Head Start Oral Health Initiative
Director Site Visit Interview Protocol
INTRODUCTION (2 minutes)
Thank you for agreeing to participate in this interview. My name is ___________________ and I work for [MATHEMATICA POLICY RESEARCH/HEALTH SYSTEMS RESEARCH], an independent research firm. As you know, we are conducting a study for the Administration on Children and Families about Head Start agencies’ experiences implementing the Head Start Oral Health Initiative. Findings from the study will be helpful to other Head Start agencies implementing similar initiatives.
Everything you tell me is confidential. I would like you to feel comfortable giving your opinions and impressions. The information we gather will be used to write a report for the Administration for Children and Families about programs’ experiences implementing the Head Start Oral Health Initiative, including successes, challenges, and lessons learned by grantees. Our report will describe the experiences and viewpoints expressed by staff across grantees, but specific comments will not be attributed to specific individuals or programs. No individual staff member will be quoted by name.
Do you have any questions before we get started?
About You
To begin, I’d like to review your role in the Oral Health Initiative.
IF STAFF ARE THE SAME AS THOSE INTERVIEWED IN THE TELEPHONE INTERVIEW ASK: Have your responsibilities on the Oral Health Initiative changed since the telephone interview?
ASK EACH RESPONDENT ONLY IF STAFF ARE DIFFERENT THAN THOSE INTERVIEWED PREVIOUSLY BY TELEPHONE: I’d like to learn about your role in the Oral Health Initiative.
What is your official job title, and what are your primary responsibilities?
How long have you worked for [GRANTEE]?
How long have you held your current position? What other positions have you held within the agency?
GRANTEE CHARACTERISTICS (5 minutes)
I’d like to update our information about your agency.
Since the telephone interview in [MONTH AND YEAR], have there been changes in:
Your program’s organizational structure
The Head Start program options you operate (home-based, center-based mixed)
The size of your program, such as the number of children, pregnant women, and families served in Head Start, Early Head Start, and/or Migrant/Seasonal Head Start
Your operating schedule
COMMUNITY AND FAMILY CHARACTERISTICS (10 minutes)
Let’s talk about your community and the characteristics of families and children targeted for the Oral Health Initiative.
Have there been any changes to your program’s geographic service area since the telephone interview? Any changes in the portion of your service area targeted by the Oral Health Initiative? If so, why have these changes happened?
Have there been any changes in the characteristics of the children and families you are targeting for participation in the Oral Health Initiative? If so, is this because of changes in your population of Head Start families or because of changes in how you are targeting Oral Health Initiative services?
Have there been any changes since the telephone interview in the availability of oral health care providers in the community? If so, has availability of providers increased or decreased, and why has this happened?
Have there been changes in the availability of other services, such as health care, transportation, and other social services? If so, has availability increased or decreased, and why has this happened?
During the telephone interview, you listed the families’ main barriers to oral health care as [FILL IN FROM TELEPHONE INTERVIEW NOTES]. Have any of these barriers been eliminated? If so, how? Are there other barriers families face now?
Please tell me about families’ cultural norms and practices related to oral health care? What are their oral health care beliefs and practices for young children? During the telephone interview, you mentioned the prevalence of the following practices that threaten oral health [FILL IN FROM TELEPHONE INTERVIEW NOTES]. Have you seen any change in the prevalence of these practices? Have you identified other common practices that negatively impact oral health? If so, what are they?
Do children and families targeted for the Oral Health Initiative has access to health and dental health insurance coverage? If yes, do they have private insurance, or are they covered primarily by public insurance programs such as Medicaid? Do dental care providers in the community accept public insurance coverage?
Approximately what proportion of children targeted for the Oral Health Initiative have a disability or developmental delay? What percentage are English Language Learners? Does this create additional barriers to accessing oral health care services? If so, how and why?
GRANTEE GOALS, OBJECTIVES, AND KEY COMPONENTS (5 minutes)
Now I’d like to begin talking specifically about the Health Start Oral Health Initiative. To start, let’s talk about how your goals and objectives for the initiative.
During the telephone interview, you listed [FILL IN FROM TELEPHONE INTERVIEW NOTES] as your primary goals and objectives for the Oral Health Initiative. Have these changed since the telephone interview? If so, what changes have you made and why?
During the telephone interview, you listed [FILL IN FROM TELEPHONE INTERVIEW NOTES] as the key components of your Oral Health Initiative. Have these changed? If so, how have they changed and why?
At the time of the telephone interview, your program was planning to serve [FILL IN NUMBERS OF INFANTS AND TODDLERS, PRESCHOOLERS, PREGNANT WOMEN, AND OTHER FAMILY MEMBERS] through the Oral Health Initiative. Have these targets changed since the telephone interview? If so, how and why?
During the telephone interview, you said you planned to make the following changes to your original design for the Oral Health Initiative [FILL IN FROM TELEPHONE INTERVIEW NOTES]/did not plan to make changes to your original changes for the Oral Health Initiative. Since that time, have you made other changes to your design? If so, what changes and why?
STAFFING STRUCTURE AND TRAINING (15 minutes)
Let’s now turn to how the Oral Health Initiative is staffed.
