The Kimberley Dental Team: A process evaluation of a volunteer dental programme serving remote Aboriginal communities in Australia

Abstract

AbstractObjectivesThis study aims to conduct a process evaluation of the Kimberley Dental Team (KDT), a not‐for‐profit, volunteer organization providing care to remote Aboriginal communities in Western Australia.MethodsA logic model was constructed to detail the operational context of the KDT model. Subsequently, the fidelity (the extent to which each of the programme's elements were implemented as planned), dose (types and quantity of services provided) and reach (demographic characteristics and communities serviced) of the KDT model were evaluated using service data, deidentified clinical records and volunteer rosters maintained by KDT from 2009 to 2019. Trends and patterns of service provision were analysed using total counts and proportions over time. A Poisson regression model was used to explore changed in the rates of surgical treatment over time. The associations between volunteer activity and service provision was also investigated using correlation coefficients and linear regression.ResultsA total of 6365 patients (98% identifying as Aboriginal or Torres Strait Islander) were seen over the 10‐year period with services being provided across 35 different communities in the Kimberley. Most services were provided to school‐aged children, consistent with the programme's objectives. The peak preventive, restorative and surgical rates occurred among school‐aged children, young adults and older adults respectively. A trend was observed indicating a reducing rate of surgical procedures from 2010 to 2019 (p < .001). The volunteer profile showed significant diversity beyond the conventional dentist–nurse structure and 40% being repeat volunteers.ConclusionsThe KDT programme maintained a strong focus on service provision to school‐aged children over the last decade with the educational and preventive components being central to the care being provided. This process evaluation found that the dose and reach of the KDT model grew with an increase in resources and was adaptive to perceived community need. The model was shown to evolve through gradual structural adaptations contributing to its overall fidelity.