"Got to build that trust": the perspectives and experiences of Aboriginal health staff on maternal oral health.


Journal

International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692

Informations de publication

Date de publication:
23 10 2020
Historique:
received: 01 01 2020
accepted: 14 10 2020
entrez: 24 10 2020
pubmed: 25 10 2020
medline: 30 4 2021
Statut: epublish

Résumé

In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.

Sections du résumé

BACKGROUND
In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy.
METHODS
A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia.
RESULTS
A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care.
CONCLUSIONS
The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.

Identifiants

pubmed: 33097061
doi: 10.1186/s12939-020-01301-5
pii: 10.1186/s12939-020-01301-5
pmc: PMC7585174
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

187

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Auteurs

Ariana C Kong (AC)

Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170, NSW, Australia. Ariana.kong@westernsydney.edu.au.

Mariana S Sousa (MS)

IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, 2007, NSW, Australia.

Lucie Ramjan (L)

Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170, NSW, Australia.
Translational Health Research Institute, Campbelltown, 2560, NSW, Australia.

Michelle Dickson (M)

Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006, NSW, Australia.

Joanne Goulding (J)

Primary and Community Services, South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.

Kylie Gwynne (K)

Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, 2109, NSW, Australia.

Folau Talbot (F)

Faculty of Medicine and Health, University of Sydney, Camperdown, 2006, NSW, Australia.

Nathan Jones (N)

Aboriginal Health Unit, South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.

Ravi Srinivas (R)

Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170, NSW, Australia.
Oral Health Services, South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.
School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006, NSW, Australia.

Ajesh George (A)

Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170, NSW, Australia.
Translational Health Research Institute, Campbelltown, 2560, NSW, Australia.
School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006, NSW, Australia.

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