How primary health care teams perceive the integration of oral health care into their practice: A qualitative study

Abstract

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.

Barriers and Facilitators to integrate Oral Health care for Older Adults in General (Basic) Care in East Netherlands. Part 2 Functional Integration

“…Apart from poor embedding of OHC in care policies and procedures, OHC was equally poorly embedded in medical guidelines and instruments such as health assessments, a barrier acknowledged by medical and dental experts alike. 12 , 13 , 14 , 15 A limited number of OH questions, mostly two or three, are included in a few health assessments such as COPD and Diabetes assessment instruments. These questions, however, as reported by our nurses and GP assistant, are often not asked owing to time constraints and low prioritisation.…”

First Nations and Metis peoples’ access and equity challenges with early childhood oral health: a qualitative study

“…Families tend to interface with primary care providers more often than with dental providers, therefore, involving primary healthcare practitioners in caries assessments could increase and fast track access to dental professionals and dental care overall. Moreover, integration of oral care into primary care practice is gaining increasing appreciation and could be successfully implemented in community-based contexts with some management of information and roles [ 56 ]. Integration in this way, is important for holistic health and is often advocated for by Indigenous peoples [ 57 , 58 ] Thus in partnership with Public Health Agency of Canada, our team developed the Canadian Caries Risk Assessment Tool for use by non-dental healthcare professionals or dental professionals in non-dental settings ( https://umanitoba.ca/CRA_Tool_ENG_Version.pdf ).…”

Reasons for (not) choosing dental treatments—A qualitative study based on patients’ perspective

“…The participants were aged 22–74. As the point of data saturation was reached in interview group 2, we did not schedule more than the four planned appointments [ 37 ]. Individuals of all statuses regarding the participants’ employment, education and income were represented.…”