Aboriginal Health Workers Promoting Oral Health among Aboriginal and Torres Strait Islander Women during Pregnancy: Development and Pilot Testing of the Grinnin’ Up Mums & Bubs Program

Abstract

Background: this study aimed to develop and pilot test the model of care, Grinnin’ Up Mums & Bubs, to train Aboriginal Health Workers to promote oral health among Aboriginal and Torres Strait Islander pregnant women. Methods: Participatory Action Research was employed to develop the different components of the model (oral health promotion resources, training workshop, and a culturally safe referral pathway to dental services). The model was piloted (pre-post), using an embedded mixed-methods design, to determine the acceptability, satisfaction, and any recommendations made by seven Aboriginal Health Workers at an antenatal service in Western Sydney, Australia. Results: there was a high level of satisfaction with the components of the model of care among the participants, who believed that the model could be integrated into practice. The training showed some improvement in oral health knowledge and confidence. The participants recommended strategies for discussing oral health with Aboriginal and Torres Strait Islander pregnant women, and changes in public health dental policy to ensure that all women would be able to access affordable dental services through the referral pathway. Conclusion: the findings suggest a high level of satisfaction with the model of care among the Aboriginal Health Workers. Further evaluation is needed to confirm the short and long-term impact of the model.

A Comprehensive Review of Optimal Approaches to Co-Design in Health with First Nations Australians

“…Community control covers all co-design process, such as conception, inception, design, delivery, analysis, monitoring, evaluation, dissemination, ongoing consultation and iterative design and re-design, reflecting the tenet from Lairid et al [ 46 ] p. 6, of “nothing about us without us” [ 46 , 48 , 52 , 53 ]. Some examples include interpretation of data [ 43 , 54 , 55 , 56 ]; dissemination and co-authorship [ 46 , 57 ]; and resource design and branding [ 58 ]. As well as engagement throughout the entire process, it is essential that First Nations Australians are engaged in a variety of roles in the co-design project including as research team members, participants, consumers, advocates, community leaders, reference group members, clinicians, community researchers, employees, interpreters, cultural advisors/liaisons [ 31 , 33 , 35 , 38 , 44 , 46 , 47 , 49 , 50 , 53 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ].…”

“…First Nations Australians must determine the specific shape and scope of the health concern to be addressed which aligns with community needs and priorities. Community leaders, Elders, organisations, individuals, reference groups, and/or communities may be involved in defining the co-design priorities [ 2 , 33 , 36 , 48 , 51 , 54 , 55 , 57 , 58 , 65 , 69 , 70 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. First Nations Australians are best placed to make these decisions because of their unique knowledge of the historical, social and cultural factors in the community [ 44 , 70 ].…”

“…Methods that are synergetic with decolonising methodologies include Yarning, Dadirri, Ganma, storytelling, art and drawing [ 58 , 60 , 62 , 72 , 73 , 74 , 82 , 89 , 95 , 105 , 108 , 115 , 117 ]. Such modes of communication align with the long history of First Nations Australians oral and art traditions.…”

“…Approval should also be sought from national, state/territory and jurisdictional First Nations Australians specific Human Research Ethics Committees (HRECs) if relevant to the scope or nature of the project and ensure approval is maintained via annual reports and approval of amendments [ 39 , 41 , 43 , 46 , 51 , 53 , 54 , 56 , 57 , 58 , 59 , 60 , 62 , 64 , 65 , 68 , 74 , 76 , 80 , 83 , 85 , 91 , 94 , 102 ]. Approval of non-Indigenous HRECs may also be sought but are generally not sufficient to commence co-design projects if they are research-based [ 80 ].…”

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

“…Relationships of trust are imperative to holistic identification of patient needs, appointment attendance, and use of health services; AHWs successfully build upon familiar relationships in health care settings to the benefit of patients [ 53 ]. Although AHWs have been successful in providing oral health education to mothers [ 54 ] and applying fluoride varnish to children’s teeth in New South Wales [ 55 ], the use of AHWs for oral health promotion in South Australia has been sporadic and poorly defined [ 55 ]. Given the significant burden of oral disease experienced by Aboriginal and Torres Strait Islander people, provision of oral health education must align with community values that best meet the needs of Aboriginal and Torres Strait Islander patients.…”