Community based programs to improve the oral health of Australian Indigenous adolescents: a systematic review and recommendations to guide future strategies

Abstract

Background: To review the international literature on community-based interventions aiming to improve the oral health of Indigenous adolescents and identify which demonstrate a positive impact. Methods: Data sources were MEDLINE, EMBASE, CINAHL, SCOPUS, the COCHRANE library and the Australian Indigenous HealthInfoNet. Articles were included where they: were published in English from 1990 onwards; described oral health outcomes for Indigenous adolescents aged 10 to 19 years; implemented a community based oral health intervention. The Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project was applied. Results: Nine studies met inclusion criteria; two rated strong in quality; only one study was conducted with an urban community; five reported moderate community engagement. Five intervention strategies were identified, and schools were the most common setting reported. Statistically significant improvements were described in eight studies with the most frequently reported outcome being change in decayed missing or filled teeth. Conclusions: Few good quality peer reviewed international studies of community-based oral health interventions which address the needs of Indigenous adolescents exist. Studies must include strong Indigenous community leadership and governance at all stages of the research, adopt participatory action-based research approaches, and are required in urban communities.

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“…However, there are challenges in Indigenous communities due to limited access to dental services, and barriers to health services in general, which include individual, organizational and policy level determinants [48]. Even though chair-side tests are easy to use and quick [49], in rural underserved Indigenous communities, prerequisite equipment and resources may be unavailable [48,50]. In addition, Indigenous Australians face many challenges and barriers in the utilization of oral health services, among them differences in perception of bene t within traditional health beliefs [48].…”

The Indigenous Adolescent Oral Health Partnership Study: A Co-Design Study Protocol

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“…A recent systematic review found that successful oral health interventions for Indigenous people globally adopted culturally safe, participatory and collaborative approaches [ 12 ]. It concluded that an effective program should employ local workers, utilise multiple settings and strategies and address the social, economic and cultural determinants of health [ 12 ]. Despite this, few oral health research papers have explored social determinants of health in this context or established career development pathways for local workers despite many claiming to adopt a ‘capacity building’ approach [ 12 ].…”