The perceptions of first nation participants in a community oral health initiative

Abstract

The Children’s Oral Health Initiative (COHI) is a federally funded community-based preventive dental program for children and their caregivers living in geographically isolated Canadian Aboriginal communities. The goal of the program is to improve access to preventive dental services for children of 0–7 years of age. It utilises community health workers in collaboration with dental therapists to promote and deliver the program. Almost half of the province of Manitoba’s (n=27) First Nations communities have implemented COHI since 2005. The objective of this investigation was to explore the opinions of COHI from the perspective of community members whose children had participated in the program. Purposeful selection identified caregivers of enrolled children for a semi-structured interview. The targeted caregivers had children who met at least one of the following criteria: (1) 0–2 years old; (2) 5–7 years old; (3) had two or more children either currently or formerly enrolled in COHI. Six open-ended questions guided the interview process. Content analysis was used to code transcripts and identify themes. One hundred and forty-one interviews were completed in 13 communities. Participants defined good oral health as the absence of dental cavities, which reflects a Western biomedical model of disease. The local, community-based nature of COHI was viewed as essential to its success in increasing access to preventive dental services and improving children and caregivers’ oral health knowledge and behaviours. In conclusion, a local, community-based oral health prevention programme is perceived as having a beneficial effect on children and caregivers’ oral health knowledge and behaviours. However, oral health preventive messages need to be further integrated into traditional Aboriginal holistic models of wellness.

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

“…Most of the programs were identified in this category. These programs were essentially targeted at Indigenous children, parents, and caregivers [48,50,53,54,56,[60][61][62][63][64]73]. However, the target populations for a few programs involved pregnant women, young adults, people with chronic disease, and the elderly [48,52,55,73].…”

“…Community engagement, shared responsibility, and partnership Community ownership and communitybased partnerships were considered essential elements for these programs' success [48-54, 58, 59, 61, 62, 64-66, 72]. Indigenous communities should give their consent to participate in the program [53,54]. From the beginning of program design, they were involved in managing and making decisions about the ongoing programs [53,54,59].…”

Dental health aides in Alaska: A qualitative assessment to improve paediatric oral health in remote rural villages

“…Workforce skill and mix, provision of public health and primary care services, geographic remoteness and service models for indigenous populations, all have a substantial influence on the effectiveness and efficiency of the indigenous healthcare systems . For some time, an innovative programme to train dental therapists has addressed the need to provide better primary dental care at the community level in the Canadian North as have programmes in other areas of the world …”

“…13,14 Evaluations of the DHA programme in Alaska and the dental therapist programme in the Canadian North have demonstrated that the dental workforce is technically competent to address the community oral health needs, especially when DHATs are utilized and when services are provided in the community. 10,[16][17][18][19][20] However, community perceptions and the perspectives of PDHAs/DHATs on providing dental care were rarely assessed. Only one of the published evaluations considered the local context.…”

Anthropological perspectives on Miyupimaatisiiun and the integration of oral health in primary care in the Cree communities of Northern Quebec

“…Few traditional medicines were known for tooth pain, and elders remember that people used to keep their teeth lifelong. Indeed, archeological evidence shows that oral diseases were rare: less than 1% of the skulls of Arctic and North West Coast Indigenous populations found by archeologists have been reported with cavities [46]. Moreover, as per Mayhall, dental decay prevalence in the Canadian Arctic was originally very low and later increased gradually from the time of European contact and then rapidly after the intense contact with southern Canadian culture [47].…”