Developing and piloting the Grinnin' Up Mums & Bubs model of care to promote oral health among Aboriginal and Torres Strait Islander pregnant women : a mixed-methods study

Abstract

Women are at greater risk for poor oral health during pregnancy, which is linked to adverse birth outcomes and an increased risk of early childhood caries. In Australia, Aboriginal and Torres Strait Islander communities experience higher rates of adverse maternal and early childhood oral health outcomes compared to other Australians. The Midwifery Initiated Oral Health (MIOH) program, an integrated model of care capacity building midwives to promote oral health, was developed to address the oral health needs of pregnant women in Australia. Although the MIOH program was found to be effective in improving maternal oral health outcomes, it was not developed to address the needs of Aboriginal and Torres Strait Islander pregnant women, many of whom may prefer not to access mainstream antenatal services. Currently, there is limited knowledge on the oral health perspectives of Aboriginal and Torres Strait Islander women and Aboriginal health staff about maternal oral health. The underlying motivation of this PhD, therefore, was to adapt the MIOH model of care to capacity build Aboriginal health staff to deliver culturally appropriate oral health promotion to Aboriginal and Torres Strait Islander pregnant women. This study thus fills an important gap in the current literature, and is clinically important, as this intervention could lead to better outcomes for Aboriginal and Torres Strait Islander mothers and their children. The aim of this embedded sequential mixed-methods study was to develop and pilot test a culturally appropriate model of care (Grinnin' Up Mums & Bubs) in Greater Western Sydney, Australia, to promote oral health among Australian Aboriginal and Torres Strait Islander pregnant women by capacity building Aboriginal health staff. The findings from the pilot suggest that the model could be effective in capacity building Aboriginal Health Workers and influencing change in practice. Using an approach where the Aboriginal Health Workers could meaningfully drive the research resulted in a model of care that was useful, relevant, culturally appropriate and built on the Aboriginal Health Workers' existing strengths. The initial findings from this research also highlight the need for further evaluation of the model of care to determine the impact on the oral health of Aboriginal and Torres Strait Islander pregnant women and the effectiveness of the model over time. Over the long term, there is also the need for changes in oral health policy to ensure that all Aboriginal and Torres Strait Islander women can access timely, affordable, and culturally safe dental care.

Date of Award	2021
Original language	English