Investigating community-based health and health promotion for homeless people: a mixed methods review.

Homeless people are susceptible to a range of health problems, yet in terms of health promotion, tend to be a hard-to-reach, marginalized group. Robust evidence regarding the ability to engage with this population via effective health promotion programmes is essential if policy and practice are to be informed to improve the health of homeless people. A structured review was conducted with the aim of examining what is known about community-based health promotion for homeless people. Six databases were searched and 8435 records screened. Thirteen studies met the inclusion criteria. A mixed-methods 'combined separate synthesis' approach was used to accommodate both quantitative and qualitative evidence within one review. Three themes emerged: (i) incorporating homelessness, (ii) health improving and (iii) health engaging. The review has implications for health promotion design, with evidence suggesting that as part of a tailored approach, homeless people must be actively involved in intervention development, ensuring that appropriate, acceptable and potentially effective individual elements are incorporated into community-based interventions.

What motivates dentists to work in prisons? A qualitative exploration.

OBJECTIVE: To explore what motivates dentists to work in prisons using Vroom's theoretical model of motivation as an explanatory framework. METHOD: In-depth interviews were conducted with ten of the 15 dentists working in Scottish prisons. The focus was to explore their motivations to work in Scottish prisons. The data were analysed using a thematic framework based on the three motivational dimensions of expectancy, instrumentality and valence. RESULTS: The dentists had the skills to help improve their prisoner-patients' oral health but their efforts were often hindered by institutional rationing and the requirement to fit in with prison routines and procedures (expectancy). Despite these institutional difficulties the dentists experienced work rewards associated with the improvement in the prisoners' oral health (instrumentality). Finally, the dentists experienced a feeling of personal worth and a sense of commitment to providing care to Scottish prisoners (valence). CONCLUSIONS: The dentists' motivation to work in Scottish prisons may be explained by Vroom's Expectancy Theory. The dentists' motivation is characterised by their beliefs that their work will improve clinical outcomes which will be rewarded by the satisfaction experienced when they overcome environmental obstacles and provide oral health care for their prisoner-patients.