CORE COMPETENCIES, IHS ORAL HEALTH PROMOTION / DISEASE PREVENTION

This framework, revised and adapted for IHS from the work of the Healthy People Curriculum Task Force, consists of four components and 20 individual domains. In keeping with the current emphasis of the IHS Division of Oral Health, these domains are aimed primarily at the prevention of dental decay. Similar domains could be outlined specifically for the prevention of periodontal disease, prevention of oral cancer through tobacco counseling, and so on.

HP/DP coordinators are not expected to be an authority in all of the following competencies. They should, however, utilize them as benchmarks to recognize and gauge areas of strength and weakness or deficiencies. If deficient or weak in a specific area, the coordinator should identify a readily available resource for consultation when needed, or seek training to become personally proficient.

The following competencies should be used to:

  1. Assess (and self-assess) the skills, knowledge, and relevant experience of individuals in key HP/DP positions, or incoming applicants seeking to fill these positions.
  2. Curriculum development: Prevention 101, other CE courses, and other presentation opportunities.
  3. Program assessment of effectiveness to achieve IHS program goals (GPRA, ECC Initiative, etc)
  4. Look for expertise in dental staff to fill gaps
  5. Set goals for program development
  6. Share competencies with key partners to foster a cooperative relationship
  7. Create professional development plans or opportunities for staff
  8. Outline a course of self-improvement of both HP/DP knowledge base and clinical skills.

Component 1: Evidence based health promotion / disease prevention practice

  1. Demonstrate knowledge of basic program planning models such as Problem, Objectives, Activities, Resources, Evaluate (POARE) model.
  2. Demonstrate knowledge of basic program management skills.
  3. Demonstrate knowledge of basic epidemiology in fields including dental caries, periodontal disease, basic biostatistics and knowledge of statistical tests (eg. p value, t tests, chi square, and so on).
  4. Locate and evaluate sources of evidence based information on oral health and disease.
  5. Assess and synthesizeoral health research literature, agency reports and other sources of dental public health literature.
  6. Develop various methods of program evaluation and outcomes assessment.
  7. Design, conduct and reportcommunity health assessment including oral health surveillance, risk factors, community resources:
  8. Identify determinants of healthsuch asburden of disease, genetics, socioeconomic status, environment, infectivity, health care access, quality of health care.

Component 2: Clinical prevention and health promotion

  1. Demonstrate knowledge of screening and examination: medical, dental, and preventive history, assessment of self-efficacy, oral health self-assessment, oral-facial functional status, caries risk assessment, caries detection, oral bacterial and salivary tests, dietary assessment, and fluoride use.
  2. Demonstrate up to date knowledge of effective oral hygiene instruction and health behavior counsel: the utilization of contemporary and culturally appropriate health behavioral science.
  3. Demonstrate up to date knowledge of professionally applied and prescribed preventive treatment: topical fluorides, dental sealants, systemic fluoride supplements, xylitol products, and prophy.
  4. Demonstrate knowledge of self-applied chemoprevention: fluoride containing dentifrices, topical fluoride.
  5. Demonstrate knowledge of professional standards and guidelines (eg. Infection Control recommendations, fluoride supplement schedules, American Dental Association, American Heart Association, American Association of Public Health Dentistry, American Dental Hygienist Association professional etc.)
  6. Ensure adherence to Standards of Care and local policies and procedures
  7. Assist local programs implement and evaluate evidence-based clinical interventions

Component 3: Community-based prevention and health promotion

  1. Develop or disseminate effective communication of health information: assessing community needs and “access points,” health literacy, and cultural awareness in communication.
  2. Assess theimpact of environmental factors such as water fluoridation status, living conditions, and infection control on oral health.
  3. Assess the effects of occupational health factors on patients, the community-based public, and the health professionals.
  4. Global health issues: various responses to oral disease, outcomes under other systems for both individuals and populations, and national and international dental organizations.
  5. Health beliefs and cultural dimensions of practice: influences on health care delivery and on recipients.
  6. Develop collaborations with key community partners to enhance community preventive services, and public health preparedness.
  7. Adhere to ethical standards of community health including use of informed consent and appropriate research guidelines and protocols
  8. Help local program assess cultural appropriateness of community interventions
  9. Identify age and culturally appropriate educational and media materials used for oral HP/DP programs

Component 4: Health systems and health policy

  1. Demonstrate knowledge of the organization of clinical and public health systems and services to beneficiaries.
  2. Collaborate with key stakeholders.
  3. Demonstrate knowledge of both public and private financingopportunities and programs pertinent to the Indian Health Service Division of Oral Health, including direct care and Tribal self determination.
  4. Identify regulations and policies related to the oral health workforce: regulation, discipline, relations to other disciplines, risk management, and legal and ethical dimensions of health care.
  5. Advocate for evidence-based health policies and practices such as water fluoridation
  6. Advocate for health policy process: the organization of dentistry, how science can be applied to help determine health policy, policy process participation, the impact of policy on health and health care, and outcomes.
  7. Demonstrate knowledge of the GPRA program, and the oral health objectives and annual goals. Monitor GPRA data and revise program activities through training and counseling.

File: hpdp / competencies hpdprevised 0810