions: This work could be rolled out to cover other areas by using a similar model. The program will be of limited effect if it is not maintained annually with a rolling program of training Keywords: Oral health, Trainer, Hygiene, Children under 5 Citation: Glover, S Train the trainer approach to oral health in early year s settings. International Journal of Perceptions in Public Health, 2 (1):6-10. DOI: /ijpph * Corresponding author: Samantha Glover, Dental Public Health Manager, Public Health England, UK. Samantha.glover@phe.gov.uk Introduction Southend is an area of known deprivation with higher than average levels of unemployment within several wards scoring high on the Indices of multiple deprivation (IMD), it has a vast ethnic mix and many families with English as a second language (SAVs, 2009). Three of the boroughs in this area are with in the most deprived lower 20% nationally. The NICE guidelines recommends that all Local Authorities and commissioning partners should specify in contracts that Early Years services include a requirement to promote oral health and train staff in oral health promotion and provide information on the topic to parents and carers (NICE, 2014). Other programs nationally have evaluated the use of train the trainer modules or training oral health champions from a child care provision perspective such as London s Keep Smiling Program (Yusuf et al, 2015) With this in mind 6

2 Glover, 2017 and building on the success of other initiatives this program was created to tackle the issue of Oral health early and reduce the rate of dental disease and hospital admission due to this. Method The program targets all those who work with children and parents/carers of children aged 0-5 who live or use services with in the Southend area. The approach would work closely with the children s centres and those child care professionals who were known to the local council. An initial literature review revealed a lack of economic evidence on interventions based on Oral health but several articles have highlighted a need for training and oral health input from an early age (Turner, 2010). This program aimed to: Increase regular attendance at the General Dental Practice Increase the conversations about oral health in the child care settings Promote brushing twice a day Promote low sugar/ sugar free snacks and drinks To encourage drinking from a freeflowing cup as early as possible To assess the effectiveness of the program an evaluation form was given to each member who attended and a thematic analysis of these results was carried out by the Oral Health Educator and Early Years Lead. After discussions with the Early Years lead the three centres that we would base the events at, were decided. The Southend catchment was separated in to three groups: Central, East and West. Intervention provided The program ran across three separate children s centres located in the heart of each Figure 1: Source: Southend Borough Council (2015) Volume 2 Issue 1, December

3 Glover, 2017 community. These were geographically spread out to ensure that ease of access for those invited. A program was formulated between the Oral Health Promotion Team and the Health Visiting Team. This included a power point and supporting lecture which highlighted the scale of the problems of dental disease and poor oral health in the children in the area and the preventative measures that can benefit them. The lecture was introduced by the Oral health Lead who used an anonymous case study of a local child who required extraction of 80% of their natural dentition prior to their fourth birthday due to gross caries. The child had no previous or underlining medical condition. This case study introduced the knock on effect on the child and families health and wellbeing. The Health Visiting lead went on to explain the local details of number of children who have had dental treatment under General Anaesthetic and for dental pain to highlight the scale of the problem in this area. The information then moved on to discuss tips and hints to help improve oral health and reduce caries. It was hoped that this would educate and encourage those who attend to become champions for oral health in their own settings and identify a lead or oral health champion. To support this we also had a range of materials set up across several stands along with displays to demonstrate some of the activities that they could carry out in their own settings. Question and answers sessions further raised awareness of resources already available a good practice happening in the area. We also invited the student hygienists from the local dental school who could provide additional information to those who attended on a one to one base and have the opportunity to carryout some work in a community setting as opposed to a classroom setting in the university. Results Those who attended completed the evaluation forms in a very positive light, commenting on both the presentation and information received being excellent. Many of the participants were surprised and the amount of sugar in baby food and food marked as healthy. Additional comments made by those who attended to the staff verbally included how needed this type of event was and how having the health visitors and oral health team together provided consistency in the messages. Some of the messages that the participants took home were about the spit don t rinse and the importance of using a free flowing cup as soon as possible. As a result of the training the centres raised the profile of Oral health with in their own setting in several different ways. Many created there own stands and target specific days to make Oral Health he main topic, they access further resources and gave information to all who visited on that day. Some amended the registration documents they keep on the children they attend to include information about the child s dentist and if they did not have one offered support around this. All those who attended felt more comfortable talking to Table 1: Attended Participants of the event West Locality Central Locality East Locality Public health Early years officers Setting covered Students Total Volume 2, Issue 1, December 2017

4 Glover, 2017 the families and children they support about oral health. All the setting was already offering healthy snacks and drinks but they became more aware of the dental implications of these foods and drinks. The children s services also have current information of the dental services available in the areas they cover. About 100% of those who attended felt the program benefited them with all 69 participants rating the session as either good or very good. The comments received stressed that the centres felt that all staff would benefit from oral health training; further to this they felt that the programme could be delivered on an annual bases to refresh knowledge and train newer members of staff. Discussion & Conclusion Although the program was evaluated very positively by all those who attended the advice will be limited to those centres that sent a representative. Several of the children s centres did not send a member of staff despite being written to and contacted by the Early Years team on several occasions. The turn over of staff in some of these centre s can also be quite high which if dissemination of information is not maintained means the skills and knowledge will be lost. To combat this, development of a rolling yearly program may be of benefit to allow newer members of staff to receive the training and to motivate those who had the training the previous year. Developing this program to be replicated in areas of similar socioeconomic deprivation would also prove useful to the staff that support young children and families and potentially to the overall oral health of the area. Ethical Information areas and felt that the most robust selection criteria would be to base this on areas of deprivation as described above. Conflict of Interest The author declared no conflicts of interest with respect to the research, authorship and/or publication of this article. Acknowledgement The author acknowledges Erin Brenan Douglas and Team, Shoebury children s centre, Blenheim children s centre, Hamstel children s centre. The program did not require ethical approval as it was not original research and all information given was evidence based. The original planning on of the event did discuss the justification for choosing the Volume 2, Issue 1, December

5 Chowdhury Glover, et al References NICE. 2014, Oral health: local authorities and partners, NICE guidelines. Available to download at, nice.org.uk/guidance/ph55 [accessed 26/10/2016]. Turner, S., Brewster, L.., Kidd, J., Gnich, W., Ball, G., Milburn, K., Pitts, N., Goold, S., Conway, D. and Macpherson, L.M., Childsmile: the national child oral health improvement program in Scotland. Part 2: monitoring and delivery. British Dental Journal, 209 (2) : Southend Borough Council Index of multiple deprivation 2015 percentage rank of IMD score by LSOA, available at URL: [accessed 16/11/2016] chrome-extension://mhjfbmdgcfjbbpaeojofohoefgiehjai/index.html Yusuf. H, Wright. K, Robertson.C Evaluation of a pilot oral health promotion Keep Smiling : perspectives from GDPs, health champions and school staff. British Dental Journal, 218( 8): Volume 1, 2, Issue 5, 1, December