Perceptions of access to preventive oral health care at a community-based dental hygiene clinic for women impacted by the criminal justice system

Objective: Women impacted by the criminal justice system experience barriers accessing oral health care. In 2013, the Elizabeth Fry Society of Greater Vancouver (EFry) and the University of British Columbia implemented a dental hygiene clinic at EFry at which dental hygiene students provide preventive care to women and children. This study aimed to describe the population utilizing the clinic and identify clients’ and EFry staff’s perceptions about how this clinic has influenced access to preventive oral care for women at EFry. Methods: Ninety-nine dental charts were reviewed retrospectively to determine client demographics, oral health status, services and referrals provided, and clinic attendance, and descriptive univariate statistical analyses were performed. Sixty-two satisfaction surveys were reviewed and three focus groups and three interviews with twelve clients and one focus group with four staff were conducted to identify perceptions of access to care. Focus groups and interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. The concept of access proposed by Penchansky and Thomas (1981) and Saurman (2015) was used to organize themes. Results: Ninety-three women and six children attended the clinic over three years. This clinic addressed women’s preventive care needs through the provision of on-site dental hygiene services. The clinic’s close proximity and services offered for which women did not need to pay out-of-pocket allowed women to access preventive care that would otherwise be inaccessible due to costs of care and transportation. The person-centered and trauma-informed care further facilitated access. Thirty-three women were referred for dental care, however access was limited by cost and likely issues of stigmatization from other dental care providers. Clinic aesthetics, communication related to time needed for care, and clinic communication strategies and advertisement precluded access. Conclusion: This clinic facilitated access to preventive oral care for a subset of women at EFry. Findings highlight that oral health care providers should accommodate for clients receiving public dental benefits and be knowledgeable about the trauma and stigmatization faced by this group. Oral health clinics should employ appropriate clinic advertisement and design, and further accommodate for this group through flexible appointment scheduling and guidance navigating the referral process.Dentistry, Faculty ofGraduat