PROSPER-OH: A Standardized Toolkit for Adapting, Implementing, and Evaluating Community Preventive Oral-Health Programs in Underserved Settings

PROSPER-OH (Preventive Oral-health Standardization, Program-Evaluation & Replication Toolkit) is an open, non-clinical toolkit that standardizes how a community preventive oral-health program is assessed for context readiness, adapted, implemented with fidelity, and, above all, measured in a replicable, equity-stratified way across sites. Background. Community preventive oral-health programs (collective and topical fluoride, supervised toothbrushing, school and community education, and population epidemiological surveys) can reduce oral-disease burden in underserved settings, but their comparability, fidelity, and replicability across sites are rarely standardized. Untreated oral disease remains a large population burden (an estimated US$45.9 billion in lost productivity in 2015, NIDCR/NIH), and need is concentrated in officially designated underserved areas (7,702 Dental Health Professional Shortage Area designations covering 70,612,204 people, with 33.51% of need met, HRSA, as of 31 March 2026). What this deposit contains. The main toolkit document (Version 1.0), plus two annexes: Annex A (ready-to-use program forms) and Annex B (trilingual Portuguese/Spanish/English educational materials for community delivery). Each is provided in PDF format; Annex A is additionally provided as a fillable PDF with interactive form fields for direct on-screen data entry. Structure. PROSPER-OH operationalizes two established implementation-science frameworks, the Consolidated Framework for Implementation Research (CFIR; context and readiness) and RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance), into seven modules (M1-M7) and two non-core add-ons (D1-D2). Its distinctive component is a standardized Core Indicator Set of 24 program-level indicators with mandatory equity stratification (geography, socioeconomic status, age band, and language need) and a trilingual codebook, combined with a 0-100 Program Quality Scorecard that places a program on a four-level maturity ladder and aligns reporting fields to federal program metrics (HRSA, CDC, Medicaid/EPSDT, Healthy People 2030). Scope. Every instrument is de-identified and aggregate by design: the toolkit operates on programs and populations, never on individual patients, and performs no diagnosis, screening, individual-risk determination, or clinical act. An illustrative, explicitly synthetic state-level walkthrough demonstrates how the modules chain together in an officially designated underserved context. Status. PROSPER-OH provides an author-independent measurement and implementation architecture designed to support replication across settings. It is released openly for replication and feedback and has not yet been empirically validated. Companion publication. A methodological technical report describing this toolkit has been prepared for peer-reviewed publication (Cureus, Technical Report article type); its citation and DOI will be added to this record once published. Use of generative AI. Generative artificial intelligence tools were used to assist in organizing, drafting, and formatting this document. The author reviewed, verified, and takes full responsibility for its accuracy, integrity, and content. No generative AI tool is listed as an author or contributor.