During the telephone interview, you reported spending approximately [FILL IN TIME FROM TELEPHONE INTERVIEW NOTES] on the Oral Health Initiative. Has your time on the initiative increased or decreased since then? If so, how much time do you spend on the initiative now, and why has it changed?
During the telephone interview, you reported that the following staff were assigned to the Oral Health Initiative: [FILL IN FROM TELEPHONE INTERVIEW NOTES]. Have there been any changes to the staffing structure since that time? If so, what changes did you make and why? How well have these changes worked out?
Have you had any turnover in staff assigned to the Oral Health Initiative? If yes, which positions? Have vacant positions been filled? How has staff turnover affected the design or implementation of your Oral Health Initiative? Has turnover affected what you have been able to accomplish on the initiative so far?
How well is the staffing structure for the Oral Health Initiative working out so far? Do you have sufficient staff resources to operate the initiative as planned?
Based on your experience with the initiative so far, if you could, would you make changes to the staffing structure? If so, why?
IF THE AGENCY HAS HIRED OR ASSIGNED NEW STAFF FOR THE ORAL HEALTH INITIATIVE SINCE THE TELEPHONE INTERVIEW, ASK: What are the qualifications of new staff hired/assigned to the Oral Health Initiative? Did they receive any special training in preparation for their work on the initiative? Did they receive training on how to conduct visual inspection of teeth and mouth to identify children who need follow-up care?
Since the telephone interview, what additional training have staff received for their work on the Oral Health Initiative? Who provided it? In your opinion, how helpful was this training?
Do you have plans to provide additional staff training to support the initiative? If so, what kind of training and why are your planning to provide it?
Since the telephone interview, what training or technical assistance has your program received from the Head Start T/TA system, the regional oral health consultants, or others to support your work on the Oral Health Initiative? In your opinion, how helpful was this T/TA? If it was helpful, what made it helpful? If it was not helpful, do you have recommendations for how to improve it?
Do you have additional T/TA needs for the Oral Health Initiative? If so, what kind of T/TA do you need? Do you have a plan in place to obtain it? If no, why not?
COMMUNITY PARTNERS (15 minutes)
During the telephone interview, you identified the following community partners that work with you on the Oral Health Initiative: [FILL IN FROM TELEPHONE INTERVIEW NOTES].
Have you ended your partnerships with any of these partners since the telephone interview? If so, which ones and why?
Have you formed any new partnerships since the telephone interview? If so, who are the partners and why did you decide to recruit them?
Do you have formal partnership agreements with these partners (both new and existing)? If so, what is included in the agreements?
What are the partners’ roles in the Oral Health Initiative? What services do they provide to Head Start children and families? Have these roles changed since the telephone interview? If so, how have they changed and why?
Do you make referrals to community partners for services? If so, do you receive information from them about treatment and needed followup? How do these referral systems work?
Have you provided training to community partners or other oral health service providers about providing oral health services to your target population? If yes, please describe the training you provided. Why did you decide to provide it, and how helpful was the training?
Have your community partnerships been implemented as originally planned? If no, what has changed and why has it changed?
How often do you communicate with the community partners and what form does the communication take (meetings, phone calls, emails, referrals)? What do you typically communicate about? How well does communication with partners work?
In your opinion, what aspects of your community partnerships have worked well, and what has been challenging? What strategies have you used to work through the challenges? How well have these strategies worked?
Based on your experience with the Oral Health Initiative, are there other kinds of partners that would have been helpful? If so, what types of partners and why?
If you could, is there anything you would change about your partnerships or partnership agreements? If so, what would you change and why?
What is the potential for sustaining these partnerships after grant funding ends?
What advice would you give to other programs about selecting and working with community partners on a similar oral health initiative? In developing and sustaining relationships with partners over time?
SERVICE DELIVERY (25 minutes)
Now let’s talk about your experiences with providing or arranging services through the Oral Health Initiative. We’ll start with a discussion of oral health risk assessments and exams, and then talk about clinical preventive and treatment services.
Risk Assessment and Clinical Services
During the telephone interview, you said that your program did the following to assess children’s oral health needs: [FILL IN TYPE OF ASSESSMENT, WHO CONDUCTS IT, AND TOOL USED]. Have you made any changes to the way risk assessment is conducted, such as the type of assessment, who conducts the assessment, or the assessment tool used? If so, what are the changes and why did you make them?
During the telephone interview, you reported the following uses of the risk assessment results: [FILL IN FROM TELEPHONE INTERVIEWS]. Have you changed the way that risk assessment results are used? If so, what are they changes and why did you make them?
During the telephone interview, you reported providing [LIST CLINICAL PREVENTIVE SERVICES FROM TELEPHONE INTERVIEW NOTES.] Has this changed, and if so how and why? Which services are provided by your program and which are provided by partners? Where are the services provided?
During the telephone interview, you reported providing [LIST CLINICAL TREATMENT SERVICES FROM TELEPHONE INTERVIEW NOTES.] Has this changed, and if so how and why? Which services are provided by your program and which are provided by partners? Where are the services provided?
