Carlos Alberto dos Santos Treichel
Professor at the Department of Maternal-Child and Psychiatric Nursing, School of Nursing, University of São Paulo. Bachelor’s and Master’s degrees in Nursing from the Federal University of Pelotas and a PhD in Collective Health with a focus on Policy, Planning, and Management from the State University of Campinas. Engaged in Postdoctoral activities at the Department of Collective Health, State University of Campinas (PD-FAPESP Fellow) from 2021 to 2023, and conducted Research Interships abroad as a visiting research student at the Centre for Implementation Science (CIS) at King’s College London through the CAPES PrInt and BEPE FAPESP programs in 2019 and 2021. In recent years, has dedicated their work to the study of the implementation of mental health public policies, with a focus on efforts to integrate specialized services and primary care. Their main areas of research include Implementation Research, Service Evaluation, Collaborative Care, Psychosocial Rehabilitation, Mental Health in the workplace, and the Impact of Care on families of individuals with mental disorders.
Established in 2007, the Programa de Saúde na Escola/ School Health Program (PSE) aims to contribute to the comprehensive education of Brazilian students in the public school system through health promotion, prevention and care . Among the actions included in the program, are those aimed at improving oral health conditions through the participation of dentists in activities such as health education, topical application of fluoride, atraumatic restorative treatment (ART) and supervised brushing . Although it presents favourable results, the implementation of the oral health component within the scope of the program is still low in several regions of the country. The objective of this study was to identify the challenges for promoting oral health in the School Health Program.
We conducted an integrative literature review in PubMed (Publisher Medline) and SciELO (Scientific Electronic Library Online) databases. The search took place between February and March 2022 and tracked studies published between 2007 and 2022 using the descriptors: Programa de Saúde na Escola; PSE; School Health Services; Dentistry; Dental surgeon; Dentist; Oral Health Promotion; Oral health; Preventive Dentistry. We categorized the identified challenges based on the Consolidated Framework for Implementation Research (CFIR) . For this categorization, we used Minayo’s thematic categorical content analysis model .
Challenges related to the internal context were the most frequent, with emphasis on those related to relationship and communication networks, and readiness for implementation. Among the most repeated challenges were the low promotion of intersectoriality and the lack of materials and adequate structure to carry out the program’s activities.
Despite a political definition at the national level, the lack of local preparation for organizing and maintaining program activities is an obstacle to promoting oral health through the program, thus demanding the use of implementation strategies to ensure its effectiveness and sustainability.