Midwifery-dental intervention to improve oral health : a process evaluation

Aim or purpose: The Midwifery Initiated Oral Health-Dental Service (MIOH-DS) program was trialled and found to be effective in improving maternal oral health. The aim of this study was to undertake a process evaluation of the program to evaluate its acceptability and feasibility from midwives' perspectives. Materials and methods: Qualitative focus groups were conducted with 14 midwives who participated in the multicentre MIOH-DS trial across two large metropolitan hospitals in Greater Western Sydney, Australia. The focus groups were recorded, transcribed and then thematically analysed to explore the midwives' perspectives. The midwives had a mean age of 45.5 years and an average of 21 years of midwifery experience. Ethics approval was obtained from the local health districts governing the two hospitals. Results: Overall, the midwives were very positive about the program and felt it was addressing current barriers to maternal oral health, such as misconceptions and lack of awareness. They found the assessment tool easy to implement while the education program provided them with the necessary knowledge and skills to promote oral health and make appropriate dental referrals for pregnant women. However, midwives did stress the need for priority referral pathways for pregnant women to ensure the continued effectiveness of the program. Conclusions: This study has shown that the MIOH-DS program is acceptable to midwives and is effective in capacity building, enabling them to promote maternal oral health. The program is feasible for roll out by midwives provided appropriate and affordable dental referral pathways are provided to pregnant women.