"What are we doing to our babies' teeth?" Barriers to establishing oral health practices for Indigenous children in South Australia

Socioeconomic inequalities in the use of dental health care among the adult population in Serbia

Objectives

The aim of this paper is to assess the association of demografic and socioeconomic determinants with utilization of dental services among Serbian adults.

Materials and methods

The study is a part of the population health research of Serbia, conducted in the period from October to December 2019 by the Institute of Statistics of the Republic of Serbia in cooperation with the Institute of Public Health of Serbia "Dr. Milan JovanovićBatut" and the Ministry of Health of the Republic of Serbia. The research was conducted as a descriptive, cross-sectional analytical study on a representative sample of the population of Serbia. For the purposes of this study, data on the adult population aged 20 years and older were used.

Results

Men were approximately 1.8 times more likely than women to not utilize dental healthcare services (OR = 1.81). The likelihood of not utilizing dental healthcare protection rises with increasing age, reaching its peak within the 65-74 age range (OR = 0.441), after which it declines. Individuals who have experienced marital dissolution due to divorce or the death of a spouse exhibit a higher probability of not utilizing health protection (OR = 1.868). As the level of education and wealth diminishes, the probability of abstaining from health protection increases by 5.8 times among respondents with an elementary school education (OR = 5.852) and 1.7 times among the most economically disadvantaged respondents (OR = 1.745). Regarding inactivity, respondents who are not employed have a 2.6-fold higher likelihood of not utilizing oral health care compared to employed respondents (OR = 2.610).

Conclusion

The results suggest that individual sociodemographic factors influence utilization of dental services by Serbian adults and confirmed the existence of socioeconomic disparities.

Building an understanding of Indigenous Health Workers' role in oral health: A qualitative systematic review

OBJECTIVES

Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitative systematic review aimed to build an understanding of IHW insights on oral health.

METHODS

Two independent reviewers searched PubMed, EMBASE, Web of Science and Scopus using a pre-established search strategy. Qualitative studies that included IHW illustrations about oral health were considered. The search was not limited by geographic setting. Included articles were critically appraised with the Joanna Briggs Institute appraisal tool for qualitative studies.

RESULTS

The search identified 1856 articles eligible for inclusion; a total of 10 articles were included. Four synthesized findings were identified during the meta-aggregation: oral health challenges in community, systemic barriers limiting IHW ability to support oral health, benefits of IHW involvement in oral health and avenues to increase IHW involvement in oral health.

CONCLUSION

The prioritization of Indigenous leadership in oral health has the potential to address many of the current challenges Indigenous communities face. Future works need to determine the capacity of IHW to provide oral health care and explore opportunities to create specific oral health roles for IHW.

Maximizing Oral Health Outcomes of Aboriginal and Torres Strait Islander People With End-stage Kidney Disease Through Culturally Secure Partnerships: Protocol for a Mixed Methods Study

BACKGROUND

Dialysis for end-stage kidney disease (ESKD) is the leading cause of hospitalization among Aboriginal and Torres Strait Islander individuals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving kidney transplant.

OBJECTIVE

This study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD in South Australia through the following objectives: investigate the facilitators of and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia; investigate the facilitators of and barriers to maintaining oral health among Aboriginal and Torres Strait Islander people with ESKD in South Australia; facilitate access to and completion of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD and their families; provide oral health promotion training for Aboriginal health workers (AHWs) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD; generate co-designed strategies to better facilitate access to and provision of culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD; and evaluate participant progress and AHW oral health training program.

METHODS

This collaborative study is divided into 3 phases: exploratory phase (baseline), intervention phase (baseline), and evaluation phase (after 6 months). The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care; the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops; and the evaluation phase will involve 6-month follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training.

RESULTS

Stakeholder interviews were initiated in November 2021, and participant recruitment commenced in February 2022. The first results are expected to be submitted for publication in December 2022.

CONCLUSIONS

Expected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges regarding oral health for individuals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant-identified and stakeholder-identified challenges to ensure accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander individuals with ESKD.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/39685.

Strategies to Support Sustained Participant Engagement in an Oral Health Promotion Study for Indigenous Children and Their Families in Australia

The health inequities of Indigenous peoples compared with non-Indigenous peoples are significant and long-standing across many countries. Colonisation and dispossession of land and culture has led to profound and devastating consequences on the health of Indigenous peoples. A lack of trust and cultural security of health services remains a barrier to participation in health care services. Similarly, engagement in research activities is also hindered by a history of unethical research practices. Creating partnerships between researchers and Indigenous communities is key in developing research studies that are culturally appropriate, acceptable and relevant to the needs of Indigenous peoples. Baby Teeth Talk was a randomised controlled trial conducted with Indigenous children and their mothers in South Australia that tested an intervention involving dental care, anticipatory guidance on oral health and dietary intake, and motivational interviewing. The study was developed in consultation and partnership with local Indigenous communities in South Australia and overseen by the study’s Aboriginal reference group. The recruitment and retention of participants in the study has been strong over numerous waves of follow-up. The purpose of this paper is to describe the strategies employed in the study that contributed to the successful and sustained engagement of the participants. These strategies included the establishment of an Aboriginal reference group, building relationships with organisations and community, flexibility of appointment scheduling and allocating adequate time, reimbursement for participant time, developing rapport with participants, encouraging participant self-determination, and adaptation of dietary data collection to better suit participants.

Walking together: Relational Yarning as a mechanism to ensure meaningful and ethical Indigenous oral health research in Australia

OBJECTIVE

Despite the colonial roots and modern presence of systemic racism within academic institutions, Indigenous researchers have successfully led a change in expectations of what constitutes 'good' research with Indigenous Communities. From a mixed Indigenous and non-Indigenous research perspective, this paper explores the processes that enable meaningful and ethical Indigenous oral health research.

METHODS

This paper utilises Yarning as its methodology to capture our research process and identify our core values. The idea for this paper was a result of social and collaborative yarns, which were used as the framework for a final research topic yarn.

RESULTS

We propose Relational Yarning as a mechanism to ensure the prioritisation of six core values in our research approach: respect, relationships, advocacy, reciprocity, time and gratitude.

CONCLUSIONS

We argue that these values are not only essential at the individual or team level but must extend to all institutions in which Indigenous research operates. Therefore, academic institutions, funding bodies and academic journals are compelled to mandate policies that disrupt patterns of symbolic violence and eliminate institutional racism.

IMPLICATIONS FOR PUBLIC HEALTH

Our framework provides an opportunity for all researchers engaging with Indigenous Communities to facilitate meaningful and ethical research and prioritise culturally secure research environments.