This is an adapted presentation by Professor Linda Brookman, RDHAP, BSDH, MS for the Community Health Program Planning and Implementation course as part of USC Ostrow’s Community Oral Health program.
What is the public health pyramid?
The public health pyramid is a framework to improve health, with the base of the pyramid including the interventions with the ability to impact the most people (infrastructure services) moving up to direct healthcare services, which offer the most immediate affects, yet not as accessible. Public health interventions are listed below, starting from the top and moving to the base of the pyramid.
Direct Healthcare Services
Direct healthcare services is the smallest section of the pyramid. They have the most immediate affect, yet impact the smallest number of people. Services include:
- Direct medical care from MDs, PAs, NPs
- Pharmacy services
- Psych counseling
- Hospital care
Enabling Services
Aggregates are a population who share common needs (e.g. mental illness, need for dental care, people with diabetes). Enabling services provide aggregates with medical care and social services. Enabling services may directly or indirectly affect the individuals, families, or communities, and address some of the social determinants of health. Some examples of enabling services include:
- Mental health drop-in centers
- School-based sealant programs
- Diabetic counseling centers
Population-Based Services
Population-based services are delivered to an entire population (e.g. city, county, state, country), and can improve the health status of a the population. These programs are directed at changing one or more social determinants of health. Examples include:
- Immunization program for all children entering kindergarten in a county
- Newborn screenings for all infants in a state
- Nutritional labeling on all foods sold in the country
Infrastructure Services
Infrastructure services are supported by laws and regulations pertinent to health care. Examples may include:
- The FDA over-seeing all prescription medications
- Seat belts required in all automotive vehicles
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6 Stages of Community Health Program Planning
Activities for the planning and evaluation of a community health program occur in stages. These stages are cyclical; when one finishes, an evaluation is done to improve the former stage, and then proceed to the next stage. Below are the six program planning stages and supporting steps to accomplish each stage.
Stage 1: Mobilize Community Support
- Getting started
- Finding partners and champions
Stage 2: Assess Needs and Resources
- Organize the assessment
- Conduct the assessment
Stage 3: Determine Priorities & Plan the Program
Priorities are based on data collection of needs.
- Prioritize needs
- Plan for integration of cultural competency
- Design the program
Stage 4: Implementing the Program
- Identify program components
- Create an implementation plan
Once resources are secured, implementation can begin. Implementation can include:
- Marketing to target audience
- Training and managing personnel
- Delivering the intervention
- Conduct a process evaluation
Once the process evaluation is completed, this can lead to necessary revisions in program delivery.
Stage 5: Evaluate the Program
- Determine how the evaluation will be used
- Determine evaluation questions
- Develop evaluation measures
At end of cycle, an outcome evaluation is required. The cycle is then repeated with improvements.
Stage 6: Participate in Policy Development & Research
- Community Oral Health Policy
- Community Oral Health Research
Online Master of Community Oral Health
Like what you’re learning? Consider enrolling in the Herman Ostrow School of Dentistry of USC’s online, competency-based certificate or master’s program in Community Oral Health.