Page 104 - JCTR-11-4

Journal of Clinical and

Translational Research

SPECIAL ISSUE ARTICLE
COVID-19 impact on school-based dental sealant

programs: De-implementation, re-implementation,
challenges, and adaptations

Eiman E. AlEissa* and Joseph A. Catania

Department of Health Promotion and Health Behavior, School of Nutrition and Public Health, College
of Health, Oregon State University, Corvallis, Oregon, United States of America
(This article belongs to the Special Issue: Challenges in Dental Public Health)

Abstract

Background: The COVID-19 crisis significantly affected school-based dental sealant
programs (SBDSPs). Nationwide mitigation efforts, including school closures, led to
the de-implementation of SBDSPs by default. Aims: We examined how COVID-19 crisis
management planning by SBDSPs, or lack thereof, influenced: (i) de-implementation-
related adaptations, (ii) re-implementation processes, (iii) workforce capacity required for
re-implementation, (iv) the role of organizational resources in early re-implementation,
*Corresponding author: and (v) overall school reach. Methods: We conducted an embedded multiple case study
Eiman E. AlEissa using a stratified random sample of organizations delivering SBDSPs in Oregon. Semi-
(e.e.aleissa@gmail.com) structured interviews were conducted with program personnel (n = 10) from the six
Citation: AlEissa EE, organizations. We performed quantitative (e.g., counts and percentages) and qualitative
Catania JA. COVID-19 impact (i.e., directed content analysis, within, and across case study analysis) analyses to
on school-based dental sealant identify crisis management efforts, de-implementation adaptations, re-implementation
programs: De-implementation,
re-implementation, challenges, timelines, and related challenges. Results: A universal absence of proactive crisis
and adaptations. J Clin Transl Res. management during SBDSP de-implementation was observed and resulted in
2025;11(4):98-112. challenges for re-implementation. SBDSPs initiated different adaptations (e.g., mobile
doi: 10.36922/jctr.24.00074
dental vans) to reach their targeted population. Re-implementation timeline varied (i.e.,
Received: November 27, 2024 partial, intermediate, and full) and followed different rates (i.e., full rapid, full gradual,
1st revised: February 19, 2025 and intermediate slow). Challenges with workforce capacity, organizational resources,
program policies, schools’ response, and inter-organizational communication influenced
2nd revised: May 14, 2025
re-implementation. Re-implementation occurred more rapidly for SBDSPs that: (i) formed
Accepted: May 21, 2025 “crisis management teams” and quickly rebuilt their workforce and (ii) operated within
Published online: June 13, 2025 well-sourced organizations that retained staff during de-implementation. However,
school responses and COVID-19-related policies often created complex approval
Copyright: © 2025 Author(s).
This is an Open-Access article systems that limited re-implementation and overall school reach. Results suggested
distributed under the terms of the that COVID-19 crisis management planning largely overlooked dental public health
Creative Commons AttributionNon- programs (i.e., SBDSPs). Conclusion: Public health and school-related organizations must
Commercial 4.0 International (CC
BY-NC 4.0), which permits all develop proactive crisis management plans that support the continuity of dental public
non-commercial use, distribution, health programs during the crises. Relevance for patients: School reach is foundational
and reproduction in any medium, to SBDSPs’ implementation processes. Addressing barriers to re-implementation during
provided the original work is
properly cited. crises is essential to ensure continued dental care access for the target population.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: School-based dental sealant programs; COVID-19 crisis; De-implementation;
regard to jurisdictional claims in
published maps and institutional Re-implementation; Dental public health; Implementation research
affiliations.

Volume 11 Issue 4 (2025) 98 doi: 10.36922/jctr.24.00074