An Oral Health Needs Assessment of Prisoners in HMP Brixton Ellie Heidari  Senior Clinical Teacher Sedation & Special Care...
Key areas <ul><li>Health Needs Assessment </li></ul><ul><li>The Oral Health Needs Assessment </li></ul><ul><li>Outcome of ...
  What is  Health Needs Assessment?   <ul><li>A systematic method which identifies unmet health and healthcare needs of a ...
Why is HNA important? <ul><li>‘ The   purpose of needs assessment in health care is to gather the information required to ...
Why has HNA become important?   <ul><li>Inequalities </li></ul><ul><li>Limitation of resources </li></ul><ul><li>Prioritis...
The OHNA development <ul><li>Expressed needs </li></ul><ul><li>Normative needs  </li></ul>
The Oral Health Needs Assessment’s aim   To investigate the oral health status and dental treatment requirements of prison...
Permission & Ethical approval <ul><li>Local Research Ethics Committee  </li></ul><ul><li>Northern and Yorkshire Multi-Cent...
Problems during the pilot study <ul><li>1. Forms  </li></ul><ul><ul><li>Not returned  </li></ul></ul><ul><ul><li>Were miss...
Results <ul><li>Demography </li></ul><ul><li>Young population </li></ul><ul><li>Social classes IV, V </li></ul><ul><li>  H...
Results <ul><li>Poor General Health </li></ul><ul><li>Depression & mental illnesses </li></ul><ul><li>Smokers, alcohol/dru...
  Factors affecting oral health <ul><li>Unhealthy behaviours  </li></ul><ul><li>Drug use </li></ul><ul><li>Alcohol consump...
Oral Health Promotion (before OHNA) <ul><li>“ Single approach” </li></ul><ul><li>Advice on   </li></ul><ul><ul><ul><li>Smo...
Oral Health Promotion (after OHNA) <ul><li>“ Whole team approach”   </li></ul><ul><li>Liaised with the medical team </li><...
Oral Health Promotion Constraints <ul><li>Mobile, shortage/lack of staff </li></ul><ul><li>- Dental Care Professional   </...
To consider <ul><li>A standardised HNA </li></ul><ul><li>Encourage oral health promotion   Motivate/maintain/value  </li><...
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Oral Health Needs Assessments

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Oral Health Needs Assessments

  1. 1. An Oral Health Needs Assessment of Prisoners in HMP Brixton Ellie Heidari Senior Clinical Teacher Sedation & Special Care Dentistry King’s College London
  2. 2. Key areas <ul><li>Health Needs Assessment </li></ul><ul><li>The Oral Health Needs Assessment </li></ul><ul><li>Outcome of the OHNA </li></ul>
  3. 3.   What is Health Needs Assessment? <ul><li>A systematic method which identifies unmet health and healthcare needs of a population </li></ul>Source: Wright J, Williams R& Wilkinson J BMJ 1998;316:1310-1313 (25 April)
  4. 4. Why is HNA important? <ul><li>‘ The purpose of needs assessment in health care is to gather the information required to bring about change beneficial to the health of the population.’ </li></ul>
  5. 5. Why has HNA become important? <ul><li>Inequalities </li></ul><ul><li>Limitation of resources </li></ul><ul><li>Prioritisation with resources </li></ul><ul><li>Expectations </li></ul>
  6. 6. The OHNA development <ul><li>Expressed needs </li></ul><ul><li>Normative needs </li></ul>
  7. 7. The Oral Health Needs Assessment’s aim   To investigate the oral health status and dental treatment requirements of prisoners in HMP Brixton.
  8. 8. Permission & Ethical approval <ul><li>Local Research Ethics Committee </li></ul><ul><li>Northern and Yorkshire Multi-Centre Research Ethics Committee (MREC) </li></ul><ul><li>Committee’s location </li></ul><ul><li>The committee’s members </li></ul>
  9. 9. Problems during the pilot study <ul><li>1. Forms </li></ul><ul><ul><li>Not returned </li></ul></ul><ul><ul><li>Were missing because prisoners had been released, bailed or transferred. </li></ul></ul><ul><li>2. No dental treatment - no participation </li></ul><ul><li>Outcome: Convenience sample </li></ul>
  10. 10. Results <ul><li>Demography </li></ul><ul><li>Young population </li></ul><ul><li>Social classes IV, V </li></ul><ul><li> High unemployment rate </li></ul>
  11. 11. Results <ul><li>Poor General Health </li></ul><ul><li>Depression & mental illnesses </li></ul><ul><li>Smokers, alcohol/drug dependency </li></ul><ul><li> </li></ul><ul><li>Poor Oral Health </li></ul><ul><li> Attitude </li></ul><ul><li> lack of perceived needs especially before imprisonment </li></ul><ul><li>Dental attendance, preference, treatment </li></ul><ul><li>Barriers (apathy, anxiety) </li></ul><ul><li> Emergency rx & pain control </li></ul>
  12. 12. Factors affecting oral health <ul><li>Unhealthy behaviours </li></ul><ul><li>Drug use </li></ul><ul><li>Alcohol consumption </li></ul><ul><li>Tobacco smoking </li></ul><ul><li>Sugar consumption </li></ul><ul><li>2) Low use of dental services </li></ul><ul><li>Dental anxiety </li></ul><ul><li>Priorities </li></ul><ul><li>3) Attitudes of dental care professionals </li></ul><ul><li>4) Low use of preventive oral health services </li></ul>
  13. 13. Oral Health Promotion (before OHNA) <ul><li>“ Single approach” </li></ul><ul><li>Advice on </li></ul><ul><ul><ul><li>Smoking cessation </li></ul></ul></ul><ul><ul><ul><li>Alcohol consumption </li></ul></ul></ul><ul><ul><ul><li>- Recreational drugs </li></ul></ul></ul><ul><ul><ul><li>- Diet/calorie intake </li></ul></ul></ul><ul><li>Craving </li></ul><ul><li>Mixer </li></ul>
  14. 14. Oral Health Promotion (after OHNA) <ul><li>“ Whole team approach” </li></ul><ul><li>Liaised with the medical team </li></ul><ul><li>Prison smoking cessation programme </li></ul><ul><li>Pharmacist </li></ul><ul><li>The canteen shop </li></ul>
  15. 15. Oral Health Promotion Constraints <ul><li>Mobile, shortage/lack of staff </li></ul><ul><li>- Dental Care Professional </li></ul><ul><li>Source: Dyer & Robinson 2006 </li></ul><ul><li>- Prison staff </li></ul><ul><li> Lack of training to undertake health intervention </li></ul><ul><li>Mobile prison population </li></ul><ul><li>Insufficient funding </li></ul><ul><li>Time </li></ul><ul><li>Difficulties to evaluate </li></ul><ul><li> </li></ul>
  16. 16. To consider <ul><li>A standardised HNA </li></ul><ul><li>Encourage oral health promotion Motivate/maintain/value </li></ul><ul><li>Change health/oral health related behaviour </li></ul><ul><li>Funding/resources </li></ul><ul><li>To increase provision of dental services </li></ul><ul><li>To perform research/audit </li></ul><ul><li>To improve toothbrush/paste </li></ul><ul><li>Interprofessional integration </li></ul><ul><li>Identify the most vulnerable group </li></ul><ul><li>Pain/infection control </li></ul><ul><li>Staff support network </li></ul><ul><li>Clinical governance </li></ul><ul><li>Follow up in community </li></ul>
  17. 17. Thank you for your time and attention

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