BRECHAS: Grant proposal to develop a telehealth school-based program to educate Hispanic parents regarding oral health in Cox, Stringfellow, Okapilco and Sunset Elementary Schools in rural Georgia. Open Access

Sandoval, Vanessa (Fall 2018)

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Disparities in both oral health disease and lack of oral health education continue to affect a large segment of Georgia’s population. Evidence shows a current lack of accessibility to oral health care education for Hispanic residents of rural counties of Georgia. Despite existing prevention initiatives and interventions, tooth decay among children continues to be one of the most common chronic diseases in the state of Georgia. Hispanic children and children in rural areas have significantly higher prevalence of tooth decay (64% and 60% respectively), compared to non-Hispanic children and children in urban areas (50% and 48% respectively). Evidence shows a current gap in availability of oral healthcare and related education for rural communities, especially the Hispanic community in Colquitt County. A major component that is impeding the access of the current oral health initiatives is lack of oral health education. Education has the ability to impact oral health throughout the community. It brings a clear perspective and clarity specifically when it comes to underserved populations.

Colquitt County, GA has an unmet need for oral health education. There is a disconnect in the understanding of the benefits of oral health and sealants in the Hispanic community, specifically for the parents of elementary school children. In response to the Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP) Telehealth Network Grant Program (TNGP), the BRECHAS pilot program plans to provide oral health education in Spanish through telehealth technology to four elementary schools in Colquitt County. This will help to close the knowledge gap and remove access barriers. Through the BRECHAS program Hispanic parents will gain an understanding of the importance of oral health, therefore helping to reduce oral health disparities among school children in Colquitt County.

Table of Contents

Chapter 1: Introduction. 1

Chapter 2: Literature Review.. 6

Introduction. 6

Chapter 3: Methods. 14

Funding Agency - The Health Resources and Services Administration. 14

Grant Review Process. 16

Chapter 4: Incorporation of Reviewer Comments. 21

Reviewer 4 comments: Dr. Leslie Dickman. 24

Reviewer 5 comments: Annie Scott 26

Chapter 5: Proposal 29

Project Abstract 29

Funding Preferences. 29

Needs, Objectives and Projected Outcomes. 29

Service Area. 30

School Based Health Centers (SBHC) 30

Clinical Services to Be Provided. 32

Actual Parents/ Persons Served. 32

Self-Assessment 32

Outcomes – Telehealth Services. 33

Sustainability. 34

 Facilities. 50

Work Plan. 51

Resolution of Challenges. 51

Evaluation Plan. 53

Organizational Information. 55

Funding Requested. 57

Budget 57

Attachments. 60

Attachment 1: Rural ID Eligibility. 60

Attachment 2: Work Plan. 61

Attachment 4: Organizational Chart 64

Attachment 5: Letter of Support 65

Appendices. 66

Appendix 1: Focus Group Questions. 66

Appendix 2: Consent Form – Videoconference (Translated to Spanish) 68

Appendix 4: Consent Form Focus Groups (Translated to Spanish) 69

Appendix 5: Baseline Survey. 70

Appendix 6: Post-Survey. 71

Appendix 7: Pamphlets (In Spanish) 71

Reference page 72

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