Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of midwives in Greater Western Sydney, Australia

Hannah G Dahlen; Maree Johnson; Julia Hoolsema; Tiffany Patterson Norrie; Shilpi Ajwani; Anthony Blinkhorn; Sameer Bhole; Sharon Ellis; Ravi Srinivas; Albert Yaacoub; Andrew Milat; John Skinner; Ajesh George

doi:10.1016/j.wombi.2018.06.021

Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of midwives in Greater Western Sydney, Australia

Women Birth. 2019 Apr;32(2):e159-e165. doi: 10.1016/j.wombi.2018.06.021. Epub 2018 Jul 17.

Authors

Affiliations

¹ School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta 2150, Australia. Electronic address: [email protected].
² Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney 2060, Australia. Electronic address: [email protected].
³ Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool 1871, Australia. Electronic address: [email protected].
⁴ COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool 1871, Australia. Electronic address: [email protected].
⁵ Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney Research, Sydney 2010, Australia. Electronic address: [email protected].
⁶ Faculty of Dentistry, University of Sydney, Sydney, 2006, Australia. Electronic address: [email protected].
⁷ Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney Research, Sydney 2010, Australia. Electronic address: [email protected].
⁸ Camden and Campbelltown Hospitals, South Western Sydney Local Health District, 2170, Australia. Electronic address: [email protected].
⁹ South Western Sydney Local Health District Oral Health Services, COHORT, Western Sydney University, University of Sydney, Ingham Institute Applied Medical Research, Liverpool, Australia. Electronic address: [email protected].
¹⁰ Nepean Blue Mountains Local Health District Oral Health Services, Penrith, Australia. Electronic address: [email protected].
¹¹ Centre for Epidemiology and Evidence, NSW Ministry of Health, University of Sydney, Australia. Electronic address: [email protected].
¹² Faculty of Dentistry, University of Sydney, Sydney, 2006, Australia. Electronic address: [email protected].
¹³ COHORT, Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool 1871, Australia. Electronic address: [email protected].

PMID: 30025676
DOI: 10.1016/j.wombi.2018.06.021

Abstract

Background: Despite links between poor maternal oral health, adverse pregnancy outcomes and early childhood decay there is limited emphasis on maternal oral health in Australia. To address this, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in collaboration with the Australian College of Midwives.

Aims: To undertake a process evaluation and explore perceptions of midwives involved in the MIOH-DS program to determine its practicability, acceptability and feasibility if it were to be up-scaled and implemented into clinical practice.

Methods: Qualitative content analysis was undertaken on data from three focus groups with 21 midwives.

Findings: Midwives generally found the MIOH-DS to be acceptable and feasible with potential for widespread scalability. The trust women had in midwives was an important factor in gaining women's attention about oral health in pregnancy. The program assisted in increasing midwives' knowledge and awareness, though some felt it was outside their scope of practice. The oral health assessment tool was acceptable to midwives but some concerns were expressed about undertaking a visual oral inspection. Most midwives stated they were now confident with referring individuals to a dentist. Significant barriers to widespread implementation included the cost of dental care and the continued lack of awareness and misconceptions pregnant women had towards oral health.

Conclusion: Midwives found the MIOH-DS to be acceptable and feasible which are two important barriers to potential implementation at scale. Misconceptions over the importance of oral health by women and cost of accessing dental services still need resolving.

Keywords: Dental care; Midwifery; Oral health; Pregnancy; Process evaluation.

MeSH terms

Australia
Dental Health Services*
Female
Health Knowledge, Attitudes, Practice*
Humans
Midwifery / organization & administration*
Oral Health*
Patient Acceptance of Health Care
Pregnancy