Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of midwives in Greater Western Sydney,Australia |
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| Authors: | Hannah G Dahlen Maree Johnson Julia Hoolsema Tiffany Patterson Norrie Shilpi Ajwani Anthony Blinkhorn Sameer Bhole Sharon Ellis Ravi Srinivas Albert Yaacoub Andrew Milat John Skinner Ajesh George |
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| Institution: | 1. School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta 2150, Australia;2. Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney 2060, Australia;3. Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool 1871, Australia;4. COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool 1871, Australia;5. Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney Research, Sydney 2010, Australia;6. Faculty of Dentistry, University of Sydney, Sydney, 2006, Australia;7. Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney Research, Sydney 2010, Australia;8. Camden and Campbelltown Hospitals, South Western Sydney Local Health District, 2170, Australia;9. South Western Sydney Local Health District Oral Health Services, COHORT, Western Sydney University, University of Sydney, Ingham Institute Applied Medical Research, Liverpool, Australia;10. Nepean Blue Mountains Local Health District Oral Health Services, Penrith, Australia;11. Centre for Epidemiology and Evidence, NSW Ministry of Health, University of Sydney, Australia;12. Faculty of Dentistry, University of Sydney, Sydney, 2006, Australia;13. COHORT, Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool 1871, Australia |
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| Abstract: | BackgroundDespite links between poor maternal oral health, adverse pregnancy outcomes and early childhood decay there is limited emphasis on maternal oral health in Australia. To address this, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in collaboration with the Australian College of Midwives.AimsTo undertake a process evaluation and explore perceptions of midwives involved in the MIOH-DS program to determine its practicability, acceptability and feasibility if it were to be up-scaled and implemented into clinical practice.MethodsQualitative content analysis was undertaken on data from three focus groups with 21 midwives.FindingsMidwives generally found the MIOH-DS to be acceptable and feasible with potential for widespread scalability. The trust women had in midwives was an important factor in gaining women’s attention about oral health in pregnancy. The program assisted in increasing midwives’ knowledge and awareness, though some felt it was outside their scope of practice. The oral health assessment tool was acceptable to midwives but some concerns were expressed about undertaking a visual oral inspection. Most midwives stated they were now confident with referring individuals to a dentist. Significant barriers to widespread implementation included the cost of dental care and the continued lack of awareness and misconceptions pregnant women had towards oral health.ConclusionMidwives found the MIOH-DS to be acceptable and feasible which are two important barriers to potential implementation at scale. Misconceptions over the importance of oral health by women and cost of accessing dental services still need resolving. |
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| Keywords: | Dental care Midwifery Pregnancy Oral health Process evaluation |
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