Which clinical services do you provide to children, pregnant women, and other family members? Has this changed from your original plan for the initiative? If so, how and why did it change?
How receptive have families been to the clinical preventive and treatment services you provide through the Oral Health Initiative? How has their receptivity changed over time? If receptivity has improved, what have you done to improve it?
Services to Support Access to Dental Services
During the telephone interview, you described the following referral system/no referral system: [FILL IN FROM TELEPHONE INTERVIEW]. How well has the referral system worked? Has it changed over time? If so, how has it changed and why?
Do you keep track of treatment outcomes and needed follow-up services? If so, how do you do this?
Do you provide services to help families access needed clinical services, such as help them make appointments, provide transportation, or provide translation services? If so, who provides these services?
Does your program help families establish dental homes for their children? If so, how do you do this? Has this changed over time, and if so how? What is your definition of a dental home?
Oral Health Education
During the telephone interview, you reported providing the following education and skills-building services to parents about oral health promotion: [FILL IN FROM TELEPHONE INTERVIEW NOTES]. Have you made any changes to these activities, such as the content of the educational messages, who delivers these services, or where they are delivered (for example, during parent meetings, home visits, or by distributing written materials)? If so, what changes have you made and why?
IF PROGRAM SERVES PREGNANT WOMEN: During the telephone interview, you reported providing the following education and skills-building services specifically to pregnant women: [FILL IN FROM TELEPHONE INTERVIEW NOTES]. Have you made any changes to these activities? If so, what changes have you made and why?
During the telephone interview, you reported providing the following education and skills-building activities to children: [FILL IN FROM TELEPHONE INTERVIEW NOTES]. Have you made any changes to these activities, such as the content of the educational messages, who delivers these services, or how they are delivered (for example, classroom activities or home visits)? If so, what changes have you made and why?
During the telephone interview, you reporting using [NAME OF CURRICULUM/NO CURRICULUM] to provide oral health education to children and families? Has this changed, and if so, what curriculum are you using now and why did you choose it? Have you changed or adapted portions of the curriculum to better meet your needs? If so, how have you changed it and why? If you stopped using a prior curriculum, why did you stop?
How well do you think the curriculum is working? Do you have suggestions for improving it?
During the telephone interview, you reported providing [LIST ORAL HYGIENE SUPPLIES/NO ORAL HYGIENE SUPPLIES FROM TELEPHONE INTERVIEW NOTES]. Has this changed, and if so how and why? IF PROGRAM PROVIDES SUPPLIES: What types of supplies are you providing now, and to whom? How do you provide them and how often? Do parents receive training on how to use the supplies?
To what extent have you tailored education and other non-clinical services to the needs and cultural norms of your target population for the Oral Health Initiative? Can you please provide some examples? Have you seen evidence that these strategies have been effective (for example, increased attendance at educational events or trainings)?
How receptive have families been to the educational services you provide through the Oral Health Initiative? How has their receptivity changed over time? Do you think the education and training has resulted in any changes in families’ oral health practices? If yes, can you give me some examples?
SUSTAINABILITY (5 minutes)
Now let’s talk about the future of the Oral Health Initiative.
What do you think is the future of your Oral Health Initiative? Will you be able to sustain the services when grant funding ends?
What services could your program continue to provide without grant funding, and which services would you have to discontinue? To what extent are the services provided to children and families through the Oral Health Initiative reimbursable through insurance?
Will you be able to sustain the referral systems developed for the initiative after grant funding ends?
Will you be able to continue helping children and families find dental homes?
What potential funding sources are available to sustain the services after grant funding ends?
IMPLEMENTATION LESSONS (10 minutes)
I’d like to wrap up the discussion by hearing your views on the successes and challenges of the Oral Health Initiative and any lessons you’ve learned.
Do you have systems in place for monitoring your progress in achieving your goals and objectives for the Oral Health Initiative? If so, can you please describe these systems? How helpful have they been? Have you used them to make program improvements? If yes, can you give me some examples?
At this point, how much progress have you made toward meeting your goals and objectives for the Oral Health Initiative?
What has the Oral Health Initiative grant enabled your program to do that you were not able to do before? For example, add new services? Provide oral health services to more children? To other family members? To add new community partners? To establish referral systems? To provide more training to staff, families, or partners? Other?
Have you been able to use the Oral Health Initiative grant to leverage other resources to support oral health activities in your program and/or community? If yes, how did you do this and what resources did you leverage?
What have been your most important successes so far? What are you most proud of?
What are the most significant challenges your program has faced so far?
What strategies have you used to address these challenges? How well do you think these strategies are working?
What are the most important lessons your program has learned about providing oral health services?
What changes, if any, would you like to make to your Oral Health Initiative and why?
What advice would you give to other programs that want to implement a similar initiative?
Is there anything else you would like to add before we end the discussion?
Thank you again for participating in the interview.
A.
| File Type | application/msword |
| File Title | MEMORANDUM |
| Author | Diane Paulsell |
| Last Modified By | Kim Doo |
| File Modified | 2006-08-03 |
| File Created | 2006-08-02 |