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UBC Theses and Dissertations

Exploring strategies for integrating preventive oral care in prenatal health care services in British Columbia, Canada Adeniyi, Abiola Adetokunbo

Abstract

Background: Pregnancy may increase the risk for developing oral diseases especially periodontal disease and dental caries, both diseases are largely preventable. Oral health promotion within an integrated care approach is included in the British Columbia (BC) prenatal care pathway. The approach for achieving this integration is however not. Objectives: The primary aim of this thesis is to explore strategies for integrating preventive oral healthcare into routine prenatal care in BC from the perspective of pregnant women and health care providers in prenatal and oral healthcare. The secondary aims are to explore the barriers and facilitators of integration, and to refine an existing model for oral health integration during prenatal care. Methods: The thesis included a scoping review, followed by qualitative studies with pregnant women and health care providers in prenatal and oral healthcare. The qualitative study framed under a social constructivist lens was conducted among 39 participants in BC using semi-structured interviews. An inductive thematic analysis was used with NVivo® software. Memos, field notes, member-checking, and an audit trail contributed to the study credibility and trustworthiness Results: From the 35 articles included in the scoping review, one model of care was identified and the most common type of integration reported was linkages. The study participants favored including oral health check-ups as a component of prenatal assessments. They suggested that prenatal providers should offer oral health education and utilize screening questions during prenatal care. They advocated the establishment of referral systems, while proposing coverage of basic oral health services via the Medical Services Plan. Regarding the model of care, including facilitators and barriers to integrated care and clear communication strategies for interprofessional collaboration were suggested. This led to development of a new portrayal of oral care integration during pregnancy for BC. Conclusion: The scoping review highlighted that limited evidence exists on integrating oral health during prenatal care. Most of the participants in the qualitative studies supported integrating preventive oral health in routine prenatal services in BC. The study findings indicate that integrating oral health in routine prenatal care might be feasible in BC.

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