Introduction
In a report by the Surgeon General released in 2000, dental caries were revealed to be the most prevalent chronic childhood disease (U.S. Department of Health and Human Services 2000). The disease was also shown to disproportionately affect children living in poverty. In addition to the high prevalence of caries, low-income children faced barriers to accessing dental care. As a result, oral health problems often go untreated, further complicating the disease. Head Start program data reflect the magnitude of the problem. In the 2004—2005 program year, 85 percent of all preschool-age Head Start children received a dental exam. Of these, 26 percent required follow-up treatment and about 80 percent of those needing care were able to access oral health treatment (Hamm 2006).
To respond to these challenges, the Office of Head Start invested $2 million in grants to 52 Head Start, Early Head Start, and Migrant/Seasonal Head Start programs to design and implement oral health models that meet the needs of the communities and populations they serve. The grants provide supplemental funding for up to four years.
The Office of Head Start contracted with Mathematica Policy Research, Inc. (MPR) and its partner Altarum (formerly Health Systems Research) to conduct a two-year evaluation of the Oral Health Initiative (OHI). The study is designed to describe the oral health promotion strategies developed by the OHI grantees and to evaluate implementation; the evaluation is not assessing the OHI’s impact on children’s oral health outcomes. Data sources for the evaluation include telephone interviews with all 52 grantees, site visits to a subset of grantees, and a program record-keeping system maintained by the grantees.