Facilitators for increasing dental attendance of people from vulnerable groups: a rapid review of evidence relevant to the UK.

Objective To rapidly review facilitators of access for vulnerable groups and to evaluate their effectiveness.Methods Data sources: MEDLINE via Ovid. Publications in English from 2000. DATA SELECTION: Research involving 'vulnerable groups' relevant to UK health systems, with a primary outcome of increasing attendance. DATA EXTRACTION: One author extracted and tabulated data. These were audited by a second author. DATA SYNTHESIS: A narrative synthesis was produced.Results Data from 31 studies were available for ten vulnerable groups: people with learning, physical or sensory disabilities (n = 8); people experiencing homelessness (n = 6); prisoners (n = 4); asylum-seekers and refugees (n = 3); people living in socioeconomically deprived areas (n = 3); people with severe mental health conditions (n = 2); vulnerable children (n = 2); dependent older people (n = 1); Gypsy, Roma or Traveller groups (n = 1); and people with drug dependency (n = 1). Many facilitators involved organisational reform and more integration of health, social and other services. Other facilitators included: modification of premises; team development and skill-mix use; and awareness of needs and flexible services to meet them. Few studies evaluated effectiveness.Conclusion Although facilitators for access for vulnerable groups have been proposed, there is little evidence to support or refute their effectiveness. Efforts are needed to promote access for vulnerable groups in the UK with evaluation plans embedded.

Lessons Learned from the Evolution of an Academic Community Partnership: Creating "Patient Voices".

THE PROBLEM: Long-term partners received federal funding to develop the Patient Voices Network, a partnership of safety-net family practices and their patients to develop health improvement strategies. The scope and structure of the newly funded grant presented unexpected challenges that threatened the future of the partnership.Purpose of Article: To present a case study of the evolution of an existing partnership and offer lessons learned along with recommendations for future partnerships. KEY POINTS: Federal funding formalized the partnership in a way that required looking at it through a new lens. Leadership, programmatic, personnel, and financial challenges emerged. Short-term and long-term strategies were applied to address evolving needs. CONCLUSIONS: This case study demonstrates how federal funding raises the bar for academic-community partnerships and how challenges can be worked through, particularly if the partnership embraces the key principles of community-based participatory research (CBPR). Recommendations have been applied successfully to future initiatives.

Preferences for labor and delivery practices between pregnant immigrants and U.S.-born patients: a comparative prospective antenatal survey study.

OBJECTIVE: To compare preferences in pregnant Somali and Sudanese immigrants with US-born women for different labor and delivery procedures and practices. STUDY DESIGN: Pregnant women who received prenatal care services at the Jericho Road Family Practice were surveyed. Ninety-three consecutive patients agreed to participate. A translator-facilitated questionnaire was administered to Somali-, Sudanese-, and U.S.-born women during antenatal visits. RESULTS: For pain relief in labor, 66.7% of U.S.-born, 64.0% of Somali, and 12.5% of Sudanese women preferred epidural analgesia (p = .002). More U.S.-born women preferred for the umbilical cord to be cut by their partners (76.2%) vs. Somali (6.7%) and Sudanese (0%) (p < .001). For infant feeding, more U.S.-born women (47%) preferred only formula feeding (Somali, 3.4%; Sudanese, 0%; p < .001). Responses were not statistically different for other preference questions, such as mobility/position in labor, attendants in labor, and duration of hospital stay. CONCLUSIONS: This prospective survey quantifies the differences in preferences for labor and delivery practices from two foreign populations and from U.S.-born women. This information is useful for all physicians who wish to better meet the needs of individual patients, especially those who are from different cultures and backgrounds.