Exploring child dental service use among migrant families in metropolitan Melbourne, Australia (original) (raw)
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Community dental health, 2016
UNLABELLED Early Childhood Caries (ECC) is the most common, preventable disease of childhood. It can affect children's health and wellbeing and children from migrant families may be at greater risk of developing ECC. OBJECTIVE To describe ECC in children from migrant families, and explore possible influences. BASIC RESEARCH DESIGN Cross-sectional analysis of caries data collected as baseline data for an oral health promotion study. PARTICIPANTS The analysis sample included 630 1-4 year-old children clustered within 481 Iraqi, Lebanese and Pakistani families in Melbourne, Australia. METHOD Child participants received a community-based visual dental examination. Parents completed a self-administered questionnaire on demographics, ethnicity, and oral health knowledge, behaviour and attitudes. MAIN OUTCOME MEASURE Child caries experience. Bivariate associations between oral health behaviours and ethnicity were tested for significance using chi-square. Multivariate logistic regressio...
Ethnicity & Health, 2014
Objective. Australia is an increasingly multicultural nation. Never before has the dental workforce been exposed to such language, cultural, religious and ethnic diversity. There is evidence that refugee and migrant children experience significantly poorer oral health than the nonmigrant population. However, little is known about the oral health knowledge, practices and beliefs of parents with young children from refugee and migrant backgrounds. The aim of this study was to identify the sociocultural influences on child oral health in these communities. Design. Participatory and qualitative research methods were utilised. Partnerships were established with community agencies representing migrants from Iraq, Lebanon and Pakistan. Focus group discussions and semi-structured interviews were conducted with community members. Qualitative data were analysed thematically, combining focus group and interview data. Results. Over 100 women participated in focus groups (n = 11) and semi-structured interviews (n = 7). Key findings included the knowledge, beliefs and practices concerning: caries risk factors, oral health practices and oral health literacy. Despite mothers' knowledge of the major causes of poor oral healthdietary changes, confusion about child oral hygiene practices and limited oral health literacy all influenced child oral health outcomes. Conclusion. This culturally competent qualitative study explores the sociocultural factors influencing child oral health in refugee and migrant communities. Understanding and acknowledging these factors are a prerequisite to determining where and how to intervene to improve oral health. Furthermore, it has implications for both dental and non-dental health professionals working to reduce health inequalities within such communities.
Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia
BMJ open, 2015
The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. Significant differences in the Debris Inde...
Research Square (Research Square), 2022
Background The purpose of the study was to explore, analyse, and describe the patterns of public dental services utilisation among the refugee populations in Victoria, Australia, and determine their predictors at the individual and contextual levels. Methods Data on the refugees who attended Victorian public dental services between July 2016 to June 2020 was gathered from the Dental Health Program dataset. Latent pro le analysis was used to identify discrete groups among the refugee clientele with similar mean utilisation patterns across six indicator variables describing the attributes of dental services received and the site of care provision, over the study period. Multilevel multinomial logistic regression analysis was performed to examine the individual and contextual level correlates of the identi ed utilisation patterns. Results Six distinct pro les of public dental service utilisation were identi ed among the study population (n = 25542). The largest group comprised refugees predominantly using restorative services under general course of care (38.10%), followed by extraction services under emergency course of care (23.50%). Only a small proportion were estimated as having a higher mean utilisation of preventive services under general course of care (9.10%). Multilevel analysis revealed that the following variables had a signi cant association with refugee utilisation pattern: at the individual-level-demographic and ethnic attributes including age, gender, region of birth, preferred language for communication, use of language interpreter services, and type of eligibility card; at the contextuallevel-characteristics of refugees' area of residence including urbanicity, area-based socioeconomic disadvantage, delivery of Refugee Health Program at the community health centres, and spatial accessibility to public dental services via driving and public transit modes of travel. Conclusions The study represents a signi cant step towards the development of an evidence-based knowledge around public dental service utilisation among Victorian refugees. Overall, the study ndings reiterate the critical need for targeted strategies to promote the importance of routine dental visits, oral disease prevention, and timely intervention among refugee groups. Background Poor oral health is considered a major burden among the resettled refugee population around the world [1]. This can be attributed to a myriad of past traumatic experiences in their home country, compounded by the challenges related to resettlement in the host country. In Australia, refugees have been shown to demonstrate higher rates of dental caries and periodontal disease compared to the general population [2-4]. This is also acknowledged in the most recent National Oral Health Plan of Australia, 2015-2024 [5], which identi es refugees as a vulnerable group. Timely use of appropriate dental services would contribute to promoting oral health of refugees by providing diagnosis, prevention, and treatment of oral diseases. In Australia, the Commonwealth government entitles all humanitarian migrants, including refugees, eligibility to access universal healthcare. However, dental services are not included in this. Recognising the vulnerability of the refugee group, the Department of Health and Human Services in the state of Victoria, extended the eligibility for public dental services (PDS) to refugees and asylum seekers [6]. Furthermore, to overcome the frequently noted barriers such as long waiting times and nancial constraints, additional policies were introduced to provide refugee populations with 'priority access,' where they are accommodated in the next available appointment without being placed on a waiting list, and fee exemption for all services [6]. Despite these measures, data from a 2016 audit suggests limited participation rates among refugees within the Victorian public dental system; approximately 17% of Victorian refugees attended PDS in 2015-16 [7]. Little is known about the characteristics of, and factors associated with dental service utilisation among refugees in Australia, in general, and in Victoria, in particular. Dental service use is considered an important indicator of dental health-related behaviour [8]. Understanding the pattern of PDS use among the refugee populations provides a valuable insight into their access to dental care; for example, whether their pattern of use comprise routine checkups and preventive care or is it primarily for the treatment of existing dental problems. It is also critical to analyse the nature of services received by refugees when visiting a dental service provider (e.g., routine checkup , preventive services or specialist treatment) to identify disparities in the utilisation of particular types of services, investigate problems associated with access to these services, and further examine factors determining their utilisation behaviour. Together, these inform the development of targeted strategies that would enable e cient use of the existing resources by the public dental system to serve this population group. Previous research examining dental service utilisation behaviour of refugees were primarily conducted using self-reported surveys [9]. Use of survey data in this regard may be limited by the sample size and characteristics, individual's recollection of past events such as dental attendance [10]. As a result, signi cant discrepancies were found between self-reported and actual utilisation [11]. Administrative data provides more accurate information on service utilisation, as the treatments received by the patient represent real-life patterns of care and is precisely recorded at the time of care provision [10]. One study used administrative data to investigate public and private dental service utilisation among refugees in Sweden, the results of which showed a low overall use [12]. However, there are no such studies in Australia. This study uses administrative data across a four-year period to examine the utilisation of publicly funded dental services and develop pro les of PDS use among the Victorian refugees. The speci c objectives of this study were to: 1) explore patterns of the use of different types of care and services provided through the Victorian public dental health system among the refugee population, 2) analyse and describe the characteristics of refugees with similar patterns of PDS use, 3) examine the association between individual and contextual factors of the refugees and their identi ed patterns of PDS use. Methods Data source This retrospective observational study used secondary data analysis of de-identi ed individual-level data of refugees who have accessed publicly funded dental services in Victoria. The data was obtained from the electronic dental records sourced from the Victorian Dental Health Program dataset. All data were provided by Dental Health Services Victoria (DHSV). Population characteristics The study population included all refugees, irrespective of their age, gender, or ethnicity, for whom a record was created within the Titanium® patient management system between 01 July 2016 and 30 June 2020. Eligible patients attended the Royal Dental Hospital Melbourne (RDHM) or any of the community dental clinics to avail PDS. Services received were any of the three types of courses of care (CoC)-general, emergency, and denture-and one or more service areas provided as part of any of these three CoCs, including diagnostic, preventive and specialist services.
BMC Oral Health, 2014
Background: Preschool children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring preschool refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children. Methods: Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bilingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software. Results: There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents' previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees' difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed. Conclusions: The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services.
BMC oral health, 2018
The purpose of this study was to gain an in-depth understanding of Arabic-speaking mothers views on the usefulness of existing oral health education leaflets aimed at young children and also to record their views on the tailored versions of these leaflets. This qualitative study was nested within a large ongoing birth cohort study in South Western Sydney, Australia. Arabic-speaking mothers (n = 19) with young children were purposively selected and approached for a semi-structured interview. Two original English leaflets giving advice on young children's oral health were sent to mother's prior to the interview. On the day of interview, mothers were given simplified-English and Arabic versions of both the leaflets and were asked to compare the three versions. Interviews were audio-recorded, subsequently transcribed verbatim and analysed by thematic analysis. Ethical approval was obtained from Human Research Ethics Committees of the former Sydney South West Area Health Service,...
Factors Influencing Children’s Regular Attendance at Dental Clinics in Al Madinah, Saudi Arabia
Saudi Journal of Health Systems Research
Objectives: This study aimed to investigate sociodemographic, clinical, and behavioral characteristics of 9- to 12-year-old schoolchildren who attend regular dental visits. Methods: A stratified sample from 10 schools in Al Madinah, SA, was selected, and a total of 1,000 students aged 9–12 years were included in the study. The WHO criteria (2013) for assessing dental caries were used to collect clinical data, and information on dental visits and sociodemographic and behavioral variables was collected through the WHO questionnaire. The logistic regression model was used to examine the relationship between regular dental visits and sociodemographic, clinical, and behavioral factors. Results: Only 9.2% of the sample reported regular dental visits. The multiple logistic regression model showed that gender (female: OR = 1.715; p = 0.041), high family income (middle income: OR = 0.464; p = 0.024; and low income: OR = 0.517; p = 0.015), and the consumption of sugary food and drinks (almost...
Oral Health Status of Immigrant and Refugee Children in North America: A Scoping Review
Journal (Canadian Dental Association), 2016
The aim of this scoping review was to assess the oral health status of the children of refugees and immigrants ("newcomers"); the barriers to appropriate oral health care and use of dental services; and clinical and behavioural interventions for this population in North America. Explicit inclusion and exclusion criteria were used in searching electronic databases to identify North American studies between 2007 and 2014 that reported oral health status, behaviours and environment of children of newcomers. Additional studies from 1995-2008 were found in a recently published review. Pertinent data from all selected studies were summarized. Overall, 32 relevant North American studies were identified. In general, children of newcomers exhibit poorer oral health compared with their non-newcomer counterparts. This population faces language, cultural and financial barriers that, consequently, limit their access to and use of dental services. Intervention programs, such as educatio...