Cost-benefit analysis of a worksite oral-health promotion program

Workplace oral health promotion activities among community-aged care workers: A qualitative exploration

BACKGROUND

The workplace is an ideal-and priority-setting for health promotion activities. Developing and implementing workplace health promotion interventions, including oral health promotion activities, can help create health-supporting workplace environments.

OBJECTIVE

To pilot workplace oral health promotion activities among staff working in the aged care sector, report their impact and explore participants' views on the factors that contribute to participation and effectiveness.

METHODS

This study comprised three phases: (i) the development and face validation of the resources, (ii) a 3-h educational session and (iii) five interview sessions with participants 4-6 weeks following the education session. The recorded interviews were transcribed verbatim and analysed thematically.

RESULTS

Eleven community-aged care workforce were invited to five feedback sessions. Ten participants were female and ranged in age from 18 to 64. All participants gave favourable comments about the content and delivery of the training session and accompanying resources. The participants felt that the benefits of WOHP include improved staff knowledge, awareness and oral care routine, the ability to share (and put into practice) the gained knowledge and information with their dependants, a lower risk of having poor oral health that adversely affects their well-being and work tasks, and potentially beneficial impacts on the organization's staff roster. Their attendance in the WOHP was facilitated by being paid to attend and scheduling the sessions during work time. Future WOHP suggestions include the possibility of a one-stop dental check-up at the workplace or staff dental care discounts from local dental practitioners and combining oral health with other health promotion activities.

CONCLUSIONS

Planning and implementing WOHP was deemed acceptable and feasible in this study context and successfully achieved short-term impacts among community-aged care workers. Appropriate times and locations, organizational arrangements and a variety of delivery options contributed to successful programme planning and implementation.

Association between Participation in the Short Version of a Workplace Oral Health Promotion Program and Medical and Dental Care Expenditures in Japanese Workers: A Longitudinal Study

Studies suggest that intensive oral health promotion programs in the workplace reduce dental and medical care expenditures. The purpose of this longitudinal study was to evaluate the short version of an oral health promotion program in the workplace from the viewpoint of dental and medical care expenditures. Data for annual expenditures and number of days of dental, periodontal, and medical treatment in fiscal year 2018 and participation in the short version of a workplace oral health promotion program of 2545 workers (20–68 years old) in a company in fiscal year 2017 and prior were obtained. Zero-inflated negative binomial regression models or negative binomial regression models were used to evaluate the association between participation in the program and expenditures or number of days of treatment after adjusting for sex and age. Program participants were more likely than non-participants to visit dentists for dental and periodontal treatment. Those who participated twice or more spent less on dental, periodontal, and medical treatment and had fewer visits to dentists than non-participants. These results suggest that the short version of an oral health promotion program in the workplace decreases expenditures for dental, periodontal, and medical treatment.

[Pilot Project for Occupational Dental Prevention]

AIM OF THE STUDY

To investigate the feasibility and effectiveness of a low-threshold disease prevention offer in a pilot project for employees Methodology: Employees of a company working in office or on production (n=144; 90 women, 54 men) with an average age of 39.25 (StA 11.5) years were interviewed and clinically examined using a questionnaire on habits and knowledge in the prevention of dental diseases. The oral hygiene indices Papillae Bleeding Index (PBI) and the modified Approximal Plaque Index (mAPI) as well as exploratory depth measurements (STM) were collected. Subsequently, a training in dental disease prevention was carried out with a specially produced video as well as the provision of sugar-free chewing gum and mouthwash solutions for twice daily use for a period of one year. After one year, the questionnaire was again issued and the clinical parameters were collected. The study was approved by the UW/H Ethics Committee. Statistical analysis was carried out with SPSS 26.

RESULTS

85 patients with an average age of 39.23 (StD 11.3) years could be examined after one year (59 women, 26 men). The analysis of the questionnaire showed a significant improvement in oral health behavior. The corresponding total score improved from 10.68 (1.93) to 9.97 (1.60) (p<0.05). The PBI improved from 0.43 (0.40) to 0.31 (0.36) (p<0.05), the mAPI from 1.54 (0.51) to 1.35 (0.39) (p<0.01). The STM was reduced from 1.83 (0.39) to 1.56 (0.36) (p<0.001).

