Word of Mouth - School of Public Health and Community Medicine ...

Word of Mouth20both acute and preventative oral health care toIndigenous peoples, including by CommunityControlled Health Services; and related evidenceof established oral health service and carevalues that reflect Aboriginal and Torres StraitIslander health values more broadly; and thebroader political, regulatory and socio-economicpressures on public dentistry in Australia andrelated workforce issues.The review found no peer-reviewed or evaluationliterature within that timeframe concerningthe delivery of dental care to Aboriginal andTorres Strait Islander communities by volunteers,although some references were found in regardto the motivation of both Indigenous and non-Indigenous volunteers generally, as well as bestpractice by non-government volunteer agencies.This review is in condensed form in Appendix 2and its method is further described below.Aim of this evaluationThe aim of this evaluation was to test theusefulness or efficacy of the ‘Filling the Gap’program as it operated from January 2006to November 2007. 7 This evaluation used amixed methods approach to systematicallyreview the program’s process of delivery and itsacceptability to participants.The evaluation set out to quantify changes inepisodes and types of care provided by thedental volunteers during the period understudy, and the recruitment and retention ofdental volunteers. It has qualitatively exploredstakeholders’ 8 feelings, attitudes and perceivedvalue of the program. Barriers and enablersto the program’s provision and sustainability,including implications for similar services, havealso been identified.This evaluation has aimed to be participatory,and has been characterised by a capacity7 Some qualitative data was still being collectedfrom volunteers during December, 2007.8 Stakeholders included Wuchopperen’s Board ofDirectors and staff, the dental volunteers, thedental practice’s clients both in Cairns and in oneoutreach site, staff from the outreach site, and theprogram’s Steering Committee.development approach, 9 involving the transferof evaluation skills and ‘two-way learning’between the Evaluation Team and Wuchopperenpersonnel.The approach taken was for the evaluation tonot be done at arm’s length, but instead for it toendeavour to obtain both insiders’ and outsiders’perspectives. Such evaluations are enrichedby real-time, iterative querying between theevaluators, informants and stakeholders [10].This evaluation did not seek to quantify thefinancial or monetary worth of the volunteerservices provided.Evaluation questionThe major question addressed by the evaluation was:“What is the worth or value of the ‘Fillingthe Gap’ Indigenous Dental Program as it isprovided in an Aboriginal and Torres StraitIslander Community Controlled Health Serviceenvironment?”The question was addressed using the followingcriteria:1. What is the context within which thevolunteer dental program has beenoperating?2. What are the perceptions of the variousstakeholders – those having a vestedinterest in the ‘Filling the Gap’ program –regarding the practical arrangements andadministration of the program?3. What details can be accumulated to providea description of dental volunteer involvement,client attendance and treatment provision?4. What are the perceptions of stakeholdersregarding the actual provision of oral healthcare through the program?9 To be self-determining and sustainable, capacitydevelopment must be driven by a local agenda,must build on the existing capacities of the group,must allow ongoing learning and adaptation withinthe group, requires long term investments, andrequires that activities be integrated at variouslevels to address complex problems. Importantly,capacity development within a partnership aimedat sustainable development involves developing thecapacity of all stakeholders [9].