Voices From the Field: Interview with Katrina Holt

Promoting a Healthy Smile for Young Children

Katrina Holt

Katrina Holt is the director of the National Maternal and Child Oral Health Resource Center where she works to improve oral health services for pregnant women, infants, children, and adolescents, including those with special health care needs, and their families. The center collaborates with federal agencies and professional organizations to provide technical assistance, training and resources.

How did you begin your career in early childhood?

My career working in early childhood began in public health settings, including health departments, community and refugee clinics, shelters for battered women and their children, and other community-based programs that provided health care to children. I also worked part-time as a dietitian in Women, Infant, and Children (WIC) clinics conducting nutrition risk assessments and providing nutrition education to pregnant women and parents of children, and as a Head Start nutrition consultant providing training and technical assistance to Head Start program staff. Working in community-based programs focusing on the prevention and early intervention of disease and the promotion of health solidified my commitment to serving the early childhood population.

What efforts have you been involved in to improve the quality of early childhood programs and services?

Since 1998, I’ve been director of the National Maternal and Child Oral Health Resource Center (OHRC) at Georgetown University, where I oversee projects supported by government agencies and foundations. Currently I’m working on a project funded by the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), and a project funded by the Office of Head Start. These projects promote oral health for pregnant women, children, and adolescents, especially those from families with low incomes and from vulnerable populations such as children with special health care needs. To do this work, the resource center collaborates with government agencies, professional associations, and foundations to share information and resources and support projects focused on improving access to and use of oral health care. 

An example of my efforts to improve the quality of oral health care for children is helping to plan and convene a national conference, Building Partnerships to Improve Children’s Access to Medicaid Oral Health Services, supported by the Centers for Medicare & Medicaid and MCHB, HRSA. The conference brought together national and state leaders and stakeholders in dentistry, Medicaid, maternal and child health, and public health to identify ways to enhance access to oral health care for children enrolled in Medicaid.

What are some challenges you have experienced in your work and what strategies have you tried to overcome them?

At both state and local levels, health programs are facing budgetary and personnel shortages due to the COVID-19 pandemic, with some staff furloughed and others redirected to focus on COVID-19 efforts. As a result, some programs that provide preventive oral health care to children have been put on hold, and health program staff are encountering individuals with competing health needs and low health literacy.

In response to the COVID-19 pandemic, information is constantly emerging on preventing transmission of the virus in settings where oral health care is provided. The virus is disproportionately affecting vulnerable populations and impacting their trust in and ability to access preventive oral health care, exacerbating existing oral health disparities. In response, OHRC has developed a webpage, Oral Health Resources in Response to COVID-19, to provide access to key resources that communicate recommendations and guidance from federal agencies and national organizations and to direct individuals to state dental directors for information about COVID-19 and oral health care in their state.

In addition, consistent health messaging is necessary to ensure that professionals and parents have the information they need to make decisions and engage in actions to maintain or improve oral health and overall health. OHRC has produced educational resources with accurate, consistent, simple messages for professionals and parents. Many resources for families are available in Spanish and some in other non-English languages (e.g., Arabic, Chinese, Chuukese, German, Korean, Portuguese, Russian, Samoan, Tagalog, Vietnamese), and many are written to accommodate low literacy levels.

What suggestions do you have for others interested in improving early childhood services and programs?

It’s essential to involve families and community members in the design and implementation of early childhood services and programs to improve oral health and overall health for children and their families. Doing this acknowledges the wealth of experience, knowledge, and skills of families and community members, sparks their interest, and encourages their engagement. Working in collaboration with families and community members has many benefits, including synergy (the whole is bigger than the sum of each part), sharing resources, and overcoming obstacles. Collaboration is also essential for providing customized care for each child.

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