Outcomes of a co-designed, community-led oral health promotion program for Aboriginal children in rural and remote communities in New South Wales, Australia.

OBJECTIVE: Improving the oral health of Aboriginal children is an Australian priority. Public policy recommends the development of evidence-based, culturally competent oral health promotion programs. Positive health outcomes are more likely for Aboriginal people when programs are co-designed with the community and tailored to local needs. This study aims to determine the impact of a community-led oral health promotion program for Aboriginal children in rural and remote communities. BASIC RESEARCH DESIGN: Consecutive surveys. Baseline data were collected on the oral health of Aboriginal children aged five-12 years in rural and remote communities in Central Northern New South Wales in 2014. Then, an evidence-based oral health promotion program was co-designed with local Aboriginal communities. It included daily toothbrushing, water bottle program, regular application of fluoride varnish, regular distribution of toothbrushes and fluoride toothpaste and dental health education and commenced in 2016 in three schools in the region. In 2018, oral health status and oral hygiene behaviours of participating children were compared against baseline data to evaluate the program. RESULTS: There was a significant reduction in tooth decay, plaque scores and gingivitis. The mean number of teeth affected by tooth decay was 4.13, compared to 5.31 in 2014. An increase was also seen in positive oral hygiene behaviour. CONCLUSIONS: The co-design elements of the program are critical to its success. Engaging local Aboriginal communities to co-design and deliver oral health promotion can reduce the burden of tooth decay experienced by Aboriginal children.

In-school toothbrushing programs in Aboriginal communities in New South Wales, Australia: A thematic analysis of teachers' perspectives.

OBJECTIVE: This qualitative analysis explores how school staff interacted with a daily in-school toothbrushing program in three schools in rural areas in Central Northern New South Wales, Australia, with a high population of enrolled Aboriginal students. RESEARCH DESIGN: Three focus groups were conducted in the schools. Participants included school teachers and one Aboriginal Oral Health Aide who manage the daily program. Focus groups were conducted, and where permitted, audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the transcripts. This study was granted ethics approval by the New South Wales Aboriginal Health and Medical Research Council (App 1281/17). RESULTS: Four themes were identified: 1) Belief of Program Need and Benefit; 2) Forming routine; 3) Children's responses and 4) Sustainability. School staff embraced the program and valued the need for and benefit of the program for children in their school, seeing it as part of the extended role of the school to promote students' health and well-being. Two important enablers for the program's sustainability emerged; promoting and supporting local school leadership and training existing school staff or local Aboriginal people to manage it. CONCLUSION: Training local Aboriginal people or existing school staff to implement a daily in-school toothbrushing program and facilitating school leadership is an important enabler for sustainable oral health promotion, including in-school toothbrushing programs, in Aboriginal communities.