Quality Education for a Healthier Scotland - Smile4life Initiative
The Smile4life initiative in Scotland aims to improve oral health and overall well-being, targeting homeless individuals. It includes behavior change strategies, client-centered stages, and assessments to address critical oral health needs. The program focuses on education, intervention, and support to promote healthier practices and empower individuals to take charge of their oral health.
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Presentation Transcript
Smile4life Quality Education for a Healthier Scotland
Smile4life Unit 4 Behaviour Change Quality Education for a Healthier Scotland
Smile4life: Unit 4 - Learning Outcomes To know the structure and application of the smile4life intervention To know how to assess client readiness to change using the assessment tool To know basic motivational interviewing techniques when interacting with clients Quality Education for a Healthier Scotland
Smile4life Survey Oral health and psychosocial needs assessment of 853 homeless people in Scotland Took place in 2008-2009 Assessed: Demographics Health and health behaviours Oral health and oral health behaviours Psychosocial health Quality Education for a Healthier Scotland
The oral health of homeless people across Scotland Majority of participants have poor oral health Treatment is based on the level of urgency and perceived need Oral health not a priority Many homeless participants attended for dental treatment only when experiencing pain Experiences of problems making and keeping appointments Quality Education for a Healthier Scotland
Barriers and Enablers Quality Education for a Healthier Scotland
The 3 client centred stages of Smile 4 Life intervention Stage 1 Basic (Not Ready) Stage 2 Intermediate (Ambivalent) Stage 3 Advanced (Ready to Change) Quality Education for a Healthier Scotland
Stage 1: Basic (Not Ready) Provide oral health information Provide toothbrush/ paste Provide local information card If in pain, arrange one off treatment Try again at a later date, when client contacts you Quality Education for a Healthier Scotland
Stage 2: Intermediate (Ambivalent) Provide oral health information Provide toothbrush/ paste Provide local information card If in pain, arrange one off treatment Understand reasons for non-adherence Discuss key oral health messages and reasons why regular attendance is important Ask client to return at a later date Quality Education for a Healthier Scotland
Stage 3: Advanced (Ready to Change) Provide oral health information Negotiate help plan action Provide toothbrush/ paste Assist with registration / appointment Assist with attending appointment and arranging follow up treatment Client moves towards mainstream services and regular dental attendance Quality Education for a Healthier Scotland
Staff Participation Role Information Role Navigator Role Advocate Role Quality Education for a Healthier Scotland
Information Role Provide local information about clinic locations, emergency dental clinics, times of opening Provide information on costs of treatment and entitlement to free NHS dental care Provide oral health information leaflets Quality Education for a Healthier Scotland
Navigator Role Provide local information about clinic locations, emergency dental clinics, times of opening Provide information on costs of treatment and entitlement to free NHS dental care Provide key oral health messages and toothbrush packs Assist the client to access dental services by making appointments and accompanying client to an appointment Quality Education for a Healthier Scotland
Advocate Role Implementing the three client-centred stages of Smile4life Use motivational interviewing to asses the client s readiness to change and assign the client to the appropriate Smile4life stage Tailor the Smile4life intervention to the needs of the client When necessary, understand ambivalence Negotiate, help and plan oral health goals and assist in achieving those goals Discuss oral health key messages Provide toothbrush and toothpaste packs Quality Education for a Healthier Scotland
Supporting Clients in Making Changes Brief Interventions Motivational Interviewing Quality Education for a Healthier Scotland
Brief Interventions Build rapport and empathy Raise the issue Screen and give feedback Listen for readiness to change Choose a suitable approach Enhance motivation options Information and advice Menu of Build Coping strategies confidence Quality Education for a Healthier Scotland
What is Motivational Interviewing? A directive client centred counselling style that is designed to assist clients in exploring and resolving ambivalence to increase motivation for change Noonan WC and Moyers TB. Motivational Interviewing: a review. Journal of substance misuse.1997; 2: P8 - 16 Quality Education for a Healthier Scotland
General Principles of Motivational Interviewing Expressing empathy Supporting self efficacy Developing discrepancies in where a client is and wants to be Rolling with resistance Quality Education for a Healthier Scotland
Communication Strategies in Motivational Interviewing Asking open ended questions Activity Quality Education for a Healthier Scotland
Effective Listening Listening reflectively Repetition Rephrase Paraphrase Reflection of feeling Quality Education for a Healthier Scotland
Build confidence Affirming client strengths Confidence building, even if not related to oral health Quality Education for a Healthier Scotland
Key points Regular Summaries - Draw attention to key points - Shift attention - Provide direction Quality Education for a Healthier Scotland
During conversations Eliciting self-motivational statements Allow The client to convince you of problem behaviour and need for change Avoid The question / answer trap Confrontation / denial trap The expert trap Judgements Premature focus Assigning blame Quality Education for a Healthier Scotland
Tailoring the Oral Health Message Choosing the behaviour Assessing readiness to change Tailoring the oral health message Quality Education for a Healthier Scotland
Communication techniques Quality Education for a Healthier Scotland
Choosing the behaviour Quality Education for a Healthier Scotland
Readiness to change Quality Education for a Healthier Scotland
Assessing readiness to change Quality Education for a Healthier Scotland
Readiness to Change instrument Quality Education for a Healthier Scotland
Readiness to change instrument key Quality Education for a Healthier Scotland
Ambivalence Quality Education for a Healthier Scotland
The Decisional Balance Instrument Useful with clients who are unsure Allows specific barriers to be explored with the client If client is not ready, their autonomy should be respected. Quality Education for a Healthier Scotland
Decisional Balance Instrument Quality Education for a Healthier Scotland
Ready to change? Quality Education for a Healthier Scotland
Negotiate, help, plan, action Tailor the oral health messages to your client using SMART framework S = Specific M = Measurable A = Attainable R = Realistic T = Time related Quality Education for a Healthier Scotland
Smile4life: Unit 4 - Learning Outcomes To know the structure and application of the smile4life intervention To know how to assess client readiness to change using the assessment tool To know basic motivational interviewing techniques when interacting with clients Quality Education for a Healthier Scotland
Questions Quality Education for a Healthier Scotland
Further Reading: Smile4life http://dentistry.dundee.ac.uk/scottish- oral-health-improvement-homelessness- programme-smile4life Motivational Interviewing http://motivationalinterviewing.org/ Quality Education for a Healthier Scotland
