Research

3 • Health & Oral Health Promotion Including Inequalities

Background

The Oral Health and Health Research (OHHR) Programme at DHSRU works on reducing health inequalities by increasing social inclusion, social capital and health. Adopting a community development approach allows people’s felt needs to be incorporated into evidence-based health promotion interventions.

Progress

Developing, Implementing and Evaluating an Oral Health Preventive Programme for Homeless Populations across Scotland (Smile4life): This project aims to evaluate current models of preventive service and practice and develop an evidence-based oral health care preventive package for the homeless in Scotland. A report of the completed Homeless Oral Health Survey in Scotland 2008-2009, Smile4life, will be launched in May 2011. An important finding to date has been that oral health related factors are implicated in depression in Scottish homeless people. Something to Smile About , a national oral health promotion and training programme will also be rolled out in 2011 enabling staff to deliver a tailored oral health intervention to their homeless client groups.

Developing, Implementing and Evaluating an Oral Health Preventive Programme for Prison Populations across Scotland: A Qualitative Assessment of Prisoners’ Needs (SOHIPP Interviews): This study aims to assess the main concerns of the prison population in Scotland in order to inform the development of an evidence-based oral health promotion intervention for prisoners. Interviews with women, young offenders, long-term, and remand/short-term prisoners are underway and a series with prison dentists completed. The overall outcome of the client-centred work is the enablement of prisoners to actively care for their own oral health and general health. In tandem with this, DHSRU is organising and analysing an oral health needs assessment survey of a sample of prisoners consisting of a dental examination and oral health questionnaire.

Equally Well is a government initiative to test new ways of working within public services to reduce health inequalities and increase mental wellbeing within defined, disadvantaged communities. The evaluation of the local test site in Stobswell, Dundee is being carried out by the OHHR programme using a mixed-method approach with an emphasis on gathering performance stories of stakeholders involved in the test site.

Developing an inventory to Assess Parental concerns and Enable child dental Registration (The DAPER study) aims to develop a questionnaire to assess parental concerns and enable ‘at-risk’ families to access preventive dental services such as Childsmile. A Parental Dental Concerns questionnaire was developed in Phase 1 which was assessed for reliability and validity in Phase 2, with almost 400 parents answering questions on dental anxiety, lack of social support, attitudes towards attending the dentist, and everyday family life. In 2011, 400 parents taking part in Childsmile will also test the questionnaire’s predictive validity. A field trial of the new measure will then aim to identify ‘at-risk’ families who would benefit from additional support in accessing preventive dental care.

Images below

Extract from an interview with a prisoner participating in the SOHIPP study and a selfportrait painted by a prisoner reproduced courtesey of the Koestler Trust.

Impact Statement

This programme of research is concerned with social inclusion, social capital, the promotion of health and oral health and is contributing to reducing health disparities in socially excluded groups in Scotland and Europe. This programme of work has informed national and international policy regarding the introduction of oral health promotion for people residing in areas of social deprivation..

‘In prison today, I think it’s one of the best things you could ever do... in prison,
you should go and see the people you need to see, especially dentists and anybody
else you need to see... I was quite surprised, made me more confident with
myself... going to see these people ’cos they never put me off ’cos it’s in prison.
I was more happy to go and see ’em. It was me really at the end of the day. You
hear some of these stories, but, half of them are just fabricated. Any experience
that I’ve ever had with ’em, I’ve always been looked after; they have been good,
really good actually.’
(Extract from an interview with a prisoner participating in the SOHIPP study)

"Self-portrait with toothache" Courtesy of the Koestler Trust. The piece is by ‘ Anon, HMP Grendon’ and was painted by a very talented ex offender. This is a good example of someone who has taken up positive work whilst in prison.