Page 107 - JCTR-11-4

Journal of Clinical and
Translational Research COVID-19 impact on SBDSPs

participate in the study. Initial contacts were made through pandemic, and the number of schools each SBDSP was
the SDBSP directors within each organization to obtain able to re-implement its services at were asked to measure
basic information about the organization and program each SBDSP’s school reach. The full interview protocol is
(e.g., organization type, SBDSP service area, and number available from the first author.
of SBDSP personnel), identify program supervisor/
manager (if different than director) and dental hygienists, 2.4. Data management and analysis
and request permission to contact program personnel. All interviews were audio-recorded, transcribed, and
SBDSP personnel were then contacted by telephone or compared to the original audio recordings for accuracy.
email to explain the study, answer prospective participants’ The transcripts were reviewed for content, annotated,
questions, and schedule interviews for those who agreed to and de-identified. Data were organized by organization
participate. The participants were not reimbursed for their and personnel within an organization. Data analysis was
participation. We conducted semi-structured telephone conducted using directed (i.e., deductive) content analysis
interviews with each participant. All interviews were informed by our prior research. 15,54 Quantitative data
conducted in English, audio-recorded with participants’ analysis involved counts, sums, averages, percentages of
permission, lasted 1 – 3 h, and transcribed by the first workforce capacity, and de-implementation timelines
author. All interviews were de-identified during the in months. Qualitative data analysis involved initial case
transcription process. coding (i.e., structural, descriptive, categorical, and causal
coding) to categorize and identify the causal inferences
2.3. Interview measures
of major content areas (i.e., workforce capacity, crisis
Interview protocols were developed by the authors and management planning, adaptations to de-implementation,
were informed by our pre-COVID-19 study, which was re-implementation timelines, and challenges and
conducted to understand the implementation processes, adaptations related to school re-engagement for each
challenges, and adaptations of SBDSPs under the normal case). 57,58 A codebook with operational and conceptual
conditions. The interview protocols were developed to code definitions was developed and updated throughout
15
elicit responses about each organization’s experience with the coding process. All the codes were reviewed for
SBDSPs during the COVID-19 crisis and were tailored reliability, and consensus was achieved on discrepancies
to the participants’ roles in the program. The interview through group discussion by two independent coders.
obtained background data (e.g., demographics, training Case study templates were then developed to guide
histories, and employment histories), as well as the type case report construction, which facilitated within- and
of program de-implementation (total disruption or between-case analysis, followed by inter-case comparative
suspension of all program services), related adaptations, analysis. The study design and analytical approach utilized
and crisis management planning (i.e., establishing a key facilitated across-case analysis, enabling the identification
informant committee, planning processes, planning of patterns of variables both within and between cases,
decisions and actions, written guidance, and expert which may support replication logic. 56,59 Using replication
consultants). It also covered re-implementation timelines logic and across-case analysis, we assessed consistencies
(the time between school closure and re-implementation and inconsistencies across cases, thereby enhancing
and the de-implementation phase) and processes, the findings’ analytical generalizability. Furthermore,
workforce capacity (i.e., staff size, turnover, and rebuilding), the number of case replications is associated with the
and organizational resources during the COVID-19 crisis level of confidence in the study findings. Therefore, the
and how these factors differ compared to before the onset current study maintained a minimum of five cases as
of the crisis. Table 1 provides the examples of the content recommended. 54
area assessed and corresponding interview questions.

Quantitative questions about the re-implementation 3. Results
processes, timelines, and number of schools and students
served were also assessed. The following questions were 3.1. Organizational and participant characteristics
asked to evaluate the program’s experience during the Six organizations delivering SBDSPs in Oregon participated
COVID-19 crisis: “When did you stop delivering the in the study. Table 2 summarizes each organization’s
program?” “After your program was shut down, when characteristics. SBDSPs in Oregon were more frequently
did you start contacting schools again?,” “When did you provided by FHQCs (n = 4) and infrequently by non-profit
reopen the program in the schools?,” and “Since the schools (n = 1) and for-profit/privately owned (n = 1) organizations.
reopened, how many schools have you served?.” Specific We collected the data from 10 participants (≥18 years of age)
questions about the number of schools served before the from the six organizations under the study. This includes

Volume 11 Issue 4 (2025) 101 doi: 10.36922/jctr.24.00074