Abstract
Problem:
In New Jersey's low-income communities, we are grappling with socioeconomic, cultural, and behavioral factors affecting pediatric health outcomes. Insufficient access to oral health care, including preventive care, affects children's health, educational success, and ability to prosper. These issues are exacerbated when one resides in a federally designated "food desert" - an area that has limited access to affordable and nutritious food, in contrast with an area with higher access to supermarkets or farmer's markets with fresh foods, which is called a food oasis. With its widespread and deep poverty, dearth of vehicle ownership and absence of a traditional supermarket within proximity to most residents, the USDA has designated Camden New Jersey as a food desert that many consider to be among the top ten worst in the country. Parts of Camden are food swamps -- washed in fast food chains, dollar stores, bodegas, and other convenience outlets. All which sell food laden with sugar, salt, and fat fueling increased rates of chronic disease among all Americans, but most alarmingly in young children.
Goals and objectives:
Objective 1: By 2028, the VPMS Oral Health & Nutrition Initiative will increase southern New Jersey's at-risk pediatric populations' connection to healthy, nutritious food in southern New Jersey by connecting Good Food To Grow childhood nutrition education/healthy food connection, to every child receiving a dental screening from the Virtua Pediatric Mobile Services (VPMS) unitObjective 2: By 2028, the VPMS Oral Health and Nutrition Initiative will increase the number of children aged 0-6 living in southern NJ's at-risk communities who receive preventative oral health care by expanding VPMS dental services to include fluoride varnish, Ride Health services, and connection to a Dental Home. Objective 3: By 2028, the VPMS Oral Health and Nutrition Initiative will train Virtua Physician Residents to perform pediatric oral healthcare screenings and fluoride varnish applications and to incorporate oral healthcare into their medical practice.
Methodology:
This project can decrease obesity, oral health emergencies, and other associated health conditions in southern New Jersey's at-risk children while increasing clinical linkages to care, by 1) teaching children that "food is medicine" - the universal construct that good nutrition has a positive effect on obesity and oral healthcare exacerbated by poverty, 2) offering an additional dental service by providing fluoride varnish, and 3) educating pediatric physicians on the importance of connecting children to oral healthcare, and a dental home, as part of a child's overall care.Strategy 1: VPMS will expand the Good Food To Grow nutrition education program to every child receiving a VPMS dental screening in southern New Jersey as part of their oral healthcare education.Strategy 2: VPMS will enhance current dental screenings to a more comprehensive approach to early pediatric oral healthcare with the addition of Smile Bags (education reinforcement), fluoride varnish, and Ride Health medical transportation vouchers to connect to a dental home.Strategy 3: Virtua Health will train resident physicians to incorporate both pediatric oral healthcare (dental screenings and fluoride application) and dental home connection into their medical practice.COORDINATION:VPMS will leverage relationships with existing community partners, coalitions and social services programs focused on child and maternal health and medical and dental providers. We offer services five days per week, with two weekend-scheduled events per month connecting health services and education to an average of 250 children per month. Without the mobile services these children otherwise would have been missed. VPMS utilizes community health workers (CHW) to engage the community in ways that are culturally and linguistically appropriate. Our CHWs encourage open sharing by letting parents and guardians know why sharing accurate information is important to the treatment plan, and then connect the family to the appropriate service for assistance. In such personalized settings on a mobile van, the power dynamic is very different from a traditional medical setting.
Evaluation:
Targeted outcomes are:
- 21,000 pounds of nutritious food distributed.
- 5,000 pediatric dental screenings
- 2,000 fluoride varnish applications
- 5,000 Dental Home referrals
- 1,000 Ride Health transportation vouchers utilized to connect to care
- 90 physician interns trained in pediatric oral healthcare
- 300 physicians incorporate oral healthcare into their practices