IADR Abstract Archives
Oral Health Interventions for Those Incarcerated, a Scoping Review
Objectives: To facilitate a better understanding of oral health interventions implemented in prison settings, synthesise the theoretical frameworks utilised and map the barriers and facilitators for implementation.
Methods: A scoping review using Joanna Briggs Institute methodology, six databases were searched; Medline (R), Emcare, Embase, AMED, Cochrane and PsychINFO. A total of 978 studies were returned and screened by abstract and title. The inclusion criteria were studies that involved interventions addressing the oral health of prisoners, published after 2000, in any language, all levels of prison security. Observational studies were excluded.
Results: Ten studies published between 2008 and 2021 were included. All were conducted in high-income countries. Three intervention types were demonstrated: health coaching or health education(n = 5), teledentistry(n= 3) and screening or triaging protocols(n = 2). A range of theoretical models were used to support the intervention; motivational interviewing, health education, peer coaching and health-promoting environments. The barriers and facilitators to successful implementation were grouped into a framework of four overarching themes and sub-themes. These themes included the prison environment, recruitment, incentives for compliance and staffing levels both for researchers and prison staff. Sub-themes diverged into factors such as staffing barriers, engagement with healthcare staff, competing interests, prisoner gaming, motivation, security procedures and the logistical challenges associated with unpredictable population numbers.
Conclusions: The prison population faces inequalities in oral health globally due to a loss of agency in accessing healthcare and risk factors predisposing them to oral disease. In order to address these challenges, successful interventions need to consider the contextually specific factors which facilitate or impede intervention implementation. A mapping of these factors is discussed in this review.
Methods: A scoping review using Joanna Briggs Institute methodology, six databases were searched; Medline (R), Emcare, Embase, AMED, Cochrane and PsychINFO. A total of 978 studies were returned and screened by abstract and title. The inclusion criteria were studies that involved interventions addressing the oral health of prisoners, published after 2000, in any language, all levels of prison security. Observational studies were excluded.
Results: Ten studies published between 2008 and 2021 were included. All were conducted in high-income countries. Three intervention types were demonstrated: health coaching or health education(n = 5), teledentistry(n= 3) and screening or triaging protocols(n = 2). A range of theoretical models were used to support the intervention; motivational interviewing, health education, peer coaching and health-promoting environments. The barriers and facilitators to successful implementation were grouped into a framework of four overarching themes and sub-themes. These themes included the prison environment, recruitment, incentives for compliance and staffing levels both for researchers and prison staff. Sub-themes diverged into factors such as staffing barriers, engagement with healthcare staff, competing interests, prisoner gaming, motivation, security procedures and the logistical challenges associated with unpredictable population numbers.
Conclusions: The prison population faces inequalities in oral health globally due to a loss of agency in accessing healthcare and risk factors predisposing them to oral disease. In order to address these challenges, successful interventions need to consider the contextually specific factors which facilitate or impede intervention implementation. A mapping of these factors is discussed in this review.