Original Research

Defining quality of preventive oral health services in a northern First Nations community: a concept mapping study


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Janelle Brown-Walkus1
(Squamish, Heiltsuk, and Gwa'sala First Nations) MSc Dentistry, Dental Student *

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Janet Smylie2
MD, MPH, Professor

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Cornelia M Borkhoff3
PhD, Associate Professor

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Billie-Jo Hardy4
PhD, Assistant Professor

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Christina Salmon5
BHSc (Hons), Research Program Manager

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Florence Duncan6
BSW, Health Director

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Herenia P Lawrence7
DDS, PhD, Associate Professor


1, 7 Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada

2, 4 Well Living House Action Research Centre, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria St, Toronto, ON M5B 1T8, Canada

3 Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada

5 MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria St, Toronto, ON M5B 1T8, Canada

6 Norway House Cree Nation Health Division, Norway House, MB, Canada

ACCEPTED: 19 April 2023

early abstract:

Introduction: In partnership with the Norway House Cree Nation (NHCN) in Manitoba, Canada, this study developed a framework based on how Indigenous parents/caregivers of young children and community-based oral health decision makers perceive 'quality of preventive oral health services'.
Methods: Concept mapping was used to develop the 'quality of preventive oral health services' framework. This involved brainstorming/idea generation, sorting and rating, and visual representation, and interpretation sessions with parents/caregivers (CG) and decision makers (DM) in Norway House, Manitoba. Using the Concept System’s GlobalMax (Ithaca, NY, USA) software, a conceptual framework was created that was modified from input from CG and DM groups, which can be visualized through the concept map.
Results: The final concept map revealed 7 domains of quality preventive oral health services: Dental Staff Character and Skills, Working with Community, Responsibilities in Preventive Education, Inclusive Preventive Oral Health Strategies, Accessibility to Appointments, Logistics of Providing Services, and Dental Environment.
Conclusion: This study provides insight into the existing gap in oral health services for Indigenous populations. Based on conversations and the concept mapping process, the developed framework can inform the steps to be taken to improve preventive oral health services for Indigenous peoples. The framework has been used to develop a quantitative scale to inform sustainable and impactful change in the quality of preventive oral health services that are meaningful to Indigenous peoples.