G-2309-19903

The University of Maryland School of Dentistry (UMSOD) aims to instill the core values of excellence and innovation in education, patient care, research, public service, and global engagement in their graduates. UMSOD is the state of Maryland's only dental school and offers one of eight dental hygiene programs.

Since 2021, CareQuest Institute has supported UMSOD's work to identify and address barriers to oral health access, with a particular focus on pregnant people and children and in response to the expanded post-partum coverage in the state. This work began with the assembly of a state-wide Prenatal Postpartum Advisory Board (PPAB), comprised of obstetric (OB) providers, dentists, and moms, who all share a vision for improved access to and integration of oral health in community health care settings. The PPAB broadened its community engagement last year by way of 28 listening sessions that involved more than 200 community members and included education as well as opportunities to establish trust and build self-advocacy skills. UMSOD and the PPAB shared many successes during the past project year, including:

Community health workers and moms with lived experience are effective messengers for empowering underserved individuals to be advocates for their oral health

Creation of a coalition of medical-dental safety net administrators and dental hygiene educators from the seven dental hygiene programs in the state to develop a community service-learning program to foster state-wide medical-dental integration (MCADE - Maryland Coalition for Allied Dental Education programs)

Racial/ethnic bias training has been incorporated into the UMSOD and Howard University dental/dental hygiene school curricula

A PPAB member who is a community health worker collaborated with another PPAB mom to present a poster at a Baltimore City leadership conference about their roles on the board

UMSOD's administration of the PPAB has created opportunities for meaningful relationship building between community health workers and moms with lived experience through shared storytelling and self-advocacy training for communities in Baltimore and surrounding counties.

With respect to proposed goals for the coming year, UMSOD will continue to support the PPAB as well as pursue two pilot projects focused on oral health integration. The first pilot will leverage efforts from the MCADE to integrate oral health education into three CHW training programs, specifically by establishing partnerships between these program educators and dental hygiene program educators that are co-located at Baltimore City Community College, Community College of Baltimore County, and the Maryland Area Health Education Center, which is housed on the University of Maryland Baltimore campus. The second pilot seeks to test the effectiveness of integrating a CHW into the UMSOD prenatal oral health program as well as the Harford County WIC program. A CHW from the PPAB will work with the Women's Health Center (UMWHC) and prenatal oral health case manager at the university to help patients referred from the UMWHC address barriers to accessing oral health services. UMSOD will partner with three prenatal clinics to integrate oral health as well as collect and report data on the integration of the 5 Core Oral Health Clinical Domains through the National Maternal Oral Health Research Center.

An impetus for these pilots, in addition to mounting interest in medical-dental integration in the state to increase utilization of expanded benefits, is an emerging policy opportunity to expand the scope of practice/function for dental hygienists. UMSOD plans to explore whether hygienists, under the supervision of a medical professional, could provide preventive screenings and services in medical settings for pediatric and geriatric populations. To this end, the PPAB will work with the Maryland Dental Action Coalition (MDAC), and other state partners, to administer a needs assessment focused on capacity at each of the state's eight dental hygiene programs to begin implementing an updated, integrated curriculum for oral health in medical settings.

The original request amount for this proposal was $228,376, which is an increase from last year. Based on the ongoing community engagement and leadership opportunities that the PPAB members create and the proposed impact to oral health integration into prenatal and maternal health care through multiple pilots, this proposal is being recommended for funding in the amount of $200,000. The funding will be used in part for personnel salaries across three roles, subgrants to three pilot sites to integrate oral health into prenatal care ($15,000 each), a contract with a facilitation partner for the PPAB, CHW training for three PPAB members, and ongoing administration of the PPAB. Funding for this grant would make up less than 1% of the organization's overall budget. Finally, the request budget indicates in-kind funding and support for oral health integration.