Page 114 - JCTR-11-4

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

that preparedness gaps, particularly those related to such as SBDSPs. Because most crisis planning focuses
workforce planning, were not uniformly distributed inward on the direct functions of the school system, it often
across organizations, disproportionately affecting smaller, neglects the complex web of services embedded within
community-based providers. the school infrastructure. Further research is needed on
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Workforce disruption, in turn, negatively affected strategies for developing crisis management programming
school re-engagement and ultimately reduced school reach for adjacent programs, particularly those requiring inter-
organizational cooperation to fully implement the program.
by delaying the return to full re-implementation. High
turnover and insufficient staff size were associated with poor 4.4. Program-related recommendations
school re-engagement, delays in full re-implementation,
and limitations in school reach (i.e., reducing the number The present study provides data that suggest a number
of schools served and, consequently, reducing the number of practical solutions to what appeared to be relatively
of students reached). We have found a relationship between common challenges for the SBDSPschool system during
the quality of school engagement and school reach under the COVID-19 crisis. First, establish crisis management
non-crisis conditions, indicating the importance of teams that develop crisis management plans for various
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workforce capacity to a wide range of implementation and potential crises. Second, a crisis management plan should
re-implementation outcomes. These findings reinforce the be developed that considers strategies to deal with various
interdependency between workforce maintenance and challenges (e.g., workforce capacity, internal mitigation
external engagement, particularly in community-based strategies, and mitigation strategies imposed by external
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programs, such as SBDSPs, that rely on repeated, trust- organizations). Third, conduct an after-action review
based interactions between school and program personnel. to review and evaluate SBDSP’s response to the crisis (e.g.,
challenges, successes, and changes needed) and make
The workforce impact of the COVID-19 pandemic was corrections for future efforts. Lastly, a larger systemic-level
not specific to the six programs in the current study. Data recommendation is to include adjacent programs in the
have been reported showing a pervasive disruption of the Department of Public Health (DPH) crisis management.
dental hygiene workforce due to various COVID-19 crisis- Adjacent programs, such as SBDSPs, need to begin
related factors. These types of crisis-related outcomes serve interacting with the DPH to make them aware of how the
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as an important reminder of the need to implement crisis imposed mitigation strategies impacted their functioning
management in advance of any potential crisis. Beyond and jeopardized oral health services. The DPH should be
COVID-19, these insights are increasingly relevant given able to provide guidance and potentially expert consultants
the growing frequency of large-scale crises, such as extreme to adjacent programs to aid in developing their crisis
weather events or regional public health emergencies, that management teams and plans.
can similarly destabilize local health and social service
systems. Programs need crisis management plans to address 5. Limitations
workforce capacity disruptions during crises. The current study has some methodological limitations.
Furthermore, clear and consistent inter-organizational First, our findings are based on a sample of SBDSPs
communication between the school systems and SBDSP is in the state of Oregon, and consequently, have limited
critical for successful implementation. Our findings illustrate generalizability beyond SBDSPs in Oregon. In addition,
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how inter-organizational communication disruption can the study is primarily qualitative; thus, we cannot estimate
significantly hinder timely re-implementation during a the relative impact of those variables identified. Finally, the
crisis. The variability in school key informants and policy data are based on the retrospective self-reports of unknown
interpretations contributed to inconsistencies in access to validity and are subject to potential recall bias.
schools, even when SBDSPs were otherwise ready to resume
services. Proactive crisis management planning would be 6. Conclusion
expected to help the SBDSPs and the schools cope with this Although all SBDSPs in the study experienced
disruption. However, we found multiple cases where this de-implementation due to the COVID-19 crisis, there
type of crisis management did not occur. We suspect that the were distinct variations in their re-implementation
absence of communication between the crisis management patterns and rates. Partial re-implementation, for instance,
components of the SBDSPs and the schools contributed was delivered by three SBDSPs out of six and involved
to inter-organizational communication challenges and crisis-related adaptations of unknown fidelity. Crisis-
delayed re-implementation. This gap points to a broader related adaptations and re-implementation efforts were
issue in crisis preparedness: The lack of integrated crisis influenced by organizational resources, workforce capacity,
communication protocols that include adjacent programs school response, COVID-19 policies, inter-organizational

Volume 11 Issue 4 (2025) 108 doi: 10.36922/jctr.24.00074