Chapter 2. Mobilizing Community Assets for
Chapter 2 reviews
methods for creating and using oral health
coalitions or other collaborative planning
efforts to address oral health problems.
Worksheets provide a framework for deciding
what collaborative relationships might
work best for your community and the type
of issues identified as priorities. Links
are provided to resources, examples of
oral health coalitions, and funding sources
for collaborative oral health projects.
Funders and community
planners are focusing more on community
collaboration as a way to address and
improve health problems. In past years,
however, many communities looked solely
to dental professionals to reduce the
incidence and burden of oral diseases
such as dental caries (tooth decay). Dental
care in the US is delivered in private
dental offices or in clinics that are
supported by government or other types
of funding, often in isolation from other
forms of health care. Access to dental
care is hampered by a number of the barriers
identified in Chapter 1. Dental professionals
cannot be expected to, nor are they necessarily
always effective in single handedly trying
to assure the public's oral health. The
situation calls for a number of partners.
Prevention of oral diseases occurs not
just in dental offices but through individual
self-care behaviors such as toothbrushing,
and through public health efforts such
as community water fluoridation or application
of fluoride varnishes in preschools (see
Assuring that people
possess the knowledge to prevent oral
diseases and have access to preventive
measures and regular dental care, requires
a great deal of coordination and significant
Identifying Potential Partners and Collaborative
What resources are needed to address the
issues you prioritized in Chapter 1? Refer back to the brainstorming
discussion in that chapter to list individuals, community
groups and businesses that might be potential partners. Make
the list as exhaustive as possible and then prioritize which
ones should be enlisted first and by what means. Examples
of categories of some potential partners are included in the
box. A partners
worksheet is provided for you to use to create your own
Health Department/ MCH Program
Social Service Agencies
School Nurses and Social Workers
Dental Assisting Society
Dental Hygiene Society
Nursing/Nurse Practitioner Society
Physician Assistant Society
Early HS/Head Start
Prenatal Outreach Programs
for Action When enlisting people's help, have them identify
their strengths (assets) and assess their interest in
specific activities. You might need to describe examples
of ways they can help with efforts to plan, market, implement
or evaluate oral health activities. View a list of ways
people can contribute; customize this list for your
own situation. How do you motivate people to want to join
in a collaborative effort?
community members can be potential
advocates for oral health. It
just may take someone with a passion
for oral health issues to awake
an interest in other people. Facts
don't motivate people to act.
You need to personalize the issue
for them-put a face on it.
How do you personalize
- Have people discuss
oral health problems they have experienced
or family members have experienced
that caused them to miss school, be
in pain, be self-conscious, or lose
- Show a series of
photos of healthy children with healthy
mouths next to photos of children
with dental decay in increasing levels
of severity and health outcomes such
as swollen faces and extracted teeth.
- Appeal to beliefs
in "social justice" and
the opportunity for all children to
start life healthy and to stay that
way. "Every child has a right
to good overall health, including
good oral health and absence of dental
- Tap into a spirit
of volunteerism and the importance
of sharing one's knowledge and expertise.
- Show how individual
efforts can make a difference in the
- Share preliminary
ideas for collaborative efforts.
Once you have identified
interested parties, convene a meeting
to review the oral health issues and priorities
discussed in Chapter 1, and develop a
structure to work as a group to move forward.
Some communities have formed task forces,
while others have formed coalitions. The
structure may depend on whether you primarily
have a gathering of individuals or a gathering
of agency representatives, and if there
is an existing agency or organization
that is willing to lead the initial effort.
enthusiasm can be quickly dampened
if there is no organization to
serve as the coordinating body
for oral health activities, or
if an organization has nobody
willing to act as coordinator.
Somebody has to step up to the
plate or somebody has to be hired
as a coordinator.
Mission, Vision, Goals and Objectives
Once the group has decided to function
as a unit, developing mission, vision
and goal statements is a useful exercise
to clarify the current and future focus.
A Mission statement for
a coalition defines the purpose or role
of a group or organization.
mission of the Alliance is to
promote and assure the oral health
of young children living in California
Eastern Sierra counties."
A Vision statement describes
what the group wants to do-a picture of
what the future should be.
Alliance is driven by the vision
of a region in which all children
and their families have access
to the full continuum of oral
health care services that allows
them to achieve optimum oral health
status. In achieving this vision,
the Alliance and its members will
be leaders for high quality, cost
effective preventive measures,
clinical care, education, and
advocacy for children and their
Using the priorities developed in Chapter
1, the group should next develop some
Goals for the future. Goals are broad
conceptual statements such as:
Goal 1. Increase the public's
awareness and knowledge of
oral health issues for young
Goal 2. Increase the capacity
of health professionals to
promote oral health, prevent
oral diseases, and refer children
with disease for dental care.
