Two-eyed seeing of the integration of oral health in primary health care in Indigenous populations: a scoping review

Abstract

Background: Indigenous people experience significant poor oral health outcomes and poorer access to oral health care in comparison to the general population. The integration of oral health care with primary health care has been highlighted to be effective in addressing these oral health disparities. Scoping studies are an increasingly popular approach to reviewing health research evidence. Two-eyed seeing is an approach for both Western and Indigenous knowledge to come together to aid understanding and solve problems. Thus, the two-eyed seeing theoretical framework advocates viewing the world with one eye focused on Indigenous knowledge and the other eye on Western knowledge. This scoping review was conducted to systematically map the available integrated primary oral health care programs and their outcomes in these communities using the two-eyed seeing concept. Methods: This scoping review followed Arksey and O'Malley's five-stage framework and its methodological advancement by Levac et al. A literature search with defined eligibility criteria was performed via several electronic databases, non-indexed Indigenous journals, Indigenous health organizational websites, and grey literature. The charted data was classified, analyzed, and reported using numeral summary and qualitative content analysis. The two-eyed seeing concept guided the interpretation and synthesis of the evidence on approaches and outcomes. Results: A total of 29 publications describing 30 programs conducted in Australia and North America from 1972 to 2019 were included in the final analysis. The following four program categories emerged from the analysis: oral health promotion and prevention programs (n = 13), comprehensive dental services (n = 13), fly in, fly out dental services (n = 3), and teledentistry (n = 1). Biomedical approaches for integrated primary oral health care were leadership and governance, administration and funding, capacity building, infrastructure and technology, team work, and evidence-based practice. Indigenous approaches included the vision for holistic health, culturally appropriate services, community engagement, shared responsibility, and cultural safety. The program outcomes were identified for biological, mental, and emotional dimensions of oral health; however, measurement of the spiritual dimension was missing. Conclusion: Our results suggest that a multiple integrated primary oral health care approach with a particular focus on Indigenous culture seems to be efficient and relevant in improving Indigenous oral health.

Indigenizing Engineering education in Canada: critically considered

“…(Cape Breton University 2020a) This Mi'kmaw worldview, coined as 'Two-Eyed Seeing' by Elder Marshall (Bartlett, Marshall, and Marshall 2012), was first introduced to us by Leah Fontaine, an Anishinaabe-Métis-Dakota Indigenous Initiatives Educator (Fontaine and Chen 2018). It has been applied to medical research (McKivett et al 2020), care of the aged (Sivertsen, Harrington, and Hamiduzzaman 2020), oral healthcare (Shrivastava et al 2020), and science education (Gilbert, Onwu, and Mufundirwa 2020;Michie, Hogue, and Rioux 2018). It is shared here with the permission of Elder Marshall, who explains, 'Two-Eyed Seeing adamantly, respectfully, and passionately asks that we bring together our different ways of knowing to motivate people, Aboriginal and non-Aboriginal alike, to use all our understandings so we can leave the world a better place' (336).…”

Spiritual Dimension in Oral Health

“…Spirituality is strong, and there is a lot of social support, and a strong sense of community mediated oral health behaviour that are beneficial. Individuals' health may be influenced by religious devotion to a social media platform and participant assistance, which could improve health related behaviour through more fast dissemination of health information and higher participation [5]. Individuals' health may be influenced by religious devotion to a social media platform and participant assistance, which could improve health-related behaviour through more fast dissemination of health information and higher participation coping with anxiety [6].…”

“…Second is Emotional well-being refers to becoming conscious of and tolerant of one's feelings and moods third is Physical Wellness and fourth is Social Wellness It helps people realize their greatest potential, find meaning and purpose in life, and find fulfillment from within. Self-actualization, transcendence, and selfevolution are all ways to achieve this condition of being [2]. The fourth component of health is spiritual well-being.…”

“…Beliefs, values, traditions, and practices all contribute to spirituality. Cultural ideas, attitudes, and practises are frequently blamed for oral health inequities, despite the fact that little is known about the scope or quality of studies on racial problems that may support this statement [2]. The value of dental hygiene to entire health and quality of life cannot be overstated.…”

Early childhood caries in multilingual community

“…Therefore, many researchers have attempted to expand basic microbiological models for ECC development, and to include various social, demographic and behavioural factors such as ethnicity, family income, maternal education level, family status, and parental knowledge (2). Children from the minority ethnic groups or immigrant children (3) have been found to be at higher risk of caries, too. Numerous studies suggested that ECC was more commonly found in children who lived in poverty (4), who were of ethnic and racial minorities (3), from single parent family (5), with parents of low educational level, especially those of illiterate mothers (6).…”