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September 2015 e-Bulletin: Focus on Oral Health
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Welcome to the Network’s annual Oral Health edition of our e-Bulletin, including a range of updates and resources on this important health issue. Our regular features can be found in the second half of this bumper edition. Click on the links to the right to scroll down =>
Photo courtesy of University of Melbourne: Two children from the Iraqi community are introduced to the dentist at a Teeth Tales site visit at MCHS.
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Teeth Tales: Oral Health Promotion with Migrant and Refugee-Background Children
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Dana Young & Associate Professor Lisa Gibbs, Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, Melbourne School of Population and Global Health
Teeth Tales was a nine year research study conducted in response to community concerns about the oral health of children from refugee and migrant backgrounds residing in the Moreland and Hume local government areas (LGAs) of Melbourne. The project was led by The University of Melbourne and Merri Community Health Services (MCHS) in partnership with Dental Health Services Victoria (DHSV), Moreland City Council, Arabic Welfare, Victorian Arabic Social Services, Pakistani Australia Association of Melbourne, The Centre for Culture, Ethnicity and Health and North Richmond Community Health Service.
The preliminary research showed that oral health programs and services were not reaching refugee and migrant communities who are at an increased risk of poor oral health. The next phase piloted the implementation of a community based child oral health promotion intervention for these families. The intervention involved peer educators leading community oral health education sessions, designed to improve oral health through increased oral health related knowledge, confidence and the adoption of positive oral health behaviours, delivered in a culturally appropriate way. The intervention also included a Cultural Competence Organisational Review (CORe) of participating community health services and local governments.
The study provided community based dental screening to 667 children aged 1 – 4 years from Iraqi, Lebanese and Pakistani backgrounds. The results showed that parents’ length of residence in Australia and parent education were predictors of child tooth decay, with the consumption of sweet drinks and adding sugar to drinks as additional risk factors. The trial showed improved child oral hygiene, improved parent knowledge of tooth brushing technique and increased knowledge of the role of fluoride in the water in the intervention group. Participating organisations showed improved cultural competence. This study makes important contributions to the limited evidence base in relation to oral health issues for these families, including:
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Community-based oral health screenings are an important means of reaching children in need of dental treatment and linking them into local dental services for ongoing care
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Working in partnership with established cultural organisations is critical to health promotion initiatives targeting families with migrant and refugee backgrounds
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Discussion of traditional oral health practices needs to be incorporated into oral health promotion initiatives and oral health care discussions in the clinical context.
Available Resources
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Healthy Teeth Healthy Families: Promoting maternal oral health in refugee background and asylum seeker communities
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Dr Elisha Riggs, co-leader of the Refugee and Migrant Research Program, Healthy Mothers Healthy Families research group, Murdoch Childrens Research Institute
There is evidence that poor maternal oral health in pregnancy may contribute to poor birth outcomes such as low birth weight and premature births. Poor maternal oral health also increases the likelihood of early dental decay in infants. People from refugee backgrounds experience significantly higher levels of oral disease. Under Victorian Government policy, pregnant women, children, and people of refugee and asylum seeker backgrounds are ‘priority groups’ for receiving free public dental care. However, many barriers remain for families to access dental services. Pregnancy and the associated provision of antenatal care provides a window of opportunity to share timely information with migrant women to ensure that their oral health care is a priority during pregnancy.
In partnership, the Murdoch Childrens Research Institute and Monash Health conducted a research project with the Afghan and Sri Lankan communities in Melbourne’s south east. The aim was to describe the knowledge and beliefs surrounding maternal oral health, barriers to accessing dental care during pregnancy, and to report the perspectives of maternity and dental service providers in relation to dental care for pregnant women. Key findings included the perception amongst Afghan and Sri Lankan women and men that dental treatment is unsafe during pregnancy, the lack of awareness amongst both the midwives and community members of the potential impact of poor maternal oral health and a general lack of awareness and understanding of the ‘priority of access’ policy that entitles pregnant women to receive dental care cost-free. A journal manuscript is currently under review
for publication. For more information please contact Elisha Riggs or Ramini Shankumar.
