Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England
Background Populations facing severe and multiple disadvantage (SMD), co-occurring homelessness, substance use and repeat offending have high levels of physical and mental ill-health. Poor oral health is one of the most common health problems in this population and is closely linked with substance u...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-05-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/1/e000626.full |
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| _version_ | 1832583234027782144 |
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| author | Sheena E Ramsay Richard G Watt Falko F Sniehotta Eileen Kaner Martha Paisi Neha Jain Martin Burrows Emma A Adams Gillian McLellan Emma C Joyes Laura J McGowan David Landes Lorenzo Iafrate |
| author_facet | Sheena E Ramsay Richard G Watt Falko F Sniehotta Eileen Kaner Martha Paisi Neha Jain Martin Burrows Emma A Adams Gillian McLellan Emma C Joyes Laura J McGowan David Landes Lorenzo Iafrate |
| author_sort | Sheena E Ramsay |
| collection | DOAJ |
| description | Background Populations facing severe and multiple disadvantage (SMD), co-occurring homelessness, substance use and repeat offending have high levels of physical and mental ill-health. Poor oral health is one of the most common health problems in this population and is closely linked with substance use, smoking and poor diet. Issues related to the implementation of interventions among SMD populations to address oral health and related health behaviours are poorly understood. This study aimed to understand the factors that affect implementation (relevance of setting, acceptability and adverse effects of interventions) and the sustainability of interventions targeting oral health, substance use, smoking and diet for people experiencing SMD.Methods Between August 2021 and April 2023, interviews and focus group discussions were conducted with two groups of participants: (1) people experiencing SMD in Newcastle Upon Tyne/Gateshead and (2) frontline staff, volunteers, policymakers and commissioners from London, Plymouth and Newcastle Upon Tyne/Gateshead. Information was gathered on factors related to the implementation and acceptability of interventions related to oral health and related behaviours. The data were analysed iteratively using thematic analysis.Results Twenty-eight people experiencing SMD (age range: 27–65 years; 21% females) and 78 service providers, commissioners and policymakers (age range: 28–72 years; 63% females) were interviewed or included in focus groups. The data were organised into three overarching themes: environmental, organisational and interpersonal factors. Environmental factors included funding and integrated services; organisational factors included inclusive services, health promotion, prevention and training healthcare providers; interpersonal factors included the presence of support workers and motivation among service providers.Conclusion The implementation and sustainability of health interventions for people experiencing SMD are influenced by factors across environmental, organisational and interpersonal levels that interact with the inherent challenges of disadvantaged groups. The findings highlight the need for tailoring healthcare interventions according to the needs of people experiencing SMD. Further research on the implementation of diet interventions and co-producing interventions is needed. |
| format | Article |
| id | doaj-art-79b8ab53702a4f1aae74fa2c78394ec3 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-79b8ab53702a4f1aae74fa2c78394ec32025-01-28T21:50:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-05-012110.1136/bmjph-2023-000626Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in EnglandSheena E Ramsay0Richard G Watt1Falko F Sniehotta2Eileen Kaner3Martha Paisi4Neha Jain5Martin Burrows6Emma A Adams7Gillian McLellan8Emma C Joyes9Laura J McGowan10David Landes11Lorenzo Iafrate121 Newcastle University Population Health Sciences Institute, Newcastle Upon Tyne, UKDepartment of Epidemiology and Public Health, University College London, London, UKDepartment of Public Health, Preventive and Social Medicine, Heidelberg University, Mannheim, GermanyInstitute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UKFaculty of Medicine and Dentistry, Peninsula Dental School, Plymouth University, Plymouth, UK1 Newcastle University Population Health Sciences Institute, Newcastle Upon Tyne, UK2 Inclusive Insights, Bournemouth, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK1 Newcastle University Population Health Sciences Institute, Newcastle Upon Tyne, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKNHS England and NHS Improvement, Newcastle upon Tyne, UK4 NHS England and Improvement, Newcastle Upon Tyne, UKBackground Populations facing severe and multiple disadvantage (SMD), co-occurring homelessness, substance use and repeat offending have high levels of physical and mental ill-health. Poor oral health is one of the most common health problems in this population and is closely linked with substance use, smoking and poor diet. Issues related to the implementation of interventions among SMD populations to address oral health and related health behaviours are poorly understood. This study aimed to understand the factors that affect implementation (relevance of setting, acceptability and adverse effects of interventions) and the sustainability of interventions targeting oral health, substance use, smoking and diet for people experiencing SMD.Methods Between August 2021 and April 2023, interviews and focus group discussions were conducted with two groups of participants: (1) people experiencing SMD in Newcastle Upon Tyne/Gateshead and (2) frontline staff, volunteers, policymakers and commissioners from London, Plymouth and Newcastle Upon Tyne/Gateshead. Information was gathered on factors related to the implementation and acceptability of interventions related to oral health and related behaviours. The data were analysed iteratively using thematic analysis.Results Twenty-eight people experiencing SMD (age range: 27–65 years; 21% females) and 78 service providers, commissioners and policymakers (age range: 28–72 years; 63% females) were interviewed or included in focus groups. The data were organised into three overarching themes: environmental, organisational and interpersonal factors. Environmental factors included funding and integrated services; organisational factors included inclusive services, health promotion, prevention and training healthcare providers; interpersonal factors included the presence of support workers and motivation among service providers.Conclusion The implementation and sustainability of health interventions for people experiencing SMD are influenced by factors across environmental, organisational and interpersonal levels that interact with the inherent challenges of disadvantaged groups. The findings highlight the need for tailoring healthcare interventions according to the needs of people experiencing SMD. Further research on the implementation of diet interventions and co-producing interventions is needed.https://bmjpublichealth.bmj.com/content/2/1/e000626.full |
| spellingShingle | Sheena E Ramsay Richard G Watt Falko F Sniehotta Eileen Kaner Martha Paisi Neha Jain Martin Burrows Emma A Adams Gillian McLellan Emma C Joyes Laura J McGowan David Landes Lorenzo Iafrate Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England BMJ Public Health |
| title | Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England |
| title_full | Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England |
| title_fullStr | Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England |
| title_full_unstemmed | Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England |
| title_short | Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England |
| title_sort | factors affecting implementation of interventions for oral health substance use smoking and diet for people with severe and multiple disadvantage a community based qualitative study in england |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000626.full |
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