Goal 3. Increase the availability,
affordability and timeliness
of comprehensive dental care
Goal 4. Improve systems for
coordinating and tracking
dental referrals and follow-up
care for young children.
Goal 5. Expand the options
for community based preventive
measures to improve the oral
health of children.
Objectives should be more specific,
measurable, achievable, relevant to the
mission, and include a timeframe. For
1. By July 1, 2005, reduce
the prevalence of early childhood
caries to 10% of 3-5 year
olds attending Head Start
programs that participate
in the fluoride varnish program.
2. By July 1, 2005, 90% of
children attending the Early
Head Start programs in the
county will have a documented "dental home." (baseline:
3. By July 1, 2004, the county
Health Department will have
implemented a case management
and tracking system for dental
referrals of children ages
0-18. (baseline: no current
4. By Sept 1, 2004, 85% of
parents attending a series
of oral health workshops will
demonstrate effective oral
care of their infants on five
criteria from an established
evaluation scale. (baseline:
5. By July 1, 2005, reduce
the average interval from
time of diagnosis of early
childhood caries requiring
hospital care to time of treatment
to 1 month. (Baseline: average
of 6 months)
Objectives should be focused on outcomes
rather than process. Specific activities
to achieve the goals and objectives will
be addressed throughout the chapters in
this resource guide.
Examples of Successful Coalitions
number of statewide, regional
or community-based coalitions
have emerged in the past few years
to address the ever worsening
problem of access to dental care
for low-income and other disenfranchised
groups. View the websites of the
following groups for a description
of how they have structured their
oral health initiatives.
are improved because individuals
convinced other individuals to
think and act differently."
and Ray, Collaboration
As mentioned in Chapter 1, a number of
states and US territories have developed
coalitions as a result of funding provided
by the Health Services and Resources Administration
(HRSA) for state dental summits and Head
Start oral health forums. They have issued
reports and action plans based on their
meetings of stakeholders. View the list
of states and their reports at http://www.mchoralhealth.org
or http://www.astdd.org (go to projects/HRSA/dental
summits or Head Start forums). They provide
ideas for the types of organizations to
"invite to the table," processes for generating
solutions to problems, and structures
for maintaining momentum.
assembling coalitions, and later
on, when assessing the effectiveness
of your coalition, consider the
following important characteristics:
Developing Ideas for Projects and Strategies
Many of the other chapters in this resource
guide describe strategies and options
for solving oral health problems of young
children and their families in a community.
As you consider each option, ask the following
- Is it scientifically sound?
- Will it result in the health outcomes
you want to achieve?
- What are realistic timelines for achieving
short-term and long-term objectives?
- Is it appropriate for the target audience
you have chosen?
- How will you evaluate effectiveness?
- Who will be the champion for this
- Will it be supported by the community?
What are potential barriers that need
to be overcome?
- What resources are needed? Is it
feasible to do with current resources?
If not, can you actually find and
acquire the resources you need, e.g.,
- Who else has conducted programs like
this? What were their experiences?
- Is it fundable? Who are the potential
- How much effort will be required to
1) secure the necessary resources,
and 2) carry out and evaluate the
program? Who will do this? Is it worth
Examples to consider for some of these questions are presented
in a table Analyzing
Project Ideas. Prioritize each of your ideas separately
in terms of 1) importance to the oral health of the target
population, and 2) feasibility of getting the resources and
doing it. Then pick your top 3-5 ideas, write a summary of
each based on the answers to the previous questions, and get
input from a larger group, if possible. Decide if you want
to select one idea, or select 2-3 that complement each other
and do them simultaneously or in phases. Develop a detailed
plan for how you will develop, implement, manage and evaluate
the idea(s) you have chosen; include timelines and assign
responsibilities. Evaluation considerations will be addressed
throughout the chapters of this resource guide.
Types of Resources You May Need
Taking the time and effort to plan what
resources you need and how to obtain them
is a crucial step in beginning any oral
health program. Resources include more
than just money.
1. Professionals who know something
about community-based oral health programs
Oral health coalitions benefit from involving
someone who has knowledge and experience
in creating and evaluating oral health
programs for pregnant women, infants,
and young children. Also look for someone
who knows the realities, challenges and
resources of rural areas. These skills
generally are not taught in most dental
and dental hygiene schools. Try to contact
a dentist or dental hygienist who also
has a background, degree, or experience
in public health. How can you find someone
with this expertise?
- Go to http://www.astdd.org
(Association of State and Territorial
Dental Directors) to see a list of
state dental directors, or if any
of the individuals listed as associate
members live in your area.
- Call the American Association of
Public Health Dentistry (see contact
info on http://www.aaphd.org)
to see if there are any members in
your state and if any live near you.
