Supporting non-dental correctional professionals to provide oral health promotion in custodial settings: A new model of care

Investigators

  • Rebecca Bosworth
  • Ajesh George
  • Samantha Helais
  • Keith Heap
  • Nicola Sutton
  • Kelsea Staden

 

  • Josephine Burton
  • Angela Masoe
  • Penelope Abbott
  • Akriti Biswas
  • Izabella Barak
  • Natalia Uthurralt

Collaborators

JHNSW: Justice Health and Forensic Mental Health Network

UOW: University of Wollongong

WSU: Western Sydney University

MOH: Ministry of Health

Project Overview

Approximately 11.5 million people worldwide are housed in correctional settings (e.g. prison/jails) on any given day. In NSW, as of December 2023, 42 274 people were living in prison. The oral health of people in custodial settings is an important aspect of public health that is often overlooked and remains largely unaddressed globally. Studies have shown oral health inequalities exist among of people in contact with the criminal justice system, reporting a high prevalence of periodontal disease, dental caries and tooth decay. Oral health conditions, especially periodontal disease, can be severe, debilitating, and serve as risk factors for other non-communicable diseases including cancers, cardiovascular disease, chronic respiratory disease, and diabetes and can lead to considerable health, social, and economic burdens that further contribute to disadvantage and inequality. Early detection of oral diseases is essential as most are largely preventable. For many people in prison, their first interaction with dental services occurs during incarceration. However, dental professionals are often unevenly distributed in prisons which limits access.

Improving oral health among people in prison is grounded in the 2022 World Health Organization (WHO)’s “Global Oral Health Status Report: towards universal health coverage (UHC) for oral health by 2030”, the draft WHO Global Oral Health Action Plan 2023-2030 and the NSW Oral Health Strategic Plan 2022-2032. Integrating oral health into primary health care is the common goal. 

Non-dental correctional professionals such as Aboriginal health workers, nurses and correctional officers are well placed to incorporate oral health promotion into routine care yet have not been traditionally involved in oral health promotion. Non-dental correctional professionals could provide oral health promotion however, limited evidence exists on their involvement in custodial settings. An opportunity exists to address the epidemic of non-communicable disease and oral health to optimise the health and wellbeing of people in prison and return healthier people to their communities upon release.

Our research closely aligns with the Sustainable Development Goals (SDGs). By providing access to oral health care, our research directly relates to SDG3 improving the ‘health and wellbeing’ of key populations. Additionally, by focusing on custodial settings, our research contributes to advancing equitable healthcare delivery by addressing the needs of key populations at increased-risk of oral health conditions a population often overlooked in healthcare research (SDG 10 – reduced inequalities). Lastly, our novel contribution of a collaborative approach, comprising experts by lived experience of incarceration, academics, clinicians, stakeholders, and industry professionals aligns with SDG 17 ‘Partnerships for Goals’. By addressing the SDGs, our research aims to contribute to broader efforts to promote health and wellbeing for all by 2030 to ensure no one is left behind, including people in contact with the criminal justice system as prison health is public health

Aims & Objectives

The aim of this project is to co-design and pilot a culturally-safe oral health model of care for people who experience incarceration, delivered by non-dental correctional professionals in NSW custodial settings. The components of the model of care may include a screening tool, training program, oral health promotional resources and a dental referral pathway.

The project aims to:

  1. Understand the capability of non-dental correctional professionals in providing oral health promotion, and the role they play to support and care for people with oral health needs in prison
  2. To identify the oral health needs of people in prison and their perceptions of a co-designed, oral health promotion program provided by correctional professionals
  3. To co-design with correctional professionals, people in prison and individuals with lived experience of prison, a culturally safe, evidence-based, oral health promotion program to strengthen access and support for people in prison with oral health needs
  4. To implement and evaluate the effectiveness, acceptability, feasibility and scalability of the oral health promotion program

Research Output

To see the various outputs from the program, please navigate to the pages below:

Publications Presentations Awards Training resources Oral health promotion resources

Alignment with ACIOH’s themes

Workforce reoriented:

CORRECTIONAL PROFESSIONALS 

This project aims to improve the capacity of non-dental correctional professionals to promote oral health among people experiencing incarceration.

 

People-centred strategies:

PEOPLE EXPERIENCING INCARCERATION

Through the co-development and implementation of a culturally safe oral health model of care, informed by the needs of people in prison and individuals with lived experience of prison, the project aims to support non-dental correctional professionals to improve the delivery of oral health and support people to improve their oral health.