"Seniors only want respect": designing an oral health program for older adults

Where Are All the Men? A Qualitative Review of the Barriers, Facilitators, and Recommendations to Older Male Participation in Health Promotion Interventions

OBJECTIVE

Older men have lower participation rates than females in health promotion interventions. We conducted a qualitative review of 20 years of existing research across a variety of academic search databases to outline the barriers, facilitators, and recommendations for this imbalance.

DATA SOURCE

A systematic search was conducted across Google Scholar, PubMed, MEDLINE, CINAHL, Academic Search Premier, Psychology and Behavioral Sciences Collection, and Web of Science from dates January 1, 2000 - December 31, 2020.

STUDY INCLUSION AND EXCLUSION CRITERIA

Abstracts were screened based on: original research, English language, recruitment or participation, health promotion or health program, and male gender.

DATA EXTRACTION

Of 1194 initial search results, 383 article abstracts were thoroughly screened for inclusion and 26 articles met inclusion criteria.

SYNTHESIS

Included studies were coded and analyzed using Grounded Theory.

RESULTS

Barriers included masculine gender roles as well as program scope, environment, and gender of the instructors and other participants. Facilitators included creating social groups of older males that participate in a variety of activities together, including hobbies and health promotion, over a long period of time.

CONCLUSION

Health promotion interventions should involve men in all aspects of program planning and implementation, take into account men's existing relationships and interests to create gender-sensitive programming, and clearly delineate the benefits to participation.

Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature

There is currently no global review of the conceptual literature on the equity of healthcare coverage (including access) for older people. It is important to understand the factors affecting access to health and social care for this group, so that policy and service actions can be taken to reduce potential inequities. A scoping review of published and grey literature was conducted with the aim of summarising how health and social care service access and coverage for older people has been conceptualised. PubMed, MEDLINE, PsycINFO, CINAHL, Web of Science, SciELO, LILACS, BIREME and Global Index Medicus were searched. Selection of sources and data charting were conducted independently by two reviewers. The database searches retrieved 10 517 citations; 32 relevant articles were identified for inclusion from a global evidence base. Data were summarised and a meta-framework and model produced listing concepts specific to equitable health and social care service coverage relating to older people. The meta-framework identified the following relevant factors: acceptability, affordability, appropriateness, availability and resources, awareness, capacity for decision-making, need, personal social and cultural circumstances, physical accessibility. This scoping review is relevant to the development and specification of policy for older people. It conceptualises those factors, such as acceptability and affordability, that affect an older person's ability and capacity to access integrated, person-centred health and social care services in a meaningful way. These factors should be taken into account when seeking to determine whether equity in service use or access is being achieved for older people.

Disparities in Access to Oral Health Care

In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.