U.S. army's "put more 'bite' into health promotion" program.

How often do you see your patients? How often do those same patients see their physicians? Usually, the answer is that your patients are seen more frequently and more regularly in the dental office than the physician's. With that in mind, how and where are your patients more likely to be exposed to health promotion messages?

The U.S. Army Dental Command's answer to the dilemma was to augment the delivery of "good health" informational messages in the dental clinics. Today's Army is a young Army (most less than 25 years of age), and they are predominately healthy. If and when they go into the medical clinic it's because of acute injury or illness, which is not the optimal time to deliver health promotion messages. At that point, the soldiers only want to know how to get better or out of pain.

On the other hand, every soldier is required to have at least an annual dental exam. This exam is not optional. Additionally, before any soldier can deploy, he or she must have a current dental exam and complete all urgent or emergent dental treatment. In other words, we have a captive audience in our dental clinics. With this, the dental-medical partnerships were strengthened and dental appointments were recognized as a valuable opportunity to raise health awareness by promoting healthy lifestyles practices. The dental/medical health promotion campaign was born. The objective of the "Put More 'Bite' into Health Promotion" program is to put more "dental" into health promotion and more "health promotion" into the Army Dental Care System.

Health promotion is the science and art of helping people achieve optimal health through changing adverse health behaviors, enhancing awareness of good health practices, and creating environments that encourage good health. The Army initiatives advance these ideals through dental-clinic-based, patient-oriented interventions. Given the heavy curative treatment workload that military dental health providers face every day, the interventions were carefully designed to take a minimal amount of a provider's time while providing a high return for the time invested.

The ultimate goals of the campaign are to improve the health of soldiers by increasing the delivery of select preventive health services and screenings, by increasing soldiers' awareness about select health problems and their risk factors, and by encouraging behavior change, where indicated, through health promotion and education. The key to successfully increasing patient awareness about health problems and risk factors is the repetitive delivery of a simple, well-focused message through multiple channels. For example, not only just telling patients about a particular health problem, but also using visual aids to get the message across and then giving them written summaries that they can read at their leisure.

An important principle for a successful campaign is the "TEAM" approach: Teach Every Available Moment. We start delivering health promotion messages as soon as the patient walks into our dental office, taking advantage of a "captured" reception room audience to deliver health promotion messages with posters, video loops, pamphlets, and brochures. Then we follow up with oral messages during the dental appointment. A health promotion message from a well-respected authority figure, such as a health care professional, carries a lot of weight with most patients and can have a positive impact on a patient's behavior. For maximum effectiveness, verbal messages are then reinforced with written ones.

Finally, we also counsel all patients on general health issues, even if they would not directly benefit from the intervention. The patient, as a peer, parent, or relative, may influence others who could benefit from the intervention. An example would include providing a nonsmoking patient with an informational booklet that might assist them with talking to their smoking spouse.

Successful implementation requires commitment and behavioral change not only on the part of patients but also on the part of providers. Providers should view every patient encounter as an opportunity to advise their patients about health risks and good health practices in a positive, encouraging manner.

The following simple steps can help you incorporate a health promotion and disease prevention program into your dental practice. Remember: Do NOT expect to do it all tomorrow. Do not expect it to "take" the first time through for you or your staff, but be prepared if your patients embrace the opportunity immediately! By following these easy steps, you can join forces with the Army Dental Care System in promoting health.

Health Promotion Program

Step #1: Start simple.

1. Decide on your primary initiatives and keep it simple.

2. Listed below are some easy startup initiatives. Don't attempt them all initially. You are probably involved with the ones "checked," so take credit for having begun already!

* Sealants

* Fluorides

* Caries Risk Assessment

* Mouthguards

* Skin, Lip and Oral Cancer

* Nutrition

* Tobacco

* Family Violence

* Blood Pressure Screening

3. Make sure the entire office staff is comfortable with the campaign. If it's not an officewide endeavor, at least keep the staff informed in case of questions.

Step #2: Awareness Campaign

1. Display health information in your reception room and treatment rooms.

2. Check websites for information, educational materials and handouts. The following websites are great resources. This list is not all-inclusive, but it gives you a good starting point.

* American Dental Assistant Association--http://www.dentalassistant.org/

* Academy of General Dentistry--http://www.agd.org/

* American Dental Association--http://www.ada.org/

* American Dental Hygiene Association--http://www.adha.org/

* National Institute of Dental and Cranial Research--http://www.nohic.nidcr.nih.gov/index.asp

* Center for Disease Control--http://www.cdc.gov/OralHealth/index.htm

* Agency for Health care Quality and Research--http://www.ahcpr.gov/

* Health Finder--http://www.healthfinder.gov/

* Kaiser Family Foundation--http://www.kff.org/

* Office on Violence Against Women--http://www.ojp.usdoj.gov/vawo/

3. Display ready-made posters in your waiting room.

4. Make pamphlets available to your patients.

Step #3: Add to your Awareness Campaign

1. Pick your topics and keep them narrow.

2. Know your available resources. Stay in your comfort zone, but expand it as you learn.

3. Begin talking with your patients about your selected initiatives.

4. KEEP IT SIMPLE.

5. Annotate the dental record with the topics discussed at each appointment.

6. Be prepared to repeat messages at each appointment.

Step #4: Develop your own personalized messages

1. Develop posters (8 1/2 x 11) on your computer.

* Use pictures of your staff

* Limit wording

* Have a poster contest in your office and use the posters!

2. Develop informational handouts or purchase ready-made newsletters.

3. Use the "We Care" marketing approach, because I'm sure you do!