Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.
School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada.
BMJ Open. 2020 Jun 28;10(6):e038164. doi: 10.1136/bmjopen-2020-038164.
The Strategic Regional Plan of the Cree Board of Health and Social Services of James Bay (CBHSSJB), serving the Quebec Cree communities, mandates the objective of integrating oral health within primary healthcare. Emerging evidence suggests that the integration of oral health into primary healthcare can decrease oral health disparities. This research study aimed to answer the following research question: how and to what extent does the integration of oral health into primary healthcare address the oral health needs of the Cree communities?
We used a multiple-case study design within a qualitative approach and developmental evaluation methodology. The Discovery, Dream, Design and Destiny model of appreciative inquiry was selected as a study framework among existing frameworks of the developmental evaluation.
Four purposefully selected Cree communities.
Healthcare providers, administrators and patients at the community wellness centres and hospital.
Integration of oral health into primary healthcare.
A total of 36 interviews and 6 focus group discussions were conducted. We identified ten themes in discovery and dream phases. The Discovery phase identified the strengths of the organisation in facilitating enablers of integration including strategic planning, organisational structure, cultural integration, coordinated networks and colocation. In the Dream phase, participants' oral healthcare stories expressed various dimensions of integration and their wish for strengthening integration via extending public oral healthcare programmes, increasing resources and improving organisational management. In the Design phase, recommendations were formulated for a future action plan within the CBHSSJB.
This study results suggested that the CBHSSJB has been successful in implementing oral health integration into primary care following its strategic planning. At present, the organisation could extend the level of integration into full integration by following study recommendations derived from the perspective of local stakeholders.
服务于魁北克克里社区的詹姆斯湾克里卫生局和社会服务局（CBHSSJB）的战略区域计划要求将口腔健康纳入初级保健的目标。新出现的证据表明，将口腔健康纳入初级保健可以减少口腔健康差距。这项研究旨在回答以下研究问题：将口腔健康纳入初级保健的方式和程度如何满足克里社区的口腔健康需求？
我们在定性方法和发展评估方法中使用了多案例研究设计。欣赏式探究的发现、梦想、设计和命运模型被选为发展评估现有框架中的研究框架之一。
四个有针对性选择的克里社区。
社区健康中心和医院的医疗保健提供者、管理人员和患者。
将口腔健康纳入初级保健。
共进行了 36 次访谈和 6 次焦点小组讨论。在发现和梦想阶段确定了十个主题。发现阶段确定了组织在促进整合促进因素方面的优势，包括战略规划、组织结构、文化整合、协调网络和共同定位。在梦想阶段，参与者的口腔保健故事表达了整合的各个方面，以及他们希望通过扩大公共口腔保健计划、增加资源和改善组织管理来加强整合的愿望。在设计阶段，为 CBHSSJB 内的未来行动计划制定了建议。
本研究结果表明，CBHSSJB 已成功实施战略规划，将口腔健康纳入初级保健。目前，该组织可以通过遵循来自当地利益相关者的研究建议，将整合水平扩展到完全整合。
