A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy

Abstract

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.

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

“…The Aboriginal Health Workers in this study discussed several strategies around initiating a conversation about oral health. The need to build rapport and trust has been identi ed in our earlier research [9,10]. However, this study highlights several other speci c strategies including the need to be exible, taking an indirect approach and using the oral health promotion resources to avoid a sense of shame, confrontation, and judgement.…”

“…Aboriginal and Torres Strait Islander pregnant women and better meet their needs [6,9,10,16]. The aim of this study was to develop and pilot test the intervention, a culturally appropriate model of care with Aboriginal Health Workers to promote oral health during pregnancy; the model of care was named Grinnin' Up Mums and Bubs.…”

“…As part of the planning for the model of care (Phase 1), literature reviews were initially carried out [6,16] to identify current gaps in this area and whether other models of care or programs had been developed. The Aboriginal health staff also suggested that focus groups with other Aboriginal health staff [10], and interviews with Aboriginal and Torres Strait Islander pregnant women and mothers of Aboriginal and Torres Strait Islander children [9], would inform ideas for the model of care. These ideas included developing a suite of oral health promotion resources, a training workbook and a training workshop, and implementation of a culturally safe priority referral pathway to the dental service reinforced through the resources and training.…”

“…Among Aboriginal and Torres Strait Islander pregnant women, poor oral health can contribute to ongoing economic and health inequalities [8]. Social, political, historical, and economic structural factors can restrict certain oral health behaviours, such as visiting the dentist, for some Australian Aboriginal and Torres Strait Islander pregnant women [6,9,10]. One example of these barriers includes obtaining a Con rmation of Aboriginality, a document issued by an Aboriginal community-controlled organisation that recognises an individual as being Aboriginal and Torres Strait Islander by a community in which the family is known or come from [11].…”

“…Depending on the context, these certi cates can support access to culturally safe and affordable services [11] such as dental care at Aboriginal community-controlled health services (ACCHSs) [10]. Other barriers to accessing dental services also include a lack of information and cultural safety among dental services [9,10]. There is a need to capacity build the broader antenatal health workforce and develop health services that provide culturally safe and engaged oral health promotion and support certain oral health behaviours such as accessing the dentist.…”