Transcript Aim - OHRN

An Oral Health Needs
Assessment of Prisoners in
HMP Brixton
Ellie Heidari
Senior Clinical Teacher
Sedation & Special Care Dentistry
King’s College London
Key areas
 Health
Needs Assessment
 The Oral Health Needs
Assessment
 Outcome 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?
Inequalities
 Limitation of resources
 Prioritisation with resources
 Expectations

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 location
 The 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
 Demography
Young population
Social classes IV, V
High unemployment rate
Results

Poor General Health
Depression & 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
Unhealthy behaviours
Drug use
Alcohol consumption
Tobacco smoking
Sugar consumption
2) Low use of dental services
Dental anxiety
Priorities
3) Attitudes of dental care professionals
1)
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 team
 Prison smoking cessation programme
 Pharmacist
 The 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/audit
To improve toothbrush/paste

Interprofessional integration
Identify the most vulnerable group
Pain/infection control
Staff support network
Clinical governance

Follow up in community
Thank you for your time and attention