- Call the Dean's office at dental
schools or dental hygiene schools
in your state and ask if any of their
faculty have public health experience
- Go to http://bphc.hrsa.gov
to see what community health centers
are in your area that may employ a
dental professional with some public
If you identify someone but they are unable
to travel to provide technical assistance,
they might at least be willing to review
your tentative plans, make recommendations,
and link you to other resources or references.
2. Worker bees
These are people who live in the community
who are willing to participate in a variety
of activities related to an oral health
coalition or program. Hopefully you already
have identified some of them through the
Potential Partners form. Everyone has
different and useful skills. Depending
on the type of activities that are planned,
try to match people's skills and schedules
with those that are needed through the
various stages of the project. Be creative
- Don't expect busy dental professionals
who work in private practices or community
clinics to attend meetings when they
have patients scheduled or to adjust
their schedules on short notice.
Teachers, child care workers, and
health department personnel might
be willing to incorporate oral health
activities into their regular job
Parents might want to participate
in activities that are scheduled in
conjunction with their children's
school or sports.
Retirees may also be willing to help
with a variety of activities, especially
around fundraising and mailings.
Children's groups such as 4-H, Girl
Scouts, or Boy Scouts can be enthusiastic
participants and role models at health
fairs or other community-based events
for families and young children.
3. Organizers and Coordinators
These are people with passion, authority,
or just the drive to get things done.
They do not necessarily have to have a
dental background as long as they understand
the goals, objectives, and logistics needed
for the projects that are chosen. Coordination
and organizational skills are important
for providing direction, identifying and
filling gaps, and scheduling and sustaining
whatever activities are planned. You cannot
conduct a project with just worker bees.
In many cases, hiring someone to serve
as a coordinator is preferred to relying
on volunteers whose time may be interrupted
by other commitments. This should be a
local person who can easily communicate
with all stakeholders and attend meetings.
"Space" Needs for Meetings
Identify types of meeting space and other
facilities you might need. Usually meeting
rooms can be obtained at no cost through
agencies that are part of your coalition
or in public buildings such as libraries,
community centers, schools, colleges or
Preventive dental programs such as fluoride
varnishes, prenatal counseling, and infant
oral exams can be integrated and conducted
onsite in programs such as WIC, Well child
clinics, Head Start, hospitals, preschools,
child care centers, or family resource
centers. Dental treatment programs for
young children are best performed in clinical
settings that are designed for comfortable,
safe, efficient provision of care, such
as private practices, community clinics,
hospitals, or mobile vans.
Equipment and Supplies
Specific needs in this category will depend
on the type and location of activities
planned. Some recommendations and examples
are included in Chapter 4 under each type
of preventive measure or in other chapters.
Note that most equipment and some supplies
can be used for extended periods of time,
while other supplies (e.g., exam gloves,
paper products) are considered "disposables"
and must be ordered periodically. Equipment
and supplies should be included in some
type of inventory tracking system. Contact
programs that already conduct these types
of activities to see if they are willing
to share their equipment and supply lists
and costs, as well as recommendations
for where to obtain the items, and inventory
systems. Spend some time discussing any
"lessons learned" that would
help you make decisions or avoid mistakes.
Sometimes leasing equipment (e.g., especially
office equipment) may be a better option
than purchasing it.
Inevitably you will think of resources
you need that don't fit into any major
category and that you may have forgotten
to initially plan for. This might be some
type of insurance, travel stipends, training
stipends, or food for a meeting.
This chapter has asked you to brainstorm
a list of potential partners and possible
activities for their participation that
would benefit your oral health coalition
or other oral health efforts. It provides
an overview and examples of how to develop
mission and vision statements as well
as goals, objectives and potential strategies.
An overview of resources that might be
needed is presented. All of these elements
will help you organize your efforts to
improve the oral health of young children
in your community.
Centers for Disease Control and Prevention,
Division of Oral Health. Oral Health Coalition
Community Catalyst, Inc. A Guide to Organizing
Community Forums. July 2002. (http://www.communitycatalyst.org.)
Health Care for All. Community Catalyst.
Addressing Oral Health Needs: A How-to-Guide
available at http://www.communitycatalyst.org/acrobat/Dental_How_To_Guide.pdf
Sierra Health Foundation We Did It Ourselves.
Guidelines for Successful Community Collaboration.
Sacramento, CA, 2000.
State of Washington Department of Health.
Community Roots for Oral Health: Guidelines
for Successful Coalitions. Olympia, WA,
Winer M and Ray K. Collaboration Handbook.
Creating, Sustaining and Enjoying the
Journey. St Paul, MN, Amhearst H Wilder
What did you learn or accomplish as a result
of reading this chapter? Did it help you
to organize your thoughts about how to
mobilize community assets around oral
health issues in your community? If you
already have formed a coalition, do you
have a written mission and vision statement,
as well as goals and objectives? Were
the resources and examples helpful? Complete the feedback form for Chapter 2 and
tell us what was useful and not useful