CONCLUSION

The dental disease prevention program for employees appears suitable for implementation at workplace and has shown significant improvements in oral health behavior as well as in clinical parameters.

Oral health in the context of prevention of absenteeism and presenteeism in the workplace

BACKGROUND

Oral health is an important factor of human morbidity worldwide. Yet is often neglected in occupational health despite its direct impact on the quality of life and health of workers.

OBJECTIVE

To discuss the role of oral health in sickness absence and presenteeism, as well as in development and work efficiency improvement processes involving governments, companies and the workers themselves.

METHODS

Review of full-text articles on oral health, occupational health, sickness absence and presenteeism published in English or Portuguese in the last 10 years and included in scientific databases.

RESULTS

Oral problems accounted for 9 to 27% cases of sickness absence and 28 to 50% of presenteeism, with toothache and temporomandibular joint pain as the most frequent reasons. About 50% of workers prefer company-provided dental care, while 40% visit public and 10% other types of facilities. Despite high, the prevalence of oral diseases and orofacial pain was not associated with high rates of absenteeism, but mainly with presenteeism, this is to say, workers do not tend to miss work days, but their performance is reduced and become susceptible to more serious health problems in the future.

CONCLUSION

Oral health is not dissociated from general and occupational health, and as such it must be enhanced and duly promoted in an integrated manner. Effective and comprehensive oral health promotion and prevention public policies and private sector actions in the workplace can enhance the quality of life of workers.

The relationship between return on investment and quality of study methodology in workplace health promotion programs

OBJECTIVE

To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs.

DATA SOURCE

Data were obtained through a systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus.

STUDY INCLUSION AND EXCLUSION CRITERIA

Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Return-to-work and workplace injury prevention studies were excluded.

DATA EXTRACTION

Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI.

DATA SYNTHESIS

ROI was calculated as ROI = (benefits - costs of program)/costs of program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences of quality score and important study characteristics on ROI were explored.

RESULTS

Fifty-one studies (61 intervention arms) published between 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r = .84-.93). Methodological quality improved over time. Overall weighted ROI [mean ± standard deviation (confidence interval)] was 1.38 ± 1.97 (1.38-1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI was found. High-quality studies (n = 18) had a smaller mean ROI, 0.26 ± 1.74 (.23-.30), compared to moderate (n = 16) 0.90 ± 1.25 (.90-.91) and low-quality (n = 27) 2.32 ± 2.14 (2.30-2.33) studies. Randomized control trials (RCTs) (n = 12) exhibited negative ROI, -0.22 ± 2.41(-.27 to -.16). Financial returns become increasingly positive across quasi-experimental, nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11-1.14), 1.61 ± 0.91 (1.56-1.65), and 2.05 ± 0.88 (2.04-2.06), respectively.

CONCLUSION

Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants.

Relationship between receiving a workplace oral health examination including oral health instruction and oral health status in the Japanese adult population

OBJECTIVES

Dental caries and periodontal disease are highly prevalent in the Japanese adult population. Oral examination is an effective method to find various oral health problems in their early stages. However, workplace oral examination is not common in Japan. The purpose of this study was to examine the relationship between receiving workplace oral health examination, including oral health instruction, and oral health status in the Japanese adult population.

METHODS

This study was performed using data from 4,484 Japanese employees aged 35-74 yr. The proportion of teeth with a probing depth (PD) ≥4 mm and the number of decayed teeth were used for periodontal disease and dental caries parameters. The subjects were asked by questionnaire about past experiences with workplace oral health examination.

RESULTS

The subjects who received a workplace oral health examination every year had better periodontal health status than those receiving an examination for the first time. The odds ratio for having ≥10% of teeth with PD ≥4 mm in the subjects who received workplace oral health examination every year was 0.63 (p<0.05) after adjustment for age, sex, smoking habits, tooth-brushing habits, routine visits to dental clinics, number of missing teeth, and oral hygiene status, in a multivariate, multinomial logistic regression analysis. On the other hand, no significant relationship was found between workplace oral health examination and number of decayed teeth.

CONCLUSIONS

These results suggest that workplace oral health examination accompanied by oral health instruction may be effective for maintenance of periodontal health.

Overview of methods in economic analyses of behavioral interventions to promote oral health

BACKGROUND

Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE.

OBJECTIVE

To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health.

METHODS

We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described.

DISCUSSION

Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.