Provision of dental services for vulnerable groups: a scoping review on children with special health care needs

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Abstract

Background

The provision of dental services for children with special health care needs (CSHCN) needs to be considered by policymakers. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group.

Methods

A review was conducted applying the 9-steps approach. Five scientific databases of PUBMED, SCOPUS, Web of Science and PROQUEST and EMBASE were searched up to 10.07.2021, applying appropriate keywords. Thematic analysis was used to analyse the extracted data, and a conceptual map was developed according to JBI manual for evidence synthesis.

Results

From the abstracts of the 136 articles that fulfilled the inclusion criteria, 56 articles were included. Five main themes were identified as determinants affecting the provision of dentistry services for CSHCN, including needs assessment, policy advice, oral health interventions, providers’ perception and access barriers. According to the developed conceptual map, assessing the needs of CSHCN can lead to particular policy advice. Regarding the policies, appropriate oral health interventions can be presented. These interventions, along with providers’ perception about service delivery to CSHCN and the barriers to access them, determine the provision of dentistry services for CSHCN.

Conclusions

An effective needs assessment of CSHCN and their parents/carers can lead to evidence-informed policymaking and applicable policy advice according to the needs. Then policymakers should develop interventions to improve the community’s health literacy, as well as support the seeking behaviours for appropriate services. Policymakers should also consider how to limit the barriers to accessing oral and dental health by CSHCN to decrease disparities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07293-4.

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Most cited references 54

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A typology of reviews: an analysis of 14 review types and associated methodologies.

Maria J Grant, Andrew Booth (2009)

The expansion of evidence-based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains. Following scoping searches, an examination was made of the vocabulary associated with the literature of review and synthesis (literary warrant). A simple analytical framework -- Search, AppraisaL, Synthesis and Analysis (SALSA) -- was used to examine the main review types. Fourteen review types and associated methodologies were analysed against the SALSA framework, illustrating the inputs and processes of each review type. A description of the key characteristics is given, together with perceived strengths and weaknesses. A limited number of review types are currently utilized within the health information domain. Few review types possess prescribed and explicit methodologies and many fall short of being mutually exclusive. Notwithstanding such limitations, this typology provides a valuable reference point for those commissioning, conducting, supporting or interpreting reviews, both within health information and the wider health care domain.

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Identifying children with special health care needs: development and evaluation of a short screening instrument.

Christina D Bethell, Debra Read, Ruth E K Stein … (2002)

Public agencies, health care plans, providers, and consumer organizations share the need to monitor the health care needs and quality of care for children with special health care needs (CSHCN). Doing so requires a definition of CSHCN and a precise methodology for operationalizing that definition. The purpose of this study was to develop an efficient and flexible consequence-based screening instrument that identifies CSHCN across populations with rates commensurate with other studies of CSHCN. The CSHCN Screener was developed using the federal Maternal and Child Health Bureau (MCHB) definition of CSHCN and building on the conceptual and empirical properties of the Questionnaire for Identifying Children with Chronic Conditions (QuICCC) and other consequence-based models for identifying CSHCN. The CSHCN Screener was administered to 3 samples: a national sample of households with children (n = 17985), children enrolled in Medicaid managed care health plans (n = 3894), and children receiving Supplemental Security Income (SSI) benefits in Washington State (n = 1550). The efficiency, impact of further item reduction, and flexibility of administration mode were evaluated. Rates and expected variation in rates across demographic groups of children positively identified by one or more of the 5 CSHCN Screener item sequences in each sample were examined and multinomial logistic regression analysis were conducted to evaluate the effect of child characteristics in predicting positive identification. The CSHCN Screener took approximately 1 minute per child to administer by telephone and 2.1 minutes per household. During self-administration, over 98% of respondents completed each of the 5 CSHCN Screener item sequences, and respondents accurately followed each of the item skip patterns 94% of the time. Mailed surveys and telephone-administered surveys led to similar rates of positive identification in the same sample. Two Screener items would have identified 80%-90% of children positively identified as CSHCN across the study samples, although using only 2 items eliminates some children with more complex health needs. Rates of children identified by the CSHCN Screener varied according to age, sex, race/ethnicity, health status, and utilization of health services. Results of this study indicate that the CSHCN Screener requires minimal time to administer, is acceptable for use as both an interview-based and self-administered survey, and that rates of children positively identified by the CSHCN Screener vary according to child demographic, health, and health care-need characteristics. The CSHCN Screener provides a comprehensive yet parsimonious and flexible method for identifying CSHCN, making it more feasible than existing measures for standardized use across public agencies, health care plans, and other users.

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WHO World Report on Disability: a review.

Gloria Krahn (2011)

The World Health Organization in collaboration with the World Bank developed the World Report on Disability to inform governments of countries about the importance of disability, analyze scientific information, and provide recommendations for action at the national and international levels. The report is remarkably readable, comprehensive, and concise. There are recurrent themes of the connection between disability and poverty, and within disability groups, the relatively greater vulnerability of women, children, and persons with mental health disabilities. Chapter content includes an overview of disability, global view addressing measurement and prevalence, general health care, rehabilitation, assistance and supports, enabling environments, education, work and employment, and recommendations for moving forward. The report successfully illustrates a great need for improved data, policies, and programs, while describing promising practices that can inform policy makers in addressing these needs. This report is highly recommended reading for anyone interested in a global view on disability and should be required reading for any students in disability and public health. Published by Elsevier Inc.

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Author and article information

Contributors

Peivand Bastani:

ORCID: http://orcid.org/0000-0002-0412-0267

bastanip@sums.ac.ir

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 4 December 2021

Publication date PMC-release: 4 December 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 1302

Affiliations

[1 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Health Human Resources Research Center, School of Management and Medical Informatics, , Shiraz University of Medical Sciences, ; Ghasrdasht street, Shiraz, Iran

[2 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Health Human Resources Research Center, School of Management and Medical Informatics, , Shiraz University of Medical Sciences, ; Shiraz, Iran

[3 ]GRID grid.1010.0, ISNI 0000 0004 1936 7304, Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, , University of Adelaide, ; Adelaide, South Australia Australia

[4 ]GRID grid.1010.0, ISNI 0000 0004 1936 7304, Faculty of Health and Medical Sciences, Adelaide Dental School, , University of Adelaide, ; Adelaide, South Australia Australia

[5 ]National Dental Research Institute, Singapore, 5 Second Hospital Ave, Singapore, 168938 Singapore

Author information

Peivand Bastani http://orcid.org/0000-0002-0412-0267

Article

Publisher ID: 7293

DOI: 10.1186/s12913-021-07293-4

PMC ID: 8642970

SO-VID: e71afc14-a77a-4363-8dea-3c2f6ae4a653

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 21 November 2020

Date accepted : 15 November 2021

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: dentistry service,provision,children with special health care needs,dental health,oral health,disparity

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ScienceOpen disciplines: Health & Social care

Keywords: dentistry service, provision, children with special health care needs, dental health, oral health, disparity

Provision of dental services for vulnerable groups: a scoping review on children with special health care needs

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Most cited references 54

A typology of reviews: an analysis of 14 review types and associated methodologies.

Identifying children with special health care needs: development and evaluation of a short screening instrument.

WHO World Report on Disability: a review.

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