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Victorian eligibility and priority access for public dental services policy
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All clients who are refugees and asylum seekers are eligible for fee exemption and priority access for general or specialist dental care through the public dental system according to the Victorian government’s Eligibility and priority access for public dental services policy June 2014. Priority access means that they are offered the next available appointment and should not be placed on a wait list. Interpreters are available to patients accessing public dental health services. Public dental care is provided at community dental clinics across Victoria or at the Royal Dental Hospital of Melbourne (RDHM). Click
HERE to visit the RDHM website, and click HERE to locate your nearest community dental clinic.
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Oral Health Model of Care: Priority access for asylum seekers and refugees
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The Victorian Refugee Health Network, in consultation with a Project Advisory Group made up of representatives from the Department of Health & Human Services (DHHS), DHSV, public dental services and settlement agencies, developed a Model of Care to promote good practice in oral health care. View the model HERE
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DHSV at VICSEG New Futures Cultural Playgroups
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Photo courtesy of VICSEG New Futures: Horn of Africa Playgroup
VICSEG New Futures coordinate six cultural playgroups in the Wyndham local government area, for families from Burma (Chin and Karen), Iran and the Horn of Africa. VICSEG have been working in partnership with DHSV to promote oral health in playgroups. DHSV staff visit the groups twice a year to discuss the importance of teeth brushing, deliver teeth brushing demonstrations, and provide each child with toothpaste and a toothbrush to take home. VICSEG combines the DHSV sessions with visits from other programs that promote healthy eating and provide information to help families identify misleading food packaging when grocery shopping, to give a complete picture of how nutrition impacts on oral health. They have established links with local organisations that provide groups with fresh fruit and veggies to take home every week.
VICSEG’s Programs Administrator Karen Diacono says “the playgroups are a soft entry point to the community for newly arrived families, some of whom come to us after only being in the country two or three weeks”. Families who require additional support are referred to VICSEG’s Refugee Family Resource and Mentoring Program, where they are matched with a bicultural mentor who provides individualised support to enable them to understand and access services. “We try to make the sessions as fun and interactive as possible. We don’t want to preach, we just want to inform”, says Karen. For more information on referral process to Refugee Family Mentors or VICSEG playgroups, please contact Karen Diacono on 8754 0512 or click HERE
to send an email.
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ORAL HEALTH RESOURCES
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Oral Health Factsheet: Identifying clients of refugee & asylum seeker background
Victorian Refugee Health Network & Dental Health Services Victoria
This factsheet aims to support client services and oral health staff to identify clients of refugee or asylum seeker background, and their priority group access and fee waiver eligibilities for public dental services throughout Victoria. Download the factsheet HERE
Oral Health Factsheet: Working with refugee & asylum seeker clients
Victorian Refugee Health Network & Dental Health Services Victoria
The factsheet contains an overview of factors that impact on oral health care with people from refugee backgrounds, including the impact of torture and trauma; lack of trust in the service provider; unfamiliarity with the Australian dental care system; low oral health literacy; and time taken to use appropriate interpreter services. Download the factsheet HERE
Translated oral health advice and guides
Dental Health Services Victoria
Oral health advice, dental service brochures, and important patient information has been translated into a range of community languages including Arabic, Dari, English, Persian, Somali, Tamil, and Vietnamese. Access the brochures HERE
Multilingual oral health resources
Health Translations Directory
Links to multilingual oral health resources published by government departments, peak health bodies, hospitals, and community health and welfare organisations in a range of community languages are available on the Health Translations Directory HERE
Evidence-based oral health promotion resource
Victorian Department of Health and Human Services
This resource summarises the most effective health promotion strategies for prevention of oral health problems. It will assist health professionals, policy makers, planners and health promotion practitioners to further promote oral health in Victoria. Chapter 9 specifically focuses on oral health among culturally and linguistically diverse communities including refugee background communities, with examples of evidenced-based health promotion activities that show evidence for effectiveness with CALD communities. Download the resource HERE
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ORAL HEALTH REPORTS
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Talking about Teeth: Exploring the barriers to accessing oral health services for Horn of Africa community members living in inner west Melbourne
A report of the findings from a qualitative research project to identify the barriers to accessing oral health services for residents of the Flemington Public Housing Estate from the Horn of Africa. Read the report HERE
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CURRENT ORAL HEALTH RESEARCH
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Christian B, Young D, Gibbs L, Silva A, Gold L, Riggs E, et al (2015) ‘Exploring child dental service use among migrant families in metropolitan Melbourne, Australia’, Australian Dental Journal, Vol 60:2, p. 200-04.
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Gibbs L, Waters E, Christian B, Gold L, Young D, de Silva A, Calache H, Gussy M, Watt R, Riggs E, Tadic M, Pradel V, Hall M, Gondal I, Moore L. (2015) ‘Teeth Tales - A community based child oral health promotion trial with migrant families in Australia’, BMJ Open, Vol 5:6.
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Gibbs L, Waters E, de Silva A, Riggs E, Moore L, Armit C, Johnson B, Morris M, Calache H, Gussy M, Young D, Tadic M, Christian B, Gondal I, Watt R, Pradel V, Truong M, Gold L. (2014) ‘An exploratory trial implementing a community based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: A protocol paper for Teeth Tales’, BMJ Open, Vol 4:3.
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Nicol P, Al-Hanbali A, King N, Slack-Smith L, Cherian S (2014) 'Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study', BMC Oral Health, Vol. 14:69.
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Nicol P, Al-Hanbali A, King N, Slack-Smith L, Cirillo G, Cherian S (2015) 'Caries burden and efficacy of a referral pathway in a cohort of preschool refugee children', Australian Dental Journal, Vol 60:1, p. 73–79.
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Quach A, Laemmle-Ruff, IL, Polizzi T, Paxton GA (2015) ‘Gaps in smiles and services: a cross-sectional study of dental caries in refugee-background children’, BMC Oral Health, Vol. 15:10.
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Riggs E, Gibbs L, Kilpatrick N, Gussy M, van Gemert C, Ali S, Waters E. (2015) ‘Breaking down the barriers: a qualitative study to understand child oral health in refugee and migrant communities in Australia’, Ethnicity and Health, Vol 20:3, p. 241–57.
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Riggs E, Gussy M, Gibbs L, van Gemert C, Waters E, Kilpatrick N. (2014) ‘Hard to reach communities or hard to access services? Migrant mothers’ experiences of dental services’, Australian Dental Journal, Vol 59:2, p. 201–7.
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Riggs E, Gussy M, Gibbs L, van Gemert C, Waters E, Priest N, Watt R, Renzaho AMN, Kilpatrick N. (2014) ‘Assessing the cultural competence of oral health research conducted with migrant children’, Community Dentistry and Oral Epidemiology, Vol 42:1, p.43–52.
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Tran N, Satur J (2014) ‘The Cultural Meaning of Traditional Tooth Extractions among Sudanese Communities’, Australian and New Zealand Journal of Dental and Oral Health Therapy, Issue 2.
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Free legal help for people seeking asylum
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The Australian Government has begun considering refugee claims by people who came by boat to Australia after 2012. The Refugee Council of Australia website has information on where to seek free legal advice available in the following languages:
A factsheet with advice for people who came to Australia by boat after August 2012 is available HERE
Health providers have reported that legal support is a key concern for many patients who are asylum seekers. To support health professionals and others working with people who are asylum seekers the Network regularly updates a comprehensive list of links to legal resources HERE
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Australian Government support for people on time-limited protection visas
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The Australian Department of Social Services has developed a guide outlining the Australian Government support services available to people who hold a Temporary Humanitarian Stay (449), Temporary Humanitarian Concern (786), Temporary Protection (785)(TPV) or Safe Heaven Enterprise (790)(SHEV) visa. Click HERE to download the guide. Earlier versions of this guide had incorrect contact details for Foundation House, this was amended yesterday. If you have an earlier version please download document again or update the contact details on page 11: Foundation House, Ph: 03 9388 0022.
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Australian Government response to the conflict in Syria and Iraq
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The Australian Government has announced that Australia will resettle an additional 12,000 refugees who are fleeing the conflict in Syria and Iraq, in addition to the existing humanitarian programme of 13,750. Read the media release from the government HERE
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FASSTT Statement of concern about the Australian Border Force Act 2015
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The Forum of Australian Services for Survivors of Torture and Trauma (FASSTT) has released a statement expressing profound concern that the Australian Border Force Act 2015 has created a serious criminal offence for people providing services to the Department of Immigration and Border Protection (DIBP) to publicly disclose information about damaging effects of government policy on individuals in detention and other asylum seekers. Read the statement HERE
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RURAL NEWS: Migration: An Opportunity for Rural and Regional Australia
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The Federation of Ethnic Communities’ Councils of Australia (FECCA) has produced a short report outlining the opportunities and challenges of refugee and migrant settlement in rural and regional Australia. Drawing on the case studies of Karen refugee settlement in Nhill, the settlement of the Iraqi, Afghan, Congolese and Sudanese communities in Shepparton, and the opportunities presented by the creation of the Safe Haven Enterprise Visas (SHEV), the report highlights key issues to be factored into the policy design and planning process. Read the report HERE
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RESOURCES
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Teach-Back: a technique for clear communication and better health literacy
The Teach-back technique focuses on the use of clear, simple language when speaking with patients and having them confirm their understanding by asking them to ‘teach-back’ the information. It is a best practice communications method for addressing health literacy, and can be used with all patients to reduce misunderstanding and better engage them in their care. Click HERE to view a new Teach-back video resource developed in partnership between the Centre for Culture, Ethnicity and Health, St Vincent’s Hospital, and Melbourne Primary Care Network, and learn how to embed the Teach-back video on your website and communication materials.
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REPORTS
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Hearing her voice: report from the kitchen table conversations with culturally and linguistically diverse women on violence against women and their children
Department of Social Services
In 2014–15, CALD women leaders hosted 29 kitchen table conversations throughout Australia with women from more than 40 ethnic and cultural backgrounds about violence against women and their children. This report focuses on 11 interrelated issues and themes which were identified as specific to CALD women and communities. Read the report HERE
On the Road with Australian Muslim Mothers – An Outer Suburbs Roundtable
Ethnic Communities Council of Victoria (ECCV)
This report details the findings from an ECCV roundtable discussion on the lived experiences of racism by Australian Muslim mothers in Melbourne’s outer south eastern suburbs held in August 2015. Read the report HERE
Multicultural access and equity: building a cohesive society through responsive services
Federation of Ethnic Communities' Councils of Australia (FECCA)
This report provides a summary of diverse community perspectives relating to the accessibility and quality of Australian Government service delivery, highlighting gaps, key issue areas, models of good practice and opportunities for continued development and reform. Read the report HERE
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PROFESSIONAL DEVELOPMENT
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Organisational Health Literacy
Centre for Culture, Ethnicity & Health
Health literacy aims to improve individuals’ capacity to understand and apply health information. This workshop provides methods to embed organisation-wide health literacy strategies into systems, operations, planning and workforce development. For: Managers, quality improvement and other senior staff.
Date: Wednesday 7 October 2015
Time: 9.15am - 1.00pm
Venue: Centre for Culture, Ethnicity & Health - 23 Lennox St Richmond
Cost: $150 Cost includes morning tea, lunch and course materials.
Register: HERE
Evening Seminar: The impact of trauma on relationships
Foundation House
This seminar will explore some of the potential far-reaching impacts of trauma on relationships for individuals, families, and communities in the resettlement context. The evening will include a panel of four speakers, including members from the Assyrian-Chaldean and South-Sudanese Diaspora communities, who will explore the impact of trauma on relationships from different angles. A discussion will follow. Participants will develop an increased knowledge and understanding of the complex and dynamic nature of the impact that trauma and collective trauma have on individuals, families or community members they might encounter. Possible ways of facilitating connection will be touched on.
Date: Wednesday 14 October 2015
Time: 5pm - 8pm
Venue: Foundation House, 4 Gardiner Street, Brunswick
Cost: $50. Refreshments provided
Register: HERE
The Refugee and Asylum Seeker Experience
Foundation House
This interactive one day workshop provides a comprehensive introduction for those who work with people from a refugee background, including asylum seekers. Participants will gain knowledge of the refugee and asylum seeker experience and ways of working with this highly vulnerable group.
Date: Thursday 15 October 2015
Time: 9.30am to 4.30pm (Registration from 9am)
Venue: Foundation House, 4 Gardiner Street, Brunswick
Cost: $210, lunch included
Enquiries: 9389 8965 or pdregistrations@foundationhouse.org.au
Register: HERE
Medico-legal reports for Asylum Seekers: Workshop for Health Professionals
This is an ASRC-Foundation House joint professional development for mental health professionals (psychologists, neuropsychologists and psychiatrists); specialists and surgeons (orthopaedic, neurologists, paediatricians); and General Practitioners who are interested in preparing medico-legal reports for asylum seekers applying to be recognised as refugees.
Date: Saturday 17 October 2015
Time: 9am-12.30pm
Venue: Foundation House, 4 Gardiner Street, Brunswick
Cost: FREE for health professionals, morning tea provided
Enquiries: Susannah Tipping on tippings@foundationhouse.org.au
Register: HERE
Evening Seminar: Focus on refugee children and families
Foundation House
Asylum seeker and refugee background children and their families may experience significant issues with their mental health. This exploratory evening will bring together professionals from different backgrounds who will explore numerous approaches to working in this area.
Date: Wednesday 21 October 2015
Time: 5pm - 8pm
Venue: Foundation House, 4 Gardiner Street, Brunswick
Cost: $50. Refreshments provided
Register: HERE
Intro to Cultural Responsiveness in Mental Health Services (Horsham)
Victorian Transcultural Mental Health
This one day workshop aims to introduce mental health professionals working in and around the Horsham area (Grampians) to cultural responsiveness. For all specialist mental health practitioners, consumer and carer advocates, and other health and community workers delivering mental health, community support and welfare services. Students of mental health and welfare related studies are also welcome to apply.
Date: Friday 23 October 2015
Time: 9.15am for a 9.30am start - 4.30pm
Venue: TBC
Cost: FREE. Morning tea, lunch and afternoon tea provided.
Register: HERE
Family Violence Has No Boundaries: Cultural Diversity and Prevention Conference
The two-day inaugural Family Violence Has No Boundaries conference will explore the theme of Cultural Diversity and Prevention and look at all aspects of family domestic violence. Organised by African Australian Multicultural Employment and Youth Services and African Think Tank, African Australian Small Businesses and Jesuit Social Services.
Dates: Monday 26 & Tuesday 27 October 2015
Venue: David P Derham Lecture Theatre, University of Melbourne Law School, 185 Pelham Street Parkville
Register: HERE
Researchers for Asylum Seekers Interdisciplinary Postgraduate Conference
Conference themes: Seeking asylum is a human right; Child refugees and asylum seekers; and Attitudes of host nations to asylum seekers and refugees. Abstract submissions from any disciplinary background are invited addressing the conference themes or reporting on work in progress. Abstract submissions of 150-250 words for papers of 20 minutes duration (accompanied by a brief biography of 50 words or less) are requested before Monday 5 October 2015. For postgraduate researchers - past and present - and practitioners and policy makers/advisors working in this area.
Date: Monday 16 November 2015
Time: 9am-5pm
Venue: Gryphon Gallery, 1888 Building, University of Melbourne
Cost: FREE with lunch provided, please advise of dietary requirements with registration
For submissions, registration, or further info: Click HERE to email Karen Block
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ABOUT US
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The Victorian Refugee Health Network (The Network) brings together health, settlement and community services to be more accessible and responsive to the needs of clients from refugee backgrounds including people seeking asylum. The e-Bulletin provides a regular forum to share news and information to support practitioners and services in providing health care to people of a refugee background.
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