An Oral Health Needs Assessment of Prisoners in HMP

Brixton

Ellie Heidari Senior Clinical TeacherSedation & Special Care DentistryKing’s College London

Key areas

Health Needs AssessmentThe Oral Health Needs

AssessmentOutcome of the OHNA

 What is Health Needs Assessment?

A systematic method which identifies unmet health and healthcare needs of a population

Source: Wright J, Williams R& Wilkinson J BMJ 1998;316:1310-1313 (25 April)

Why is HNA important?

‘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.’

Why has HNA become important?

InequalitiesLimitation of resourcesPrioritisation with resourcesExpectations

The OHNA development

Expressed needs

Normative needs

The Oral Health Needs Assessment’s aim

 

To investigate the oral health status and dental treatment requirements of prisoners in HMP Brixton.

Permission & Ethical approval

Local Research Ethics Committee Northern and Yorkshire Multi-Centre

Research Ethics Committee (MREC) Committee’s locationThe committee’s members

Problems during the pilot study

1. Forms – Not returned – Were missing because prisoners had

been released, bailed or transferred.

2. No dental treatment - no participation

Outcome: Convenience sample

Results

DemographyYoung population

Social classes IV, V

High unemployment rate

Results

Poor General HealthDepression & mental illnesses

Smokers, alcohol/drug dependency

Poor Oral Health Attitude

lack of perceived needs especially before imprisonment

Dental attendance, preference, treatment Barriers (apathy, anxiety)

Emergency rx & pain control

Factors affecting oral health

1) Unhealthy behaviours Drug useAlcohol consumptionTobacco smokingSugar consumption

2) Low use of dental servicesDental anxietyPriorities

3) Attitudes of dental care professionals

4) Low use of preventive oral health services

Oral Health Promotion (before OHNA)

“Single approach” Advice on

- Smoking cessation- Alcohol consumption

- Recreational drugs

- Diet/calorie intake

Craving

Mixer

Oral Health Promotion (after OHNA)

“Whole team approach”

Liaised with the medical teamPrison smoking cessation programmePharmacistThe canteen shop

Oral Health Promotion Constraints

Mobile, shortage/lack of staff- Dental Care Professional

Source: Dyer & Robinson 2006

- Prison staff Lack of training to undertake health intervention

Mobile prison population Insufficient funding Time

Difficulties to evaluate

To consider A standardised HNA Encourage oral health promotion

Motivate/maintain/value Change health/oral health related behaviour Funding/resources To increase provision of dental services

To perform research/auditTo improve toothbrush/paste

Interprofessional integration Identify the most vulnerable group

Pain/infection controlStaff support networkClinical governance

Follow up in community

Thank you for your time and attention