The case for integrating oral health into primary health care (original) (raw)
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BMC oral health, 2018
Despite its importance, the integration of oral health into primary care is still an emerging practice in the field of health care services. This scoping review aims to map the literature and provide a summary on the conceptual frameworks, policies and programs related to this concept. Using the Levac et al. six-stage framework, we performed a systematic search of electronic databases, organizational websites and grey literature from 1978 to April 2016. All relevant original publications with a focus on the integration of oral health into primary care were retrieved. Content analyses were performed to synthesize the results. From a total of 1619 citations, 67 publications were included in the review. Two conceptual frameworks were identified. Policies regarding oral heath integration into primary care were mostly oriented toward common risk factors approach and care coordination processes. In general, oral health integrated care programs were designed in the public health sector and...
Barriers and facilitators in the integration of oral health into primary care: a scoping review
BMJ Open
ObjectiveThis scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care.MethodsGrounded in the Rainbow conceptual model and using the Levacet alsix-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results.ResultsFrom a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients’ oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdi...
Challenges impeding integration of oral health into primary health care
Eastern Mediterranean Health Journal, 2017
The primary healthcare (PHC) services in the Islamic Republic of Iran have succeeded in addressing high levels of communicable diseases; however, they seem less able to deal with maternal and paediatric oral diseases. The aim of this study was to examine problems in integrating oral health services into PHC. This was a qualitative research study comprising focus group discussions and interviews. Five focus-group discussions were held with midwives, family healthcare practitioners, rural PHC workers, duty-service dentists, and public health dentists. Also, individual interviews were organized with experts of faculty members in related fields, informant managers and policy makers, and in-depth interviews were done with pregnant women in four PHC centres. Audiotapes were transcribed following each session, and then a qualitative thematic analysis was carried out on gathered data. Data analysis resulted in 4 main themes relating to the challenges: environmental, educational, organizational and school-based programme factors. This study provides a clearer understanding of the challenges of integrating oral health services into PHC.
Integrating Oral Health Care into Primary Health Care System
ISRN Dentistry, 2012
Introduction. Systematic evaluation is an integral part of the organization and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. This study aimed to assess the knowledge and practice of primary health care (PHC) personnel regarding their duties toward oral health. Methods and Material. A cross-sectional study was carried out among three groups of PHC personnel in the city of Kerman (Iran). Volunteer personnel completed a piloted questionnaire which included demographic data, some question regarding their knowledge about oral health, their duties and also their practice regarding public oral health. All data were analyzed using chi-square and Pearson correlation test. Results. One hundred and fifty-seven out of 225 eligible personnel participated in the study. Sixty percent were auxiliary health workers (Behvarz). All personnel had a good level of knowledge regarding oral health. Despite significant differences among the knowledge of the personnel toward oral health, there was no significant difference between their knowledge related to their duties regarding oral health. The auxiliary health worker group had a higher rate (45.6%) for better public oral health practice. Conclusion. The study showed the personnel have good knowledge of their duties regarding oral health. However, their practice is not in line with their knowledge and needs more attention.
PLOS ONE, 2018
Recently, new models for the integration of oral health into primary care have been proposed. However, these models may be adopted by a variety of health care systems, and will reach successful outcomes only if they can be adapted to suit the local context. To this end, the objective of this study was to explore the perceptions of Quebec primary health care teams on the integration of oral health into primary care. A qualitative approach and interpretive description methodology were used to conduct the study within a case-study design. Purposeful sampling with maximum variation and snowball technique were used for recruitment of study participants. Seventy-four in-depth, semi-structured interviews and five focus groups were conducted with primary health care teams including health care providers and managers working in a rural and an urban health care center. The interview guide and study conceptual framework were based on the Rainbow model. Data collection and data analyses were conducted concurrently and continued until saturation was achieved. To analyze the data, four phases of qualitative analysis were followed. The thematic analysis included interview debriefing, transcript coding, data display, and interpretation. Data analysis was conducted both manually and with the use of Atlas-ti software. A total of four themes emerged from the interviews and focus group discussions. These themes covered all domains of the study theoretical model and included: 1) drivers of integration; 2) importance of integration; 3) professionals' role in integrated care; and 4) barriers and enablers of integration. In general, most of the barriers expressed by study participants were related to the organizational and system domains of integration. Primary health care teams who provide care in rural and urban areas in Quebec expressed their concerns on the absence of integrated oral health services. Implementation of governance policies, the prioritization of educational and management measures as well as inter-professional collaboration toward innovative care models could facilitate this integration.
Returning the mouth to the body: integrating oral health & primary care
Issue brief (Grantmakers in Health), 2012
G rantmakers In Health convened a group of funders, researchers, and practitioners on April 17, 2012, for the Issue Dialogue Returning the Mouth to the Body: Integrating Oral Health and Primary Care to discuss the benefits, challenges, and approaches to integrating oral health and primary care. Dental disease is one of the great preventable public health challenges of the 21 st century. Labeled a "silent epidemic" by the U.S. Surgeon General, dental disease ranks high in prevalence among chronic health conditions (HHS 2000). It is universally prevalent, but a number of subpopulations are particularly vulnerable, including seniors, children and adolescents, low-income people, minority groups, and people with special health care needs (IOM 2011).
A review on oral health care in four different health care systems
Background : A universal approach to oral health is said to improve oral health outcomes, but research has shown mixed results. This study aimed at critically reviewing the literature available on the oral health care systems of four countries in terms of structure, scope, and delivery, along with their impact on oral health outcomes. Methods : A comparative literature review of the oral health care systems in Brazil, New Zealand, Canada, and Sweden was performed between August 2017 and January 2018 using PubMed/MEDLINE and the key words ‘universal’ OR ‘publicly funded’ AND ‘dental OR oral’ AND ‘care OR access’ AND ‘outcome’. This is a critical essay based on evidence available in the literature that was enriched by accounts from 12 key informants from these four countries. Results : All four countries provide some form of universal health care, but the administration, funding, and delivery of oral health care varied. Approximately 6% of oral health care expenditure in Canada is pub...