Public Health Practice and Administration: Programs, Policy, and Evaluation
From assessment to assurance
Public health administration rests on the three core functions - assessment, policy development, and assurance - operationalized through the Essential Public Health Services. Candidates should map a dental program activity to its function: a needs assessment is assessment; drafting a fluoride policy is policy development; delivering school sealant services is assurance.
Program planning models
Know the logic of needs assessment → objectives → intervention → evaluation. Objectives should be SMART (specific, measurable, achievable, relevant, time-bound). Distinguish process evaluation (was the program delivered as planned?) from outcome evaluation (did oral health change?) and impact evaluation (intermediate effects). A frequent trap is labeling attendance counts as an outcome; attendance is a process measure.
Budgeting and financing
Understand line-item, program, and performance budgeting, and the difference between cost-benefit (monetary outcomes) and cost-effectiveness (health outcomes per unit cost, e.g., cost per caries increment prevented). Know that Medicaid is a federal-state partnership with state-set dental benefits, while CHIP covers children in eligible families; Medicare historically offers limited dental coverage. Questions test who sets eligibility and who shares cost.
Workforce and delivery models
Be familiar with direct service, contracting, and grant models, and with dental hygiene and expanded-function roles that extend reach. Recognize safety-net settings (FQHCs, health department clinics) and the concept of dental home.
Worked rule of thumb
If a stem asks how to judge whether a sealant program worked, ask: did the outcome (caries increment) change versus a comparison? If the stem asks whether it was implemented well, choose a process indicator such as percent of eligible children sealed.
Traps
- Confusing outputs (children screened) with outcomes (caries reduced).
- Assuming federal agencies set Medicaid dental eligibility - states do.
- Selecting cost-benefit when the outcome is a health metric; that is cost-effectiveness.