Maximising Oral Health Outcomes of Aboriginal and Torres Strait Islander Peoples with End-stage Kidney Disease through Culturally Secure Partnerships (Preprint)

Abstract

Dialysis for End Stage Kidney Disease (ESKD) is the leading cause of hospitalization for Aboriginal and Torres Strait Islander individuals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving a kidney transplant.

This study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD in South Australia through the following objectives (1) Investigate the facilitators and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia; (2) Investigate the facilitators and barriers to maintaining oral health for Aboriginal and Torres Strait Islander people with ESKD in South Australia; (3) Facilitate access to, and completion of, culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD and their families; (4) Provide oral health promotion training for Aboriginal Health Workers (AHW) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD; (5) Generate co-designed strategies to better facilitate access to, and provision of, culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD; and (6) evaluate participant progress and the AHW oral health training program.

This collaborative research study is divided into three phases: exploratory phase, intervention phase, and evaluation phase. The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care; the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops; the evaluation phase will involve follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training.

Stakeholder interviews were initiated in November 2021, with participant recruitment commencing February 2022. The first results are expected to be submitted for publication in December, 2022.

Expected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges to oral health for individuals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant and stakeholder identified challenges to ensuring accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander individuals with ESKD.