Food insecurity and the dental team: a pilot study to explore opinions


A total of 76 dental professionals completed the online survey, resulting in a response rate of 9.6%. The findings are organized and presented according to our research objectives.

Demographics

Respondents were aged between 18 and 64 years old, with the majority between 25 and 34 years old (51.3%) n= 39), with a uniform proportion between the ages of 35 and 64. 90.8% are women (n= 69) and 9.2% male (n= 7). Many respondents (35.5% n= 27) Qualified 6-10 years ago.

Main characters and main work locations

The largest proportion of respondents work in hospital dental services 55.3% (n= 42) and community dental services 40.8% (n= 31), a small number of respondents worked in general dental clinics. 3.9% (n= 3).

Professional roles vary widely. Consultants and specialist registrars in hospital dental services made up the largest proportion of respondents at 44.7% (n= 34), followed by community dental service representatives 35.4%, (n= 27).

The majority of respondents were dentists (96%) (n= 73) Dental therapist response rate 2.6% (n= 2) and a dental student.

Provide oral health education

Most respondents believe diet is a major component of oral health (94.7%)n= 72), while 5.3% disagreed (n= 4). Likewise, 96% (n= 73) of the respondents believed that dental professionals have the responsibility to provide dietary counseling, of which 80.3% (n= 61) of respondents said they had enough knowledge to provide this advice. A small number of people were not confident in providing oral health education (19.7%, n= 15).

80.3% of respondents (n= 61), are aware of the impact of food insecurity on oral health, but only 36.8% of respondents (n= 28) Confident in identifying individuals who may be food insecure, 32.9% (n= 25) Would be happy to discuss this further.

Responsibilities as a Dental Professional

Many respondents 81.6% (n= 62) agreed that the dental team has a role to play in advising patients experiencing food insecurity. Four interviewees disagreed with this statement.

When asked to leave a free comment, some respondents indicated that there were more appropriate services available to assist patients:

“I don't think it's my job to have these discussions. There are other more appropriate services that can provide this information.

“I don’t think it’s the dentist’s job to be a social worker. Of course, I will guide families who I think are struggling to seek services that might help address that, but I don’t think the dentist should be the one leading those discussions.

obstacle

Figure 1 shows the perceived barriers to discussing food insecurity with households. This includes lack of time 65.8% (n= 50), lack of confidence to ask patients 77.6% (n= 59), difficulty in identifying patients 71% (n= 54). Lack of knowledge 73.4% (n= 56) and consultation skills 68.4% (n= 52) is also considered a hindrance.

Figure 1: How often respondents indicate barriers they encounter when discussing food insecurity.
figure 1

Answers to free text replies.

Other factors identified included salary, lack of public policy, follow-up support, family reluctance to discuss, and these factors were outside my remit.

Support for the dental team

Total 32.9% (n= 25) of respondents were aware of services available to food insecure households, 18.4% (n= 14) Can find signposts to further support.

Monographic analysis

The word map (Figure 2) illustrates the main themes that emerged when asked, “What would enable dental teams to initiate conversations about food insecurity?”

Figure 2: Word map.
figure 2

A word map used to illustrate common themes in qualitative responses.

patient

Respondents recognized the need for appropriate and sensitive communication and made the following recommendations:

“As part of the assessment, be open and asking” and “If both parents and children are involved and relaxed, they are likely to talk about food insecurity. People who are aware of food insecurity may feel shame while respecting the rights of children” ”, “It is important to be able to provide practical, realistic and comprehensive advice in a non-judgmental way”.

This topic needs to be discussed in a structured way to allow for proper screening and ensure consistency of approach, such as “Agree to ask a set question that will not offend anyone.” “I think you need a sentence that serves as the basis for your history taking Part of it, you can use it directly as a question to all your patients, you often use this sentence so you can feel comfortable saying it, like asking about social care involvement or asking questions like: BMI very high or very low.

One respondent highlighted the need for tailored dietary advice, commenting: “I do worry about the lack of knowledge and skills in cooking and nutrition, which adds to problems in everyday life. I think all children in secondary education should need Nutrition and basic cooking skills However, if a family cannot afford to cook from scratch, it is important to be sensitive when colleagues talk about sugar in baked beans as an oral health issue when in fact it has nothing to do with it. It's important because these foods are nutritious and cheap, and can be eaten cold if there's a power outage.

train

Respondents recognized that additional training was needed in this area before they felt confident to discuss it further, including “training by experts in the field on how to approach difficult conversations, i.e. how to ask questions and what to know” asked/ Providing appropriate advice” requires training in counseling and role-playing.

One respondent also suggested additional training in undergraduate and postgraduate training programmes. “I always raise socioeconomic issues with trainees and how to ask respectful questions to help patients/parents. Many trainees come from wealthy families and have no idea how many patients we have. Over the years, I have developed methods to be kind and Asking patients non-judgmentally if they have a toothbrush or a poor diet should be done by trainees/undergraduates as part of their training”.

resource

Respondents suggested the need for posters, information leaflets in waiting rooms and awareness of follow-up referrals, with one respondent suggesting, “Have a good resource and then I can point patients in the direction. If we start a conversation and provide advice, But then not being able to find the appropriate services can feel empty if I had a website/leaflet/way I could point patients in the direction of, I would be more confident to start discussions.

Likewise, a minority of respondents felt that this was outside their remit, with one respondent highlighting the need for “more media and government coverage – social acceptance and understanding of food insecurity”.

Differences based on graduation time

Finally, the differences are explored based on years of experience and trust levels. Respondents across the spectrum were confident in providing dietary counseling. (image 3).

Figure 3: Number of respondents confident in providing dietary counseling as a function of years since graduation.
image 3

Likert scale response answers.

Figure 3 shows that a larger proportion of respondents are confident in providing dietary counseling in each category, but more respondents disagree with the statement that they have qualified within the last 10 years 5.3% (n= 4). However, this number is small and cannot be used to make generalizations across the entire population. All ethnic groups believe that dental health education is important, with 5.3% of ethnic minorities (0-10 years old) in early career (n= 3) Who doesn’t believe this is the case.

Figure 4 shows that a larger proportion of groups disagree or strongly disagree that they feel confident discussing food insecurity, which is consistent across all age groups.

Figure 4: Number of respondents confident in discussing food insecurity within the household compared to qualifying years.
Figure 4

Likert scale response answers.

Likewise, there appear to be differing views on levels of responsibility, particularly among recently qualified groups.



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