Making Oral Health A Community Wyatt Hornsby Delta Dental of Colorado Foundation Campaign Director Priority
WELCOME!
DELTA DENTAL OF COLORADO Operates as a non-profit Largest dental insurer in Colorado, since 1958 9 out of 10 dental providers in the state accept our insurance Community Benefit
DELTA DENTAL OF COLORADO FOUNDATION MISSION: Improving Colorado s oral health by eradicating childhood tooth decay
DELTA DENTAL OF COLORADO FOUNDATION Founded 1997 as 501(c)(3) Receive 55% of company s net gain Programs: Public Will Building Delta Dental Frontier Center at the School of Dental Medicine Hygienist Co-Location Program Cavity Free at Three High Performing Health Centers
Childhood Caries in Colorado: A Public Health Problem
MOST COMMON CHRONIC DISEASE OF CHILDHOOD 20% of the population experiences 80% of all dental disease Nearly half of Colorado s 1.2 million children start kindergarten with painful cavities from tooth decay Tooth decay is 5X more common than asthma
DENTAL DISEASE IN COLORADO S CHILDREN
OVERWHELMINGLY A DISEASE OF POVERTY
CAN LEAD TO ORAL SURGERY 3,300 children visited the OR at Children s Hospital Colorado for dental surgery last year 70% of 3-year-olds seen at Denver Health have dental disease
IMPACTS CHILDREN S FUTURES children with toothaches 4x more likely to have a low GPA 2.5 days of work missed by parents per year because of their children s dental problems For every 100 disadvantaged elementary school children, 58 hours are missed each year due to dental disease
IT S PREVENTABLE SUFFERING Because tooth decay can be prevented in nearly every case!
HOW DO WE BEAT THIS PROBLEM? How do we get people to prioritize about oral health? How do we get families to adopt habits that help prevent childhood tooth decay? How do we get these changes to last longterm?
What is Public Will Building?
building Public Will FRAMING THE PROBLEM BUILDING AWARENESS BECOMING KNOWLEDGEABLE/ TRANSMITTING INFORMATION CREATING A PERSONAL CONVICTION EVALUATING WHILE REINFORCING PHASE 1 PHASE 2 PHASE 3 PHASE 4 PHASE 5 Grassroots outreach + mass media Existing, closely held values Cultural context Target audiences in development and testing Long-term shifts in behavior, attitude, policy, practice, norms
PUBLIC WILL BUILDING EXAMPLES Cigarette smoking Drunk driving Methamphetamine
GOALS WE WANT TO ACHIEVE Eliminate early childhood caries Desired outcomes: Families prioritize oral health The community prioritizes oral health
THE PROCESS Understand the target audience, their values and their behaviors related to dental health Outreach (advertising, PR, patient education, events) and ongoing evaluation and adjustment Create a new tradition of dental health habits in Colorado families Prioritize dental health as a community issue End Goal Eliminate caries in Colorado s children Formative Research (2011-2012) Integrated Campaign (2013-2017)
INGREDIENTS TO SUCCESS Research Plan Implement Evaluate
Research Findings
FRAMING STARTS WITH RESEARCH Needed to understand how families view oral health Baseline survey prior to campaign launch Interviews Observations at safety-net clinics Review of existing data One-on-one in-home or inclinic visits
HOW WE DID IT Sought to understand how families view oral health Baseline telephone survey Interviews with influencers Observations at safety-net clinics Review of existing data One-on-one in-home or inclinic visits
DREAMS FOR YOUR CHILD http://www.wordle.net/create
HOW DO TEETH FIT IN? Play a role, but aren t the only factor Ability to get a job Self-esteem Establishing good habits for life It goes both ways Economic success = dental insurance and care Dental insurance and care = economic success Affects overall health
COMPETING FACTORS Pressures of daily living Overwhelmed Dealing with urgent stresses Own inconsistent brushing Status quo Knowledge Soda, candy = bad. Juice and milk = OK! Carbs Appeal of junk food Economics
CONFUSION/LACK OF KNOWLEDGE Link between milk and juice to cavities Skeptical Link between teeth and GPA Do kids really need to be 6+ before brushing their own teeth?
PARENTS DENTAL EXPERIENCE Assumption: Disease perpetuates through culture But so does prevention Sometimes a culture of disease sparks a future of prevention
GENEALOGY OF CARE Grandparents cared for parent s teeth? Parents care for their own teeth? Parents care for children s teeth? Dental Outcomes? Yes 50% 46% 4% Yes 91% No 9% 46% 0% 2% 2% Yes 100% No 0% Yes 50% No 50% No reports, n=9, 43% Caries +, n=9, 43% Baby state, n=3, 14% No reports Caries +, n=1, 100% No reports Caries +, n=1, 100% No 50% 35% Yes 69% 35% 0% Yes 100% No 0% No reports, n=4, 25% Caries +, n=10, 63% Baby State, n=2, 13% 15% No 31% 7% 9% Yes 9% No 91% No reports, n=0, 0% Caries +, n=3, 100% No reports, n=2, 50% Caries +, n=2, 50%
PARENTS BRUSHING HABITS Parents brushing habits are predictive of how often their children brush their teeth* Target parents brushing behaviors as much as the child s brushing behaviors * This finding was statistically significant.
Brush with Me Campaign
BRUSH WITH ME QUICK FACTS 5 years (2013-2017) Funded by Delta Dental of Colorado Foundation Public will building campaign model Goal is to eliminate childhood caries in Colorado
WHO ARE OUR AUDIENCES? People living in low SES conditions (2x FPL) 50/50 Hispanic/General Market Pregnant women; parents and caretakers of kids aged 0-3 Opportune time to establish health behaviors Influencers and providers in year 2
TWO KEY MESSAGES 1.Make it a habit to brush teeth together as a family, because brushing prevents painful tooth decay. 2.Put only water in sippy cups and bottles between meals and at night, to keep smiles healthy and prevent painful tooth decay.
BRUSH TOGETHER Model good behavior Parents brush young children s teeth and monitor older children s brushing Means parents are brushing, reducing bacteria and transmission
ONLY WATER IN SIPPY CUPS Disconnect between knowledge and behavior Sugary drinks Mealtimes Tap water Solution Only water in sippy cups and bottles between meals and at night.
2013 A PILOT YEAR Efforts focused on Denver Metro Area Every project evaluated for effectiveness Ongoing market testing Future expansion of successful elements
CAMPAIGN ELEMENTS: PARTNERSHIPS Partnership with Children s Museum of Denver Weekly story-time Floss E. Saurus Pearl E. White It s a Toothy Tradition Molar Expedition Planned exhibit highlighting oral health and importance of brushing as a family.
CAMPAIGN ELEMENTS: PROMOTORES Promotores de Salud = Health Promoters Partnership with LiveWell Colorado 2013 goals: Train 200 grassroots health education workers Reach 1,000 families
CAMPAIGN ELEMENTS: HISPANIC/LATINO OUTREACH Hungry for knowledge Knowledge leads to desire and confidence to adopt the behavior and tell others about it
CAMPAIGN ELEMENTS: ADVERTISING & PR Ad/public relations Television Radio Print Mobile-optimized website
CAMPAIGN ELEMENTS: INFLUENCERS & PROVIDERS Influencers Policy change Campaign advisory committee Outreach to systems of care OB/GYNs, pediatricians, WIC, FQHCs, dentists, etc.
YEAR 2 PUEBLO Continue in Denver Pueblo expansion Mass media, earned media, events and promotores Systems of care and influencer efforts
WHY PUEBLO? 1 in 4 Pueblo children lives in poverty (CO 17.7%) 45% of Pueblo adults have lost teeth because of decay/disease (CO 35%) 44% of adults didn t visit a dental professional (CO 36%) Pueblo teen pregnancy rate 56% higher than CO rate High adult and childhood overweight/obesity rates: Adults 66% (CO 56%) Children 32% (CO 26%) Data gathered by Colorado Health Institute
Brush with Me Creative
TV AD
WEBSITE www.brushwithme.com www.cepillaconmigo.com
WEB BANNERS
EVENTS/GRASSROOTS OUTREACH 1-on-1 outreach to target audience Reinforce messages Festivals, community events, etc.
FACEBOOK TAB
Ultimate Outcomes
REDUCING CAVITIES IN CHILDREN Motivate family behaviors that reduce cavities Families prioritize dental health Concrete behaviors to do every day Dentists and pediatricians support these behaviors State oral health survey
COMMUNITY PRIORITIZES DENTAL HEALTH Community leaders know why oral health is important Becomes a funding priority Social norm changes from inevitable to preventable Cavity-preventing behaviors are the social norm
Q & A
THANK YOU Wyatt Hornsby Campaign Director Delta Dental of Colorado Foundation 303.489.4730 whornsby@ddpco.com