Preventive Oral-Health Standardization, Program-Evaluation and Replication Toolkit (PROSPER-OH): A Standardized, Non-clinical Toolkit for Adapting, Implementing, and Evaluating Community Preventive Oral-Health Programs in Underserved Settings

Community preventive oral-health programs (collective and topical fluoride, supervised toothbrushing, school-based dental sealant programs, and community education) have an established evidence base for caries prevention, yet their adaptation, delivery fidelity, and measurement are rarely standardized across sites. This limits comparability, replicability, and equity accountability, especially in underserved settings where oral-disease burden is concentrated. This report describes Preventive Oral-health Standardization, Program-Evaluation and Replication Toolkit (PROSPER-OH), an open, non-clinical toolkit that standardizes how a community preventive oral-health program is assessed for context readiness, adapted, delivered with fidelity, and, above all, measured in a replicable, equity-stratified way. PROSPER-OH operationalizes two established implementation - science frameworks, the Consolidated Framework for Implementation Research (CFIR; context and readiness) and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM; the measurement and continuity layers), into five core modules, two extension modules, and two non-core add-ons. 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 Portuguese/Spanish/English 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 (Health Resources and Services Administration, Centers for Disease Control and Prevention, Medicaid/Early and Periodic Screening, Diagnostic and Treatment, and Healthy People 2030). Every instrument is de-identified and aggregated 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. 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.