BURDEN DOCUMENT REVIEW: AN EVALUATION OF USE AND STATE DENTAL DIRECTOR'S PERCEIVED USEFULNESS OF ORAL DISEASE BURDEN DOCUMENTS PRODUCED THROUGH COOPERATIVE AGREEMENT 3022 Open Access
Ramos, Kevin L (2011)
Abstract
ABSTRACT
BURDEN DOCUMENT REVIEW:
AN EVALUATION OF USE AND STATE DENTAL DIRECTOR'S
PERCEIVED
USEFULNESS OF ORAL DISEASE BURDEN DOCUMENTS PRODUCED
THROUGH COOPERATIVE AGREEMENT 3022
By
Kevin Ramos
The Centers for Disease Control and Prevention (CDC) is the federal
agency that
is responsible for improving the oral health of the nation and
reducing inequalities in oral
health ("CDC - Oral Health," n d). Because strong state-based
public health programs
are critical to the nation's oral health, CDC invested in the
development of a cooperative
agreement (Cooperative Agreement 3022) to support the growth of
infrastructure and
capacity for state oral health programs.
Of the 10 recipient activities outlined in Cooperative Agreement
3022, recipient
activity # 2 requires that states develop an oral health burden
document to describe the
oral disease burden, health disparities and unmet needs of their
state. The purpose of this
focused utilization evaluation is to examine the use and perceived
usefulness of the oral
health burden document and to assess if and how
states funded thru CA 3022 utilized the
burden document to strengthen their oral health infrastructure
within the their state oral
health programs.
An open-ended interview was developed using a component evaluation
approach.
Respondents were interviewed by phone about their use and perceived
usefulness of the
burden document. Additionally, qualitative data were compiled and
analyzed using
thematic categories and frequency counts.
Findings from this utilization-focused program evaluation may serve
as a
foundation to guide CDC in evidence-based decision-making and
building program
infrastructure. Also it may provide guidance for future studies
related to the burden
document.
BURDEN DOCUMENT REVIEW:
AN EVALUATION OF USE AND STATE DENTAL DIRECTOR'S PERCEIVED
USEFULNESS OF ORAL DISEASE BURDEN DOCUMENTS PRODUCED THROUGH
COOPERATIVE AGREEMENT 3022
By
Kevin Ramos
Bachelor of Science in Business Administration
Boston University
1983
Thesis Committee Chair: Iris Smith, PhD, MPH
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
Master of Public Health
in Behavioral Science
2011
Table of Contents
Table of Contents
CHAPTER 1................................................................................................................................................. 1
INTRODUCTION........................................................................................................................................... 1
PURPOSE STATEMENT................................................................................................................................... 5
EVALAUTION QUESTION................................................................................................................................ 6
PUBLIC HEALTH PROBLEM.............................................................................................................................. 6
DESCRIPTION OF THE PROGRAM LOGIC MODEL................................................................................................ 10
THEORETICAL FRAMEWORK.......................................................................................................................... 14
SIGNIFICANCE STATEMENT.......................................................................................................................... 15
DEFINITION OF TERMS................................................................................................................................ 16
CHAPTER II............................................................................................................................................... 18
REVIEW OF THE LITERATURE........................................................................................................................ 18
Chapter III................................................................................................................................................ 25
Methodology.............................................................................................................................................. 25
Introduction............................................................................................................................................... 25
Population................................................................................................................................................. 26
Survey Sample.......................................................................................................................................... 26
Inclusion/exclusion criteria........................................................................................................................... 26
Research Design......................................................................................................................................... 27
Procedures................................................................................................................................................ 27
Instruments............................................................................................................................................... 28
Data Analysis............................................................................................................................................. 30
Human Subjects Protection........................................................................................................................... 30
Limitations and delimitations......................................................................................................................... 31
Summary................................................................................................................................................... 31
CHAPTER IV................................................................................................................................................ 32
RESULTS.................................................................................................................................................... 32
Introduction................................................................................................................................................ 32
Results....................................................................................................................................................... 32
Evaluation Question 1:
How was your burden document used to strengthen the state oral health program's infrastructure?............................ 33
Evaluation Question 2:
How was the burden document used to influence policy?..................................................................................... 36
Evaluations Question 3:
How did your state oral health program use the burden document to affect programmatic change?............................. 39
Evaluation Question 4
How do you plan to utilize your burden document in the future to strengthen your state's oral health program?............. 41
Evaluation Question 5:
Based on your experience, what would you say were the strengths of your burden document?................................... 44
Evaluation Question 6:
Based on your experience, what would you say were the weaknesses of your burden document?............................... 46
Evaluation Question 7:
How valuable of an exercise was the development of the burden document?.......................................................... 47
Table 8: Question 7:
How valuable of an exercise was the development of the burden document?.......................................................... 49
Other Findings............................................................................................................................................. 50
Summary................................................................................................................................................... 51
Chapter V................................................................................................................................................... 58
Conclusions, Implications, and Recommendations.............................................................................................. 58
Introduction................................................................................................................................................ 58
Implications................................................................................................................................................ 59
Recommendations........................................................................................................................................ 60
Summary of Study....................................................................................................................................... 64
REFERENCES............................................................................................................................................... 65
Appendix A: Program Logic Model................................................................................................................... 71
Appendix B: Introduction and Recruitment Letter............................................................................................... 72
Appendix B: Verbal Consent Form................................................................................................................... 73
Appendix D: Interview Script......................................................................................................................... 75
Appendix E: Interview Questions.................................................................................................................... 77
Appendix F: Emory University Institutional Review Board Exemption Letter............................................................ 79
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