Oral health promotion for rural adolescents: A process evaluation of a co-designed pilot program.

INTRODUCTION: Adolescents living in rural areas are more likely to have poorer oral health compared with their metropolitan counterparts. Co-design is emerging as an effective method for developing health promotion programs that meets the needs of stakeholders; however, little evidence exists to inform successful co-designed oral health promotion programs for rural adolescents. OBJECTIVE: The aim of this study is to understand the value of a co-designed oral health promotion program undertaken with rural adolescents in northeast Victoria with objectives to: Co-design an oral health promotion program with rural adolescents. Evaluate the program for appropriateness, acceptability, and feasibility. Make recommendations for program refinement and scalability. DESIGN: Study participants included year 11 and 12 students in a rural secondary school in Northern Victoria (n=2), who collaboratively along with schoolteachers, and the local health service staff led by an oral health therapist, co-designed, and delivered an oral gealth promotion program in their schools. This qualitative study used semi-structured group interviews (n = 8) to evaluate the co-design process and impact. Audio-recorded interviews were transcribed and thematically analysed using a co-design evaluation toolkit as a framework for analysis. FINDINGS: Qualitative inductive analysis revealed three main thematic categories around participant benefits (intended and unintended learning outcomes; interpersonal skills), the quality of the process (value of co-design, qualities of facilitators, and engagement); and scalability and replicability. CONCLUSION: The study indicates that co-design was both acceptable and appropriate for designing an oral health promotion program for rural adolescents delivering unexpected benefits. Building the capacity of schoolteachers could offer sustainable and cost-effective solutions for scalability.

Supporting the needs of pre- and primary school children in rural Victoria: Multidisciplinary views and experiences.

PROBLEM: Predicted effects on children from the COVID-19 pandemic include poorer mental health and increased behavioural and developmental concerns. Rural children are at higher risk due to socio-economic factors, isolation and reduced access to services. Investigation by health services into the physical, social and emotional needs of children in rural areas is critical to inform local health promotion planning, service delivery priorities and workforce capacity building. SETTING: Located in a Modified Monash Model category 5, our northern Victorian health service undertook a child-focused needs assessment in order to be strategically responsive to community issues. KEY MEASURES: The project utilised a quantitative community profiling approach and qualitative interviews with a purposive sample (n = 17) of multidisciplinary professionals. STRATEGIES FOR CHANGE: Three main themes emerged: (1) Perpetual navigation of rural access limitations highlighted professionals' exhaustion in working in environments with ongoing unmet needs. (2) Cycles of disadvantage and early intervention gaps identified flow-on negative effects, with concerning trends in poorer child outcomes. (3) Solutions through collaboration grouped ideas to improve support for children. EFFECTS OF CHANGE: Community-level enablement strategies could increase contact with allied health professionals for rural children and reduce reliance on individualised treatment approaches. LESSONS LEARNT: One collaborative action is to pilot and evaluate allied health student placement models to deliver group programs for rural children.