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ORIGINAL RESEARCH article

Front. Oral. Health
Sec. Oral Health Promotion
Volume 5 - 2024 | doi: 10.3389/froh.2024.1355429
This article is part of the Research Topic Co-designing and Evaluating Oral Health Promotion Interventions for Vulnerable Groups View all 7 articles

A Stakeholder Co-Design Approach to Designing a Dental Service For Adults Experiencing Homelessness

Provisionally accepted
Declan Cairns Declan Cairns 1*Andrea Rodriguez Andrea Rodriguez 2
  • 1 NHS Grampian, Aberdeen, United Kingdom
  • 2 University of Dundee, Dundee, Scotland, United Kingdom

The final, formatted version of the article will be published soon.

    The homeless population faces a "cliff edge of inequality" when trying to access essential dental services. There are several additional barriers to accessing dental care in comparison to the general population and the heterogeneous nature of patients presents a significant challenge when designing dental services to meet their needs. Following the Smilr4Life report in 2009, there is limited up-to-date and population-specific evidence available for the preferred model of service delivery in Glasgow.Aim: This study aimed to co-design principles for a prospective dental service for adults experiencing homelessness.A qualitative methodology was used to incorporate experts-by-experience into elements of co-designing a dental service for adults experiencing homelessness. The study combined elements of an experienced-based co-design framework for healthcare innovation with community-based participatory research. Focus groups with people experiencing homelessness and healthcare practitioners were conducted to identify principles for any prospective dental service, as well as several barriers and enablers to establishing a homeless dental service. The findings were transcribed and analysed using thematic analysis on Nvivo software.From the qualitative analysis five key themes emerged: 1. Impact and expectations of oral health while experiencing homelessness, 2. Barriers to accessing dental care; 3. Practitioner's views about homelessness and access to care; 4. Barriers to designing a homeless service and 5. Enablers for co-designing a new model of dental care delivery for the homeless population.Five key principles for a new model of homeless dental service were identified: i)Services designed to address the needs of patients; ii)Services delivered in a safe and welcoming environment iii)Training and consistency of staff; iv)Focus on dental education v)Developing peer mentoring and peer support Conclusion: While the barriers to accessing dental care while homeless are well established and understood by healthcare practitioners, more work is required to gain consensus on the most effective way to deliver an innovative a sustainable dental service for patients experiencing homelessness.Previous negative experiences, lack of readily available information on services and barriers to access in the current system could be addressed by developing peer mentors within the homeless community, empowering individuals to share their knowledge and skills to support others in improving their oral health.

    Keywords: co-design, dental services, Homelessness, Inequalities, Qualitative Research -7043 words total

    Received: 13 Dec 2023; Accepted: 08 Jul 2024.

    Copyright: © 2024 Cairns and Rodriguez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Declan Cairns, NHS Grampian, Aberdeen, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.