Advances in Oral Cancer: Applications in Public Health
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1 Advances in Oral Cancer: Applications in Public Health Putting it all together for use in Public Health Settings 2007 National Oral Health Conference
2 What have we heard? Brian Hill- Implications of changing demographics of oral cancer David Wong- Salivary diagnostics: Oral cancer Miriam Rosin- Biomarkers an adjunct tool for oral cancer early detection
3 What is our challenge? Putting it all together for use in public health settings
4 In order to put it all together for use in public health settings we need to know what the it is.
5 What is it? it? Is it : New knowledge? New technologies? Teams of providers? Changes in policies? Modifications in protocols of care, management of programs? None, some, all of above? New to us? Achievable? A structural issue? A matter of will?
6 Basic issues Getting the science we need Moving science into action Communicating, educating, evaluating
7 Traditionally our approach has been linear.. Laboratory Research Clinical Research Public Health Translational Research Population Research
8 Often we do not have research that involves the community and informs public health programs.. Community Trials Demonstration Research Health services research Health policy research Public Health
9
10 The challenge is to facilitate continual integration: Laboratory Research Health literacy Public s s Health Population-based Clinical Research Health services
11 Moving science into practice
12 We love the characteristics of the ideal public health measures: Safe Effective Easy to use Low in cost Acceptable, accessible, affordable, available, accountable, sustainable
13 Do we need to develop characteristics for emerging technologies for public health settings? What about self-care, family care, services to be provided by care- givers?
14 Does our approach to public health functions need to be revisited?
15 Public Health in America, Public Heath Functions Steering Committee, 1994.(Adapted) ASSURANCE (Treatment & Follow-up) Assure Competent Workforce Link to / Provide Care Enforce Laws Evaluate Monitor Health RESEARCH Develop Policies Diagnose & Investigate Inform, Educate, Empower Mobilize Community Partnerships ASSESSMENT (Examination & Diagnosis) POLICY DEVELOPMENT (Treatment Plan)
16 Steps have been taken to take formal action: State Models for Oral Cancer Prevention and Early Detection Oral visual screening can reduce mortality in high-risk individuals and has the potential of preventing at least 37,000 oral cancer deaths worldwide. (Lancet 2005; 365: ) 33). Oral Cancer Foundation
17 We have put it together here and there. The challenge is, that the it keeps changing and other issues emerge.
18 The Future Paradigm: Transform Medicine from Curative to Preemptive and focused on the individual Predictive Personalized Preemptive Participatory
19 Health Care Providers Public Legislators Policy makers Social Service Sector Oral Cancer Prevention Educators Researchers Media Government
20 Enough of the problems, what are the solutions for putting it all together in public health settings?
21 Moving it takes perseverance and will political and personal Redefine public health settings Launch new Task Force start now education, oversight, science Set formal plan for actions at local, state and national levels Extend the science base; stimulate successful proposals Support community- based multi-sectoral sectoral, multi-professional partnerships Think local and global
22 Why is this time different from all other times? We are being challenged to go beyond the traditional causal factors and beyond a traditional screening approach New technologies are at the frontier of development further refinement of these technologies are needed for ultimate personal use; and for real time analysis and response Oral cancer detection is one of many diagnoses the emerging technologies can provide -- our role as primary care providers/public health practitioners continues to expand
23 Take leadership for the nation s s health Of no one thing are we more assured than that dentistry of today must either advance or give place: to attempt to confine it to its present limits is to seek to control that progress which is itself evolution. Editorial: The Future of Dentistry, Dental Cosmos, 14(11:18:1872)
24 Sources that influence diffusion: organized by effect of policymakers (PM) Insensitive to PM Prevailing Theory Attributes of Innovation Features of Clinical Situation Subject over time to PM Practice setting Decision-making process Characteristics of potential adopters Susceptible to PM Environmental constraints and incentives Conduct and methods of evaluation Channels of communication Presence of Advocate ** also consider reimbursement, training, patient/community acceptance